Mixed methods inquiry into traditional healers' treatment of mental, neurological and substance abuse disorders in rural South Africa

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. We studied the cause of five traditional illnesses known locally as "Mav...

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Bibliographic Details
Published in:PloS one 2017-12, Vol.12 (12), p.e0188433
Main Authors: Audet, Carolyn M, Ngobeni, Sizzy, Graves, Erin, Wagner, Ryan G
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Aged
AIDS
Analysis
Biology and Life Sciences
Care and treatment
Chronic illnesses
Costs and Cost Analysis
Dementia
Demography
Disorders
Drug abuse
Education
Female
Global health
Healers
Health care policy
Health sciences
Health services
HIV
Human immunodeficiency virus
Humans
Illnesses
Male
Males
Medicine and Health Sciences
Medicine, African Traditional - economics
Mental depression
Mental disorders
Mental Disorders - diagnosis
Mental Disorders - economics
Mental Disorders - therapy
Mental health care
Methods
Middle Aged
Mixed methods research
Mortality
Nervous system diseases
Nervous System Diseases - diagnosis
Nervous System Diseases - economics
Nervous System Diseases - therapy
Neurological diseases
Paralysis
Patients
People and places
Practice
Primary care
Psychiatry
Public health
Referral and Consultation
Rural areas
Schizophrenia
Seizing
Seizures
Social Sciences
South Africa
Stroke
Substance abuse
Substance use disorder
Substance-Related Disorders - diagnosis
Substance-Related Disorders - economics
Substance-Related Disorders - therapy
Systematic review
Tactile stimuli
Touch
Traditional medicine
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Summary: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. 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
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0188433