Collaboration Between Traditional Practitioners and Primary Health Care Staff in South Africa: Developing a Workable Partnership for Community Mental Health Services (original) (raw)
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Transcultural …, 2010
The majority of the black African population in South Africa utilize both traditional and public sector Western systems of healing for mental health care. There is a need to develop models of collaboration that promote a workable relationship between the two healing systems. The aim of this study was to explore perceptions of service users and providers of current interactions between the two systems of care and ways in which collaboration could be improved in the provision of community mental health services. Qualitative individual and focus group interviews were conducted with key health care providers and service users in one typical rural South African health sub-district. The majority of service users held traditional explanatory models of illness and used dual systems of care, with shifting between treatment modalities reportedly causing problems with treatment adherence. Traditional healers expressed a lack of appreciation from Western health care practitioners but were open to training in Western biomedical approaches and establishing a collaborative relationship in the interests of improving patient care. Western biomedically trained practitioners were less interested in such an arrangement. Interventions to acquaint traditional practitioners with Western approaches to the treatment of mental illness, orientation of Western practitioners towards a culturecentred approach to mental health care, as well as the establishment of fora to facilitate the negotiation of respectful collaborative relationships between the two systems of healing are required at district level to promote an equitable collaboration in the interests of improved patient care.
African Journal of Psychiatry, 2010
Objective: In many traditional belief systems in Africa, including South Africa, mental health problems may be attributed to the influence of ancestors or to bewitchment. Traditional healers are viewed as having the expertise to address these causes. However, there is limited information on their explanatory models and consequent treatment practices. The present study examines traditional healers' explanatory models (EMs) and treatment practices for psychotic and non-psychotic mental illnesses. Method: 4 focus group discussions (8 healers in each group) and 18 in-depth interviews were conducted. Four vignettes were presented (schizophrenia, depression, panic and somatization) and traditional healers' views on the nature of the problem, cause, consequence, treatment and patient expectations were elicited. Results: Traditional healers held multiple explanatory models for psychotic and non-psychotic disorders. Psychotic illnesses appear to be the main exemplar of mental illness and were treated with traditional medicine, while nonpsychotic illnesses were not viewed as a mental illness at all. Additionally, traditional healers do not only use herbs and substances solely from "traditional" sources but rather have incorporated into their treatment practices modern ingredients that are potentially toxic. Conclusion: Interventions aimed at increasing the mental health literacy of traditional healers are essential. In addition, investigations of the effectiveness of traditional healer treatment for psychiatric disorders should be conducted.
Malawi Medical Journal
IntroductionCollaboration between traditional and biomedical medicine can lead to holistic care and improved health outcomes for people withmental illnesses. The current study aimed to explore the views and experiences of traditional and western medicine practitioners onpotential collaboration in the care of people living with mental illness in Blantyre, Malawi.MethodA phenomenological qualitative research design was used. Data were collected using both one-on-one in-depth interviews (IDIs)and focus group discussions (FGDs). Participants were traditional healers and western medicine practitioners in Blantyre, Malawi.We conducted 10 in-depth interviews with traditional healers, 4 focus group discussions (2 for traditional healers and 2 for westernmedicine practitioners) and 6 key informant interviews with leaders of the two groups. The sample was determined based on datasaturation. Thematic analysis was used to analyse the data. We used a combination of deductive and inductive coding...
International …, 2010
Limited research has been conducted to explore the factors that support or obstruct collaboration between traditional healers and public sector mental health services. The first aim of this study was to explore the reasons underpinning the widespread appeal of traditional/faith healers in Ghana. This formed a backdrop for the second objective, to identify what barriers or enabling factors may exist for forming bi-sectoral partnerships. Eighty-one semi-structured interviews and seven focus group discussions were conducted with 120 key stakeholders drawn from five of the ten regions in Ghana. The results were analysed through a framework approach. Respondents indicated many reasons for the appeal of traditional and faith healers, including cultural perceptions of mental disorders, the psychosocial support afforded by such healers, as well as their availability, accessibility and affordability. A number of barriers hindering collaboration, including human rights and safety concerns, scepticism around the effectiveness of 'conventional' treatments, and traditional healer solidarity were identified. Mutual respect and bi-directional conversations surfaced as the key ingredients for successful partnerships. Collaboration is not as easy as commonly assumed, given paradigmatic disjunctures and widespread scepticism between different treatment modalities. Promoting greater understanding, rather than maintaining indifferent distances may lead to more successful cooperation in future.
Transcultural Psychiatry, 2020
This qualitative ethnographic study complements an epidemiological study on first episode psychosis in Vulindlela, a rural area in KwaZulu-Natal, South Africa. It focuses on two themes that emerged from our data: (1) the calling of the ancestors to become a traditional health practitioner and (2) ukuthwasa, the training to become a traditional health practitioner. The purpose of this study is to describe the ancestral calling, and to explore whether ukuthwasa may help with the management of mental disturbances, including unusual perceptual experiences. We also provide a discussion of the changing sociopolitical context of healing in KwaZulu-Natal, as a background to our study. In-depth interviews were conducted with 20 (apprentice) traditional health practitioners, formal health practitioners, patients and relatives recruited through local traditional health practitioners and a health care clinic. Our results show that the ancestral calling might announce itself with symptoms of men...
International Journal of Mental Health Systems, 2020
Background This qualitative pilot study aimed to establish views of traditional and biomedical practitioners towards collaboration between the two sectors on the treatment of people with mental illness in Zanzibar, Tanzania. Methods Six traditional healers (known as “waganga” in Swahili) and six nurses working in government secondary mental health services were invited to participate in a series of focus group discussions (FGDs). Two sets of FGDs took place approximately seven weeks apart. In each set, FGDs were conducted with traditional healers only, nurses only, and finally nurses and traditional healers together. FGDs were conducted in Swahili, audio-recorded and then translated to English by an independent translator and coded thematically using NVivo software. Results All participants expressed that they were in favour of collaboration between traditional and biomedical practitioners on mental healthcare. Opinions varied regarding what form this collaboration should take. For ...
Traditional healers in the treatment of common mental disorders in South Africa
2009
Abstract There are few population-level insights into the use of traditional healers and other forms of alternative care for the treatment of common mental disorders in sub-Saharan Africa. We examined the extent to which alternative practitioners are consulted, and predictors of traditional healer visits. A national survey was conducted with 3651 adults South African between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses.
International Review of Psychiatry, 2010
Limited research has been conducted to explore the factors that support or obstruct collaboration between traditional healers and public sector mental health services. The first aim of this study was to explore the reasons underpinning the widespread appeal of traditional/faith healers in Ghana. This formed a backdrop for the second objective, to identify what barriers or enabling factors may exist for forming bi-sectoral partnerships. Eighty-one semi-structured interviews and seven focus group discussions were conducted with 120 key stakeholders drawn from five of the ten regions in Ghana. The results were analysed through a framework approach. Respondents indicated many reasons for the appeal of traditional and faith healers, including cultural perceptions of mental disorders, the psychosocial support afforded by such healers, as well as their availability, accessibility and affordability. A number of barriers hindering collaboration, including human rights and safety concerns, scepticism around the effectiveness of 'conventional' treatments, and traditional healer solidarity were identified. Mutual respect and bi-directional conversations surfaced as the key ingredients for successful partnerships. Collaboration is not as easy as commonly assumed, given paradigmatic disjunctures and widespread scepticism between different treatment modalities. Promoting greater understanding, rather than maintaining indifferent distances may lead to more successful cooperation in future.
South African Journal of Psychology, 2019
In South Africa, traditional healers treat a wide range of health-related problems and culture-bound syndromes considered non-responsive to Western medicine. Given the widespread use of traditional medicine in treating common mental disorders, especially among low-income groups, it is important to explore the self-identification, training, and practices of traditional healers. We also explored traditional healers’ perceptions of collaboration with Western health care institutions (hospitals, clinics). IsiXhosa traditional healers ( n = 50, female = 40, mean age = 52.7 years, SD = 14.7 years) were interviewed using both a structured and a semi-structured interview schedule, including the Patient Health Questionnaire-9. Data were analysed using SPSS version 24 and Statistica. Interview notes were typed soon after each interview and thematically analysed. Participants described similar experiences regarding the three steps of becoming a traditional healer and treating clients with ment...