Medical pluralism and cancer care trajectories in Ethiopia: perspectives and health-seeking practices among individuals with cancer, family caregivers, and religious leaders

Despite advances in biomedical cancer care, socio-cultural and religious explanatory models continue to shape health-seeking behaviors and treatment options. This study explored how individuals diagnosed with cancer and their family caregivers navigate cancer care trajectories in Addis Ababa, Ethiopia. Using a phenomenological approach, we conducted 41 semi-structured interviews with individuals diagnosed with cancer, their family caregivers, and religious fathers, and thematically analyzed the data. The findings revealed two interrelated themes. First, religious health-seeking behaviors, including prayer, spiritual counseling, and the use of sacred spaces or substances, such as bathing with or drinking holy water, played a central role in how participants interpreted illness, sought meaning, and made treatment decisions alongside biomedical care. Second, participants reported complementary options, particularly natural and nutritional approaches, which were employed to manage symptoms, strengthen the body, and support biomedical treatment rather than replacing it. These practices coexisted in ways that were sometimes complementary and sometimes competitive, reflecting a broader pattern of medical pluralism. Overall, explanatory models of cancer were co-constructed through religious beliefs, family networks, local knowledge systems, and social interactions, highlighting that cancer care is not merely an individual or biomedical process but a socially and culturally embedded practice. Recognizing and engaging with this pluralism is essential for developing responsive cancer care policies in Ethiopia and similar contexts, including strategies that promote culturally sensitive clinical communication, collaboration with religious leaders, and safe integration of complementary practices within formal healthcare systems.