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Mixed methods inquiry into traditional healers' treatment of mental, neurological and substance abuse disorders in rural South Africa
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Agincourt Research Unit, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 12, article id e0188433Article in journal (Refereed) Published
Abstract [en]

Background: Traditional healers are acceptable and highly accessible health practitioners throughout sub-Saharan Africa. Patients in South Africa often seek concurrent traditional and allopathic treatment leading to medical pluralism. Methods & findings: We studied the cause of five traditional illnesses known locally as "Mavabyi ya nhloko" (sickness of the head), by conducting 27 in-depth interviews and 133 surveys with a randomly selected sample of traditional healers living and working in rural, northeastern South Africa. These interviews were carried out to identify treatment practices of mental, neurological, and substance abuse (MNS) disorders. Participating healers were primarily female (77%), older in age (median: 58.0 years; interquartile range [IQR]: 50-67), had very little formal education (median: 3.7 years; IQR: 3.2-4.2), and had practiced traditional medicine for many years (median: 17 years; IQR: 9.5-30). Healers reported having the ability to successfully treat: seizure disorders (47%), patients who have lost touch with reality (47%), paralysis on one side of the body (59%), and substance abuse (21%). Female healers reported a lower odds of treating seizure disorders (Odds Ratio (OR): 0.47), patients who had lost touch with reality (OR: 0.26; p-value<0.05), paralysis of one side of the body (OR: 0.36), and substance abuse (OR: 0.36) versus males. Each additional year of education received was found to be associated with lower odds, ranging from 0.13-0.27, of treating these symptoms. Each additional patient seen by healers in the past week was associated with roughly 1.10 higher odds of treating seizure disorders, patients who have lost touch with reality, paralysis of one side of the body, and substance abuse. Healers charged a median of 500 South African Rand (similar to US$35) to treat substance abuse, 1000 Rand (similar to US$70) for seizure disorders or paralysis of one side of the body, and 1500 Rand (similar to US$105) for patients who have lost touch with reality. Conclusions: While not all healers elect to treat MNS disorders, many continue to do so, delaying allopathic health services to acutely ill patients.

Place, publisher, year, edition, pages
Public library science , 2017. Vol. 12, no 12, article id e0188433
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-143936DOI: 10.1371/journal.pone.0188433ISI: 000418554900004PubMedID: 29261705OAI: oai:DiVA.org:umu-143936DiVA, id: diva2:1174333
Available from: 2018-01-15 Created: 2018-01-15 Last updated: 2018-06-09Bibliographically approved

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