South Africa is experiencing a dearth of qualified health care practitioners, a problem that existed even before the political liberation in 1994. Rural state hospitals and clinics have arguably never had enough health care personnel. As if the scarcity of qualified health care personnel is not enough to put enormous strain on the system, many nurses and highly qualified and experienced doctors, that the country desperately needs, continue to move abroad at an alarming rate. Consequently, state hospitals and clinics are undesirably understaffed, and health care personnel in these facilities execute their duties with limited operational resources.
In South Africa, as in many African countries, the traditional African healing system has, for centuries, been a fundamental but unrecognised component of the general health care system [1,2]. A history of traditional healing methods has not been documented in South Africa except to say that these healing methods have been in existence way before the colonization of the African continent by some European countries. What is known about the history of traditional healing in South Africa, and indeed in other African states, is that the knowledge in traditional African healing has been part of the oral traditional that has been passed on from one generation to another or from the ancestors to the selected few relatives of the ancestors who would gain traditional healing knowledge by undergoing traditional healing initiation or through dreams and visitations by the ancestors . Nyika and Vontress argued that the majority of people who use the services of traditional healers do so because Western medicine is not easily accessible to them and most of them are illiterate. Contrary to Vontress argument, it would appear that for many decades Africans level of education and religious beliefs did not necessarily determine the likelihood of their consulting traditional healers when the need to seek health care arose [4-6]. Many educated and middle class Africans, young and old, still uphold their traditions and customs and continue to consult with both traditional healers and Western trained medical practitioners’ depending on their perception of the conditions they want to consult about . Even the technological advances in Western medicine do not seem to overshadow the popularity of traditional medicine .
It is common among Africans to think that those (Africans) who consider themselves ‘Westernized’ and therefore ‘civilized’ tend to consult with Western medical practitioners’ during the day and with African traditional healers at night when people cannot see them. It is also generally thought that people do so to reduce cognitive dissonance that might be caused by, amongst other factors, orthodox and charismatic Christian teachings as well as Westernization that frown upon the use of traditional healing . However, MacLachlan and Carr contended that cognitive dissonance does not exist in many people who make use of both health care systems. There is in fact, according to them, cognitive tolerance because consumers believe that there is nothing wrong with using both systems as both seem to work well for them .
Satimia et al., reported different results and advanced different reasons for the choice between traditional healing and Western healing . They found that in rural Tanzania age and education influence the choice of health care, with people aged between 15 years and 34 years leaning more towards Western healing because of Western education whilst those aged 55 years and older lean more towards traditional African healing because many in this age bracket have not been formally schooled and have been brought up using traditional African medicine.
On the question of age, contrary to Satamia et al., and Edginton et al., found that, at one of the rural villages in the Limpopo province, South Africa; people aged 15 and older consulted traditional African healers before and after consultation with medical doctors and clinics [11,12]. This discrepancy might be explained by the level of formal education of the respondents in this study, with most having fewer than four years of formal schooling. In some cases, the education level may play a role in health care choices.
Overall, much of the literature points to a collaborative approach to the complex issue of health care, and shows that traditional healing is in high demand in the rural and urban areas of South Africa and elsewhere on the African continent [13-16]. In several studies mentioned above, age, education level and social standing of African respondents did not play a major role in people’s choice of healing, which seemed to be based on cultural perception of illnesses and the efficacy of traditional healing. Such efficacy is an aspect that continues to be debated and discussed internationally [17,18]. Given the above reviewed literature on traditional healing in mind, it is important to study Western trained health care practitioners’ attitudes towards traditional healing, particularly because traditional healing is in high demand and its consumers tend to use both traditional healing and Western medicine. The present study was part of a larger study that investigated health practitioners’ views on traditional healing. The aim of the present study was to explore Western trained health care practitioners’ attitudes towards traditional African healing.
The assumption was that an understanding of Western trained health care practitioners’ attitudes towards traditional healing could contribute to guiding the proposed integration process (i.e., integrating traditional healing and Western medicine) and its sustainability, in South Africa; and that health care practitioners, traditional healers, medical aid schemes, the South African Department of Health, consumers of traditional African healing and other interested parties would benefit from the findings of the study. It was hypothesized that there would be significant differences between the four categories of health care practitioners’ in terms of their attitudes towards traditional African healing.
|Item||Agree/Strongly agree||Notsure||Disagree/strongly disagree|
|I would support integration of TH & WH||43.6||139||18.2||58||38.2||122|
|I do not want to learn anything about TH||45.8||146||16.0||51||38.2||122|
|I would not encourage anybody to use TH||43.9||140||20.3||65||35.8||114|
|WH & TH could improve health if worked together||35.7||114||21.7||69||42.6||136|
|I would collaborate with THs in treating patients||47.3||151||16.9||54||35.8||114|
|I would never use TH for any reason||49.8||159||21.3||68||28.9||92|
|TH should continue to be separate from WH||50.5||161||13.4||43||37.1||115|
|If proper regulation of TH, TH would be a good system||23.5||75||29.8||95||46.7||149|
|TH is important for maintenance of health||50.5||161||21.3||68||28.2||90|
|TH cannot be trusted||42.0||135||27.3||87||30.7||98|
|Government is doing well by supporting TH||28.2||90||31.0||99||40.8||130|
|I would consider referring patients to THs||62.1||198||21.9||70||16.0||51|
|TH should be discarded||22.6||72||31.7||101||45.7||146|
|When people ill, should see Western doctors & not THs||53.9||172||18.2||58||27.9||89|
|Integration of TH and WH will not work||35.1||112||30.4||97||34.5||110|
|I want to learn more about TH||38.2||122||16.0||51||45.8||146|
|I would consider consulting THs in the future||55.5||177||25.1||80||19.4||62|
|TH is dangerous||41.1||131||36.0||115||22.9||73|
|When ill, I consider both TH and WH||69.3||221||6.9||22||23.8||76|
|TH belongs in the olden days||35.4||113||20.1||64||44.5||142|
|I would seek help from THs even when Western medicine is available||66.5||212||15.7||50||17.8||47|
|Medical aid schemes should not recognize TH||41.1||131||22.5||72||36.4||116|
The study aimed to explore Western trained health care practitioners’ attitudes towards traditional African healing. As hypothesized, there were significant differences between the four categories of health care practitioners’ in terms of their attitudes towards traditional healing. Current results indicate that psychiatric nurses and psychiatrists had more positive attitudes towards traditional healing than general nurses and physicians. Although previous studies have yielded similar results with proffering an explanation for such results, the explanation of these findings could be that psychiatrists and psychiatric nurses work with psychiatric issues and that traditional healing is believed to deal better with psychic and psychosomatic diseases, hence their more positive attitudes towards traditional healing [21,22]. A further explanation could be that in some healthcare facilities, some psychiatrists and psychiatric nurses already show a willingness to collaborate with traditional healers in treating some psychiatric conditions . These findings are consistent with previous findings in which psychiatric nurses and psychiatrists were of the opinion that there should be formal collaborations between Western trained health care practitioners’ and traditional healers . This view is in agreement with the World Health Organization’s support for the integration of traditional healing into the national health care system of the member states . Other researchers also recommended a formal collaboration between traditional African healing and Western medicine [25,26]. However, in the current study, health care practitioners’ generally viewed traditional healing in a positive light yet they indicated their reluctance to support a formal integration of the two health care systems. Just over half of the participants would prefer that traditional healing should continue to be separate from Western medicine despite acknowledging the importance of traditional healing for the maintenance of health.
Health care practitioners’ concurrently practicing both Christian and traditional African religions had more positive attitudes towards traditional healing than any other religious group. This finding may be due to the fact that traditional African healing and traditional African religion go hand in hand and therefore those who subscribe to traditional African religion tend to also be consumers of traditional African healing and tend to have more knowledge and an understanding of how traditional healing works as compared to those who do not subscribe to traditional African religion [27-29].
Health care practitioners’ working in urban areas showed more positive attitudes towards traditional African healing than those working in rural areas, and males had more positive attitudes towards traditional healing than females. This is contrary to Upval who found that health care practitioners’ working in urban areas where either ambivalent towards traditional healing or were showing less positive attitudes towards traditional healing than health care practitioners’ who were working in the rural areas .
Overall, majority of health care practitioners’ indicated that they would personally consider using both traditional healing and Western medicine when they are ill. This indicates that Western trained health care practitioners’ in this study were generally in fovour of traditional healing.
In this study, majority of health care practitioners’ indicated that they would consider referring patients to traditional healers, if necessary. These findings are inconsistent with previous findings wherein health care practitioners’ indicated low rates of patient referrals to traditional healers . The low rates of referrals of patients from health care practitioners’ to traditional healers could be attributed to the fact that traditional healing is not formally recognised by the Health Professions Council of South Africa . Referral of patients to traditional healers by Western trained health care practitioners’ has always been a contentious issue; with traditional healers lamenting the fact that referral of patients seems to be a one way process in which traditional healers refers patients to Western trained health care practitioners’ without reciprocation.
Majority of health care practitioners’ indicated that traditional healing is safe to use and that they would want to learn more about traditional healing and that traditional healing should not be discarded.
The number of general nurses in the current study was far greater than that of other groups of health care practitioners’. There was overrepresentation of health care practitioners’ working in rural areas majority of who spoke Sepedi as home language. Therefore, current results should be read with this skewness of participants in mind.
It is recommended that future studies should try to balance the number of participants in each group of health care practitioners’ so as to increase the power of the statistical analyses. Future research regarding health care practitioners’ attitudes towards traditional healing should consider including a qualitative technique to collect data. This will enable health care practitioners’ to use their own words to further elaborate on their attitudes towards traditional healing. An addition of a qualitative technique will yield a rich data that will supplement their quantitative responses to closed ended questions.
Furthermore, future studies could investigate the feasibility of training registered traditional African healers in helping to disseminate modern medicines (e.g., antiretroviral drugs and TB drugs) to patients to improve adherence to treatment. Lastly, future studies could include more in depth interviews or focus group discussions consisting of Western trained health care practitioners’ and the general public to determine possible limitations which stop both groups from preferring the services of traditional healers.
This study showed that different groups of health care practitioners’ (i.e., psychiatrists, psychiatric nurses, physicians and general nurses) have different attitudes towards traditional healing. Health care practitioners’ specialized in and dealing with psychic and psychosomatic issues were shown to have more positive attitudes towards traditional healing than did general nurses and general physicians.
Citation: Mokgobi M (2017) Health Care Practitioners’ Attitudes towards Traditional African Healing. J Altern Complement Integr Med 3: 025.
Copyright: © 2017 Maboe Mokgobi, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.