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

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...

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Autores principales: Audet, Carolyn M., Ngobeni, Sizzy, Graves, Erin, Wagner, Ryan G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736181/
https://www.ncbi.nlm.nih.gov/pubmed/29261705
http://dx.doi.org/10.1371/journal.pone.0188433
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author Audet, Carolyn M.
Ngobeni, Sizzy
Graves, Erin
Wagner, Ryan G.
author_facet Audet, Carolyn M.
Ngobeni, Sizzy
Graves, Erin
Wagner, Ryan G.
author_sort Audet, Carolyn M.
collection PubMed
description 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 (~US$35) to treat substance abuse, 1000 Rand (~US$70) for seizure disorders or paralysis of one side of the body, and 1500 Rand (~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.
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spelling pubmed-57361812017-12-22 Mixed methods inquiry into traditional healers’ treatment of mental, neurological and substance abuse disorders in rural South Africa Audet, Carolyn M. Ngobeni, Sizzy Graves, Erin Wagner, Ryan G. PLoS One Research Article 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 (~US$35) to treat substance abuse, 1000 Rand (~US$70) for seizure disorders or paralysis of one side of the body, and 1500 Rand (~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. Public Library of Science 2017-12-19 /pmc/articles/PMC5736181/ /pubmed/29261705 http://dx.doi.org/10.1371/journal.pone.0188433 Text en © 2017 Audet et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Audet, Carolyn M.
Ngobeni, Sizzy
Graves, Erin
Wagner, Ryan G.
Mixed methods inquiry into traditional healers’ treatment of mental, neurological and substance abuse disorders in rural South Africa
title Mixed methods inquiry into traditional healers’ treatment of mental, neurological and substance abuse disorders in rural South Africa
title_full Mixed methods inquiry into traditional healers’ treatment of mental, neurological and substance abuse disorders in rural South Africa
title_fullStr Mixed methods inquiry into traditional healers’ treatment of mental, neurological and substance abuse disorders in rural South Africa
title_full_unstemmed Mixed methods inquiry into traditional healers’ treatment of mental, neurological and substance abuse disorders in rural South Africa
title_short Mixed methods inquiry into traditional healers’ treatment of mental, neurological and substance abuse disorders in rural South Africa
title_sort mixed methods inquiry into traditional healers’ treatment of mental, neurological and substance abuse disorders in rural south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736181/
https://www.ncbi.nlm.nih.gov/pubmed/29261705
http://dx.doi.org/10.1371/journal.pone.0188433
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