Dataset Information

Seizures in Namibia: A study of traditional health practitioners.

ABSTRACT:

Objective

Countries in sub-Saharan Africa are plagued by poor healthcare facilities, lack of specialist care, and limited financial resources. People with seizures often rely on the help of traditional health practitioners (THPs). Traditional health practices are not acknowledged in Namibia and remain unregulated and open to exploitation. We conducted a qualitative study to gain an understanding of THPs' perceptions and experiences in delivering seizure care in Namibia.

Methods

This study formed part of a larger mixed-method study that explored seizure care among healthcare providers (HCPs) in Namibia. Semi-structured interviews were conducted with 11 THPs in Namibia. Thematic analysis was used to identify themes and subthemes in the data. Themes were interpreted using the different levels of Bronfenbrenner's Ecological Systems Theory to illustrate the perceptions and experiences of THPs in the management of seizures.

Results

THPs distinguish between seizures with physical causes and those caused by witchcraft, evil spirits, and supernatural forces. THPs acknowledge the role of Western medicine in the treatment of medically explained seizures (physical causes). Seizures as a result of medically unexplained symptoms (spiritual) are deemed best treated by traditional medicine (TM). Diagnostic and treatment practices are person-specific and are guided by divination and the use of plant and animal material. Treatment success is measured by the complete absence of seizures. Biomedical treatment is seen as lacking due to its focus on seizure control and failure to provide a permanent cure.

Significance

In countries with limited healthcare resources, the untapped potential of THPs may play a valuable role in bridging the treatment gap for seizures. Incorporating THPs into the healthcare system depends on proper regulation and clear demarcation of roles between service providers. Improved referral practices and collaboration between service providers will be of benefit for people with seizures who are often exposed to stigma and discrimination.

SUBMITTER: du Toit A

PROVIDER: S-EPMC6119750 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Seizures in Namibia: A study of traditional health practitioners.

du Toit Anina A Pretorius Chrisma C

Epilepsia open 20180710 3

<h4>Objective</h4>Countries in sub-Saharan Africa are plagued by poor healthcare facilities, lack of specialist care, and limited financial resources. People with seizures often rely on the help of traditional health practitioners (THPs). Traditional health practices are not acknowledged in Namibia and remain unregulated and open to exploitation. We conducted a qualitative study to gain an understanding of THPs' perceptions and experiences in delivering seizure care in Namibia.<h4>Methods</h4>Th ...[more]

PMID: 30187008

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Project description:IntroductionHealthcare seekers around the globe use more than one healthcare system, with most using the traditional and the Western approaches concurrently. To date, little collaboration between the two systems has taken place within the mental health space compared with other areas of medicine. In order to inform integrating plans for traditional health practitioners and biomedical health practitioners in the South African mental health system, it is important to know which models of collaboration are used in other medical settings and contexts. This study aims to document global evidence on collaboration practices between traditional health practitioners and biomedical professionals when working with various health conditions.Methods and analysisThis scoping review will be guided by an improved Arksey and O'Malley framework, the 2010 Levac et al methodological framework and the 2017 Joanna Briggs Institute guidelines. A systematic literature search will be carried out using seven different databases, EMBASE, PubMed, LILACS MEDLINE, APA PsycArticles, CINAHL Plus, Academic Search Complete and Scopus, in addition to the WHO repository, bibliographical search engines, and Open Access Theses and Dissertations. Moreover, the references of relevant publications between January 1978 and March 2020 will be scanned. Two reviewers will independently screen articles for eligibility based on the predetermined inclusion and exclusion criteria. Thematic analysis and descriptive numerical analysis will be performed using ATLAS.ti V.8 and Excel software, respectively. The results for this review will be presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Review.Ethics and disseminationThis study will not require ethics approval because publicly available material will be used. Study findings will be published in an open-access journal and be presented to other key health system stakeholders and academic research gatherings.

Project description:BackgroundIn South Africa, traditional health practitioners' (THPs) explanatory frameworks concerning illness aetiologies are much researched. However there is a gap in the literature on how THPs understand HIV-related opportunistic infections (OIs), i.e. tuberculosis, candidiasis and herpes zoster. This study aimed to comprehend THPs' understandings of the aforementioned; to ascertain and better understand the treatment methods used by THPs for HIV and OIs, while also contributing to the documentation of South African medicinal plants for future conservation.MethodsThe study was conducted in two locations: Strand, Western Cape where THPs are trained and Mpoza village, Mount Frere, Eastern Cape from where medicinal plants are ordered or collected. Semi-structured interviews were conducted with 53 THPs of whom 36 were diviners (amagrirha: isangoma) and 17 herbalists (inyanga). THPs were selected through a non-probability "snowball" method. Data were analysed using a thematic content analysis approach. An ethnobotanical survey was conducted and plants used to manage HIV and OIs were collected. A complete set of voucher specimens was deposited at the University of the Western Cape Herbarium for identification. Plant names were checked and updated with Kew's online website http://www.theplantlist.org .ResultsTHPs conceptualise the aetiology of HIV and OIs at two related levels. The first involves the immediate manifestation of the illness/condition because of a viral infection in the blood (HIV), the presence of bacteria in the lungs (tuberculosis), or weakened state of the body making it susceptible to OIs. The presence of OIs is indicative of the probable presence of HIV. The second level of causation affects the first, which includes pollution, changes in cultural sexual norms, witchcraft, environmental factors, and lack of adherence to ancestral rituals. THPs reported using 17 plants belonging to 12 families. Remedies included mixes of up to five plants.ConclusionThis study explored the THPs' perspectives on HIV and commonly associated OIs and their herbal treatment methods. THPs generally rely on biomedical diagnosis before treating a client. They also seek guidance from the ancestors for a particular diagnosis, the plants to use for a specific treatment, when to harvest, and how to administer herbal remedies.

Project description:BackgroundThis 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.MethodsSix 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.ResultsAll 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 many nurses and healers, there was acknowledgement of the role of the other group in providing treatment for people with mental illness, with support for the idea of bi-directional referrals between the two sectors. For some nurses, the value of collaboration would be purely in the education of traditional healers in the recognition of mental illness, with subsequent referral to biomedical services. For some traditional healers, the idea of collaboration seemed to appeal in part because of a perceived opportunity to learn additional skills from biomedical practitioners. Both categories of participant expressed a belief that patients possessed by a jinn (a spirit) or those that had been bewitched needed treatment by traditional healers. On the other hand, those with what participants considered to be "mental illness" needed treatment at the hospital clinic. However, some nurses felt that that traditional healers might be able to provide helpful treatment for mental illness, as well as those suspected to be affected by jinn or witchcraft. There was agreement on the need to establish clear referral pathways between the two service providers. The creation of an office for traditional healers at the hospital was an area where there was disagreement among participants.ConclusionsWe conclude that there is a positive view of collaboration among traditional healers and nurses who participated, and a willingness to work towards actual collaboration. The results suggest that views vary as to what form this collaboration should take, with opinions differing between nurses, as well as between traditional healers. Additional work is needed in order to further explore the nature of potential collaboration and extend the research to the wider population of traditional and biomedical practitioners in Zanzibar, to include primary health care workers.

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Dataset Information

Seizures in Namibia: A study of traditional health practitioners.

Objective

Methods

Results

Significance

Publications

Seizures in Namibia: A study of traditional health practitioners.

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