The indigenous healers or traditional doctors play a significant role in the healthcare provisioning in Africa. Although traditional healing has been in practice for several centuries, very little has been achieved in terms of harvesting the wealth of tacit knowledge possessed by these practitioners for future references.
The objectives of this article were twofold. The first objective was to capture the tacit knowledge possessed by traditional healers in Mozambique. The second objective was to enhance preservation of tacit knowledge for sharing and training of other traditional healers.
The cognitive semiotic model was used as a basis for capturing the tacit knowledge. Qualitative and quantitative data were collected by using interviews and questionnaires were applied during systems requirements elucidation, designing the user interface and in building the knowledge repository. In the requirement elucidation phase, 13 traditional doctors were interviewed. Besides text and voice recordings, video recordings and photos were used in capturing the tacit knowledge. The usability of the system was tested by using the heuristic evaluation technique.
The findings revealed that the system developed could be used for capturing the tacit knowledge and storing it in an explicit form. The usability tests indicated that the prototype developed served its purpose to a great extent.
The study concludes that cognitive semiotic model is a suitable tool for capturing tacit knowledge of traditional doctors in Mozambique. The results of the usability evaluation confirm that the system developed supports information sharing and ease of use. It is observed that the developed application could support users with little formal education. However, some basic computer literacy training would assist in maximising the benefits of the system.
Today, there is very little doubt that one of the most important assets of any organisation is its knowledge and knowledge sharing ability (Geisler & Wickramasinghe
Although there is an existence of a knowledge base for explicit knowledge, the same is not true for tacit knowledge. The value of harvesting the tacit knowledge held by the traditional doctors is vast and presents new frontiers in the field of knowledge management. However, there is not much work conducted in harvesting of tacit knowledge from traditional doctors (Gibert-Tisseuil
Mozambique is a country located in the south-east of Africa surrounded by the Indian Ocean to the east (see
Map of southern Africa.
The health department of Mozambique often conducts seminars to facilitate the interchange of knowledge between traditional doctors and modern doctors. Topics related to diagnosis, prevention and treatment of epidemic diseases are discussed. Unfortunately, not all traditional doctors are willing to participate in this exchange of knowledge due to factors such as lack of time and trust and fear that divulging their knowledge would result in a loss of competitive advantage.
The three main categories of traditional health services in Mozambique are: herbalists (
They are traditional doctors relying on the use of various plants for healing of common ailments. They predominantly focus on the preparation and administration of traditional medicines derived from various parts of plants (Bruschi et al.
In many cultures of Mozambique, diseases are believed to be linked to social and spiritual factors (Lechner
With an increase in a number of churches in Mozambique, many people are leaving behind their traditional animist beliefs and are drawn to churches to resolve problems related to ill health and misfortunes (Pfeiffer et al.
As a vast number of people in Mozambique still rely on traditional doctors for their well-being, the services offered by the traditional doctors are vital. Because the knowledge possessed by these traditional doctors is mostly in the form of personal experiences, know-how, insight and mental models, the harvesting and preservation of such knowledge are crucial. These knowledges are mostly abstract and human dependent and therefore more difficult to codify and share (Burnett, Macafee & Williams
The rest of the article is structured as follows: Firstly, the theoretical background and literature review are presented in Section 2. Next, the research methodology used in this research is explained in Section 3. This is followed by results and discussion in Section 4, and lastly, the summary, conclusions and future work are provided in Section 5.
Knowledge is considered to be a vital asset that needs to be managed properly to ensure its preservation (Muniz
Knowledge sharing forms a cornerstone of many organisations’ knowledge management strategy. Knowledge sharing practices and initiatives often form a key component of knowledge management programmes, in terms of organisational or individual learning (Laudon & Laudon
The SECI model.
With reference to the SECI model, the process of conversation of tacit knowledge into a new tacit knowledge through social interaction and shared experiences takes place in the socialisation phase. The new tacit knowledge is usually acquired through activities such as observation and replication of practices of a more experienced person. Externalisation involves articulating tacit knowledge in the form of explicit concepts such as metaphors, analogies, hypotheses and cognitive models by recombining different situations in order to create more explicit knowledge (Moreno & Cavazotte
Cognitive semiotics can be defined as an interdisciplinary matrix of disciplines and methods, focused on multifaceted phenomenon of meaning (Zlatev
The sensory knowledge is constructed on the first dimension of Charles Sanders Peirce semiotics, which relies on senses and is based on awareness (Purnama & Susetyo-Salim
The second tier in the cognitive semiotic model is the coded knowledge. This dimension introduces the use of codes to which an object or an experience refers. The coded knowledge promotes the possibility of communicating knowledge without the presence of that to which the knowledge refers. It is knowledge at descriptive level, for example describing how to apply a certain plant-based portion to a patient suffering from high fever. In our application, the coded knowledge was described by using series of pictures, videos, computer animations and notes taken during the interview process.
The third tier of the cognitive semiotic model is the theoretical knowledge. It puts the knowledge in perspective and refers to knowing the essence of a concept to be able to relate one concept to another. Theoretical knowledge essentially provides structure to coded knowledge and seeks to eliminate ambiguity in the code (Purnama & Susetyo-Salim
In efforts related to harvesting tacit knowledge, Pfeiffer (
To achieve our research objectives, data from 13 randomly selected traditional doctors situated in rural areas around the capital city Maputo were collected. Most of the participants (77%) were herbalists and the remaining 23% were diviners. Among the participants, 15.38% had completed secondary school education, and the remaining 84.62% had only acquired some levels of primary education. Most of the participants were female (69.23%). The ages of the participants ranged from 30 to 70 years and each had more than 6 years of experience. Communication among the participants concerning the acquisition and sharing of knowledge happened mostly during informal social gatherings and formal meetings organised by AMETRAMO.
Both qualitative and quantitative data were collected by using semi-structured interviews, questionnaires and observations. The interview questions were based on a combination of knowledge management processes found in the literature, and interviews were conducted at the traditional doctors’ premises. Procedures and practices applied in the healing process of various ailments, plants used, methods of preparation and administering of the medication were captured by using photographs, video and voice recordings. These data were then used in the requirements elucidation and the design phases of the system development. For the purpose of usability testing, 10 of the 13 participants were used. Three of the participants could not be available for usability testing because of some prior commitments.
Based on the cognitive semiotic principles, we modelled the application by using the Unified Modelling Language model. The cloud architecture was used to promote the availability of the system. The software system was developed by using Java programming language. MySQL version 5.7 database was selected as a repository for storing the tacit knowledge captured in the forms of text, voice, videos, photographs and animations. XAMPP was chosen as the server to host the application. Java was used as it enables cross-platform deployment of the application, MySQL database was selected as it is an open source database management tool with support for security, reliability and scalability. The choice of XAMPP was based on the fact that it is a free, open source web server that is easy to install. The usability of the system was tested by using the heuristic evaluation method.
The dual objective of our system was that it must be able to capture tacit knowledge and be able to support users with minimal computing skills. To achieve these objectives, we had extensive consultations with the traditional knowledge holders. Several methods and techniques such as interviews, questionnaires, video and audio recordings of the traditional practices were taken. These data were then used to elucidate the systems requirements and design of the knowledge repository. Based on the inputs received from the participants a Unified Modelling Language model was designed. The model was then implemented in Java. Cloud architecture was used to promote availability of the system.
Based on the types of traditional health services, i.e. herbalists, diviners and prophets, the tacit knowledge associates in these healing practices are captured by using appropriate tools. Before this information is stored in the database, pre-processing activities are performed on it to assist with its categorisation. The categorisation assists in quick retrieval of information from the database (see
System architecture of the application.
A module to assist with query or search the database and produce reports that are relatively easy to understand was incorporated into the system. For instance, the report (codified knowledge) incorporated both texts and pictures. If any videos are associated with the report, they are displayed on the client’s screen. The report can be used for guiding other traditional doctors on how to treat a particular ailment or to compare and analyse various ways of treating a particular ailment.
The usability testing of the developed application is presented in this section.
There are numerous methods to evaluate a system’s usability. In this study, usability testing was conducted by using the heuristic evaluation method, designed to assist in the identification of functionality and interface problems (Nielsen
Tasks performed during usability testing.
Task | Tasks associated with | Number of incidences | Participants needed assistance (%) |
---|---|---|---|
A: Registering themselves | User could not find the menu item for registering themselves. | 2 | 60 |
User could not correctly set their birthdate in the required format. | 6 | ||
User could not match the set password during the confirmation stage. | 0 | ||
User failed to set the mandatory fields. | 2 | ||
B: Login by using their credentials | User could not find the menu item to login. | 0 | 20 |
User typed incorrect information. | 2 | ||
User forgot pin or password. | 0 | ||
C: Add information related to illnesses, symptoms and treatments | User could not find on the menu to add a new sickness. | 2 | 90 |
User failed to make use of combo boxes. | 5 | ||
User failed to make use of radio buttons. | 4 | ||
User failed to make use of check buttons. | 4 | ||
User failed to set the mandatory fields. | 6 | ||
User failed to add or delete items in the text boxes. | 7 | ||
D: Generating reports | User could not find the menu item to generate reports. | 0 | 90 |
User could not select a specific report to generate. | 7 | ||
User failed to view or print the report. | 8 | ||
User tried to generate a second report without closing the first report window. | 8 | ||
E: Performing search activities | User failed to select the desired search items. | 5 | 90 |
User could not migrate to the search window. | 5 |
From the data presented in
In addition to performing the assigned tasks, the participants were also required to comment on aspects related to the heuristic evaluation categories:
Number of usability issues identified in the various heuristic evaluation categories.
A requirement to enhance usability of a system is that there should be a
Input window using tooltip in Portuguese.
Although most of the traditional doctors (70%) had written down record-keeping in place, very few commonalities were observed in the details of these records and in the format in which they were kept. Hence, it was difficult to design the electronic forms in a way that matched their forms. This contributed to the large gap between the system and the users’ world.
The
This work was ethically approved by the Faculty of Information and Communication Technology committee on research ethics of Tshwane University of Technology, South Africa. Ref#: FCRE/ICT/2015/04/007.
The traditional doctors of Mozambique have a rich heritage of medicinal plants usage and possess great knowledge typically in a tacit form. To avoid erosion of this indigenous knowledge, we presented a computer-based application to convert, capture and store tacit knowledge held by the traditional doctors for its preservation and sharing. Methods such as interviews, questionnaires, observations, photographs, video and voice recordings and computer animations were used in converting tacit knowledge into an explicit form. We observed that the cognitive semiotic model not only assisted in capturing the tacit knowledge but also had an influence on the design of the computer application. The developed application was subjected to heuristic evaluation for its usability. The overall test participants’ response to the application was positive. However, a major concern identified during the usability testing was the match between system and real world. A contributing factor was the difference in the language in which the users are conversant (Portuguese) and the language used on the application interface (English). This gap was minimised by providing tooltips in Portuguese. It was observed that the developed application could support users with little formal education. However, some basic computer literacy training would assist in maximising the benefits of the system. In this regard, organisations such as AMETRAMO could play a central role.
As an extension to this work, we aim to increase the use of Portuguese in the look-and-feel of the user interface, and in the reports generated. This will simplify the activities related to knowledge capturing and improve on the general acceptance of the system. We also aim at providing voice dictation capabilities to enhance the usability of the system.
The authors would like to thank Tshwane University of Technology for its financial support and the faculty of ICT committee on research ethics for approving this research (Ref#: FCRE/ICT/2015/04/007).
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Y.I.R.A. was involved in data collection and implementation of the software system. O.P.K. was involved in the design of the software system, heuristic testing and in the writing of the article. M.L. was involved in the heuristic testing, writing of the article and its proofreading.