Integrating Traditional Healers into the Health Care System: Challenges and Opportunities in South Africa

Abstract

Background: Traditional medicine is widely used around the world to prevent, manage and cure illnesses. For many people living in low- and middle-income countries, particularly in rural areas, traditional medicine is their primary source of health care. Traditional medicines are often used concurrently with treatment from allopathic providers, resulting in concerns related to toxicity, dosing, adherence, and retention in chronic disease treatments. This paper explores opportunities for integrating traditional healers into the allopathic health care system by analysing the challenges hindering integration in order to improve health outcomes for those who routinely oscillate between the two systems.
 Method: Qualitative interviews were conducted with 30 traditional healers in rural South Africa. Thematic data analysis, using a combination of deductive and inductive coding, was applied using Nvivo Data management software.
 Results: The study showed that collaboration between traditional healers and the health care system exists in an ad-hoc manner, primarily via health education (allopathic to healer), provision of protective materials to healers (e.g. latex gloves), and the referral of patients to the health system for tests and treatments not available to traditional providers. Despite these collaborative efforts, mistrust and a perceived lack of respect for traditional healer’s practices by allopathic providers make formal collaboration difficult. Traditional healers propose opportunities to improve relations including; trust building, bi-directional referral systems as well as improved resource and information sharing systems. 
 Conclusion: This study has identified potential for more formal linkages between the traditional and allopathic medical systems in SSA, as a means to support patients who ulitize both services for their healthcare needs. The lack of formal policy direction and guidelines has made it difficult to officially bring together these complementary systems that provide parallel services to the same patients and community.