The Viability of a Partnership between Traditional Health Practitioners and the South African Healthcare System: A Qualitative Systematic Review Open Access

Abstract

Background:The Traditional Health Practitioner (THP) Act of 2007 helped institutionalize Traditional African Medicine (TAM) in South Africa, where THPs are held in high esteem in local communities and deliver care to patients in a culturally familiar setting. Yet, collaborative efforts between THPs and the biomedical (BM) healthcare system have often been hindered by power structures at play, particularly in the context of the HIV/AIDS epidemic. 

Objective:This Qualitative Systematic Review (QSR) aimed to describe the characteristics and outcomes of HIV/AIDS care collaborations between South African THPs and the BM healthcare system and determine the feasibility of a partnership. 

Methods:A QSR was conducted to identify, collate, and evaluate published and gray literature on HIV/AIDS-related South African THP/BM collaborations from 1983-2018. Using a modified PRISMA statement and adapted Cochrane protocol guidelines, a six-domain search strategy was applied to search Africa-Wide Information, Anthropology Plus, EMBASE, Global Health (CAB Direct), JSTOR, PubMed databases. 

Results:This review features 12 documents including assessments, reports, and research studies on THP/BM collaborations 1995-2018. The 12 documents showed a range of information on community engagement, financial support, PI familiarity with socio-cultural context, monitoring and evaluation plans, and stakeholder relationship dynamics. 

Conclusion:PI familiarity with the socio-cultural context of initiatives was mostly unaddressed. Some encouraging collaboration outcomes were found, yet further research is needed on relationship dynamics between stakeholders at all stages of the process. A surprising number of documents did not describe a methodology incorporating meaningful participatory community engagement. The literature consistently supports that THP involvement in the healthcare system is vital to curb the HIV epidemic in South Africa; a strategy of meaningful participation needs to extend to all stakeholders. We suggest consideration of CBPAR approaches to research and healthcare interventions for a viable partnership between THPs and the South African healthcare system.

Table of Contents

CHAPTER 1: INTRODUCTION .................................................................................................................................1

CHAPTER 2: BACKGROUND...................................................................................................................................6

Table 1: Existing Literature Reviews .................................................................................................................... 7

CHAPTER 3: METHODS........................................................................................................................................16

CRITERIA FOR CONSIDERING DOCUMENTS FOR THIS REVIEW ................................................................................................. 17

Types of publications ......................................................................................................................................... 17

Place, Population, and Temporal Range............................................................................................................ 18

Types of interventions/collaborations ............................................................................................................... 18

Types of descriptive outcomes........................................................................................................................... 18

Figure 1: Stakeholder Relationship Model......................................................................................................... 19

SEARCH METHODS ...................................................................................................................................................... 19

Table 2: Online Databases Search ..................................................................................................................... 20

DATA COLLECTION AND ANALYSIS .................................................................................................................................. 20

Selection of studies ............................................................................................................................................ 20

Data extraction and management .................................................................................................................... 21

CHAPTER 4: RESULTS ..........................................................................................................................................24

DOCUMENTS REVIEWED ............................................................................................................................................... 24

Table 3: Eligible Documents Retrieved from Database Search .......................................................................... 24

Table 4: Additional Eligible Documents ............................................................................................................. 25

Documents Evaluated........................................................................................................................................ 26

Table 5: Documents Selected for Evaluation ..................................................................................................... 26

DESCRIPTIVE OUTCOMES: KEY COLLABORATION FACTORS ................................................................................................... 36

Funding.............................................................................................................................................................. 36

Project/Program Evaluation .............................................................................................................................. 36

Community Engagement ................................................................................................................................... 37

Stakeholder Relationship Dynamics .................................................................................................................. 38

Table 6: Stakeholder Relationship Dynamics Described .................................................................................... 38

CHAPTER 5: DISCUSSION ....................................................................................................................................40

PI/PROJECT LEADER FAMILIARITY WITH SOCIO-CULTURAL CONTEXT .......................................................................................

41 COMMUNITY ENGAGEMENT AND CBPAR ........................................................................................................................ 42

CONCLUSIONS AND RECOMMENDATIONS ......................................................................................................................... 43

LIMITATIONS .............................................................................................................................................................. 44

BIBLIOGRAPHY ...................................................................................................................................................46

APPENDIX........................................................................................................................................................... 50

APPENDIX A: SEARCH STRATEGY FOR PUBMED, EMBASE, AFRICA-WIDE INFORMATION, AND GLOBAL HEALTH (CAB DIRECT) ...... 50

APPENDIX B: SEARCH STRATEGY FOR JSTOR AND ANTHROPOLOGY PLUS............................................................................... 51

APPENDIX C: DOCUMENT ELIGIBILITY SCREENER FORM ...................................................................................................... 52

APPENDIX D: DOCUMENT EXTRACTION FORM .................................................................................................................. 56

APPENDIX E: DOCUMENTS REVIEWED ............................................................................................................................. 69

APPENDIX F: DESCRIPTIVE OUTCOMES ............................................................................................................................ 71

APPENDIX G: GOOGLE FORMS SCRIPT ............................................................................................................................. 73

APPENDIX H: PRISMA FLOW CHART ............................................................................................................................. 74

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Traditional Health Practitioners Collaboration South Africa Traditional African Medicine HIV/AIDS
Committee Chair / Thesis Advisor	Claudia Ordóñez, Emory University
Committee Members	Vincent Marconi, Emory University

Last modified

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	The Viability of a Partnership between Traditional Health Practitioners and the South African Healthcare System: A Qualitative Systematic Review ()	2019-04-24 14:03:06 -0400	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions