The Roles and Challenges of Traditional Health Practitioners in Maternal Health Services in Rural Communities of Mthatha, South Africa
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Setting
2.3. Population
2.4. Sampling Procedure
2.5. Data Collection
Focus Group Discussion
2.6. Data Analysis
2.7. Ethics and Consent
2.8. Measures for Trustworthiness and Reliability
3. Results
3.1. Theme 1: Categories of Traditional Health Practitioners
“There are herbalists, diviners, faith healers. We are all working under the Department of Health.”Participant 1, THP-FGD
“We are of different categories of traditional health practitioners; I will therefore ask Pastor’s wife to say something because I know her well when it comes to traditional healing”Participant 1, THP-FGD
3.2. Theme 2: Roles of THPs in Proving Traditional Health Services to Pregnant Women
3.2.1. Pre-Conception and Antenatal Care
‘We, traditional health practitioners, give a woman who has a problem of not conceiving a traditional mixture to drink”Participant 1, THP-FGD
“It start s when a young woman starts attending antenatal care, she comes to us or traditional birth attendant when she has missed a period for one month after you gave her the traditional medicine for conception”Participant 3, THP-FGD
“We, traditional health practitioners know how to stop the occurrence of miscarriages using our medicinal products”Participant 4, THP-FGD
3.2.2. Diagnosis, Treatment or Preventive Health
“There is a certain herb that we use for protection of pregnancy from the evil spirits”Participant 7, THP-FGD
“Another fact about the safety of pregnant woman is that there are dangerous places which a pregnant woman must avoid walking in them so that she is not affected by evil spirits. It is one of our responsibilities to protect them from these spirits by using some traditional medicinal products so that they do not have miscarriages”Participant 7, THP-FGD
3.2.3. Management of Pregnancy Complication
“When pregnant women have swollen feet and legs, they come to us, and we treat them successfully”Participant 6, THP-FGD
“People do not have the same problems when they are pregnant. There are pregnant women who present with swollen legs and feet, and they will be treated with either water traditionally prepared or prayed for, herbs, or traditional mixtures, because our traditional practices are different. I am a traditional health practitioner who uses most of these traditional medicines”Participant 2, THP-FGD
“When I see that the woman is about to deliver and I notice that she is feeling cold and she tells me that she is in labour, I prepare a certain traditional mixture which I put in small bottle and thereafter I take Gin, mix it with little boiling water and give her to drink and tell her to go and sleep. When she reports that she is in labour, I switch over to Western medicine and she takes it together with a spoon of castor oil and she sleeps. If it happens that she goes to the hospital, she would deliver the baby well without operation”Participant 3, THP-FGD
“When it comes to swollen feet of the woman who is about eight months pregnant, and the baby has turned but is not in the normal position, I take the medicine which I prepare from herbs which I am not going to explain the type of medicine; I use it to turn the baby to be delivered in the right position”Participant 1, THP-FGD
“There is no need for a woman to go to the clinic or hospital when the baby is coming with legs first because we know how to correct when they come to us”Participants 2, THP-FGD
“A woman will come to you with a breech presentation. I give her some stuff to make her sneeze, and then I assess her using my ‘water’ to massage her abdomen. Sometimes I mix the product that I use to make her sneeze with camphor body cream, petroleum jelly, and another confidential ingredient. I massage her abdomen, and the breech is corrected to the normal position”Participant 3, THP-FGD
“If it happens that a pregnant woman comes to you reporting that she has delayed labour contractions I give her traditional mixture only and she gets contractions and delivers her baby well”Participant 7, THP-FGD
3.2.4. Maintenance and Restoration of Health
“When the woman has retained placenta retained placenta you tell her not to go to the hospital, and you attend to her. This is what we do, if there is a woman with retained placenta, you put your fingers in the vulva and pull it or we give her the bottle to blow until the retained placenta comes out”Participant 5, THP-FGD
“It happens often that a woman comes to me having retained placenta and I remove it”Participant 3, THP-FGD
“A baby with a natural birth mark will be having dry furred tongue and an open mouth. We, traditional health practitioners, mix glycerin with a certain type of traditional mixture. There are different types of traditional mixtures which we use to treat birth mark the baby, as well as meconium”Participant 1, THP-FGD
3.3. Theme 3: Challenges Faced by THPs in Proving Traditional Health Services to Pregnant Women
3.3.1. Unregistered Traditional Practitioners
“There are those fake traditional health practitioners who say they heal people and instead they cut the parts of the people”Participant 2, THP-FGD
“There are no complications following the use of traditional medicine. Complications are seen when people consult other people who market themselves in town as traditional health practitioners by putting posts on the walls. People start undermining us and running after these so-called traditional health practitioners”Participant 2, THP-FGD
“There are traditional health practitioners who are not working together with us, who do dirty things in the name of healing people”Participant 4, THP- FGD
“Some traditional health practitioners say they can conduct deliveries telling lies instead they kill the innocent pregnant woman and her baby”Participant 6, THP- FGD
3.3.2. Lack of Transparency about the Traditional Products Used by THPs
“We cannot as traditional health practitioners tell you, our secrets of how and which medicinal practices and products we use to treat pregnant women. We cannot give the government our secrets in case she steals our secrets. Otherwise, what we do, we go and dig the herbs, prepare them for the clients to be taken during the term of pregnancy. What we are confident of is that the woman delivers well without any complications”Participant 1, THP- FGD
“… traditional health practitioners do not reveal their secrets, but if a person comes to us for consultation she goes back cured as if she was treated in the hospital”Participant 5, THP- FGD
3.3.3. Concerns of THPs about the Protection of Their Practice
“The government is lagging behind in helping the traditional health practitioners towards authorisation of herbs, and as a result we do not want to mention the herbs we use which are very useful like a certain type of traditional medicine prepared from either the herb, stone or powder”Participant 6, THP-FGD
“There are those who call themselves traditional health practitioners and yet they lie, those who have neither undergone any form of initiation nor have been called to treat people. Others do not want to be in our association”Participant 3, THP-FGD
“There are people who say that they are traditional health practitioners and yet they do not know what they are doing, they bring complications to our people and tarnish our practice”Participant 2, THP-FGD
“When the person gets complications, it will be said that it is us the THPs who caused the illness and yet it is these THPs from foreign countries. We usually ask ourselves what happened in their countries that they come and treat our people here because to them this is an employment opportunity”Participant 1, THP-FGD
“Other traditional health practitioners do not know the herbs. They only heard about them, and they do not even know measurements and how they are prepared. This lack of skill would be seen when a woman gets complications which are a result of using the wrong medicine. This act brings bad image to our services as traditional health practitioners”Participant 3, THP-FGD
“they are claiming that they cure birth mark by cutting it with a razor blade; and yet we know how to treat birth mark without cutting it. These false traditional health practitioners put on white beads to pose as trained traditional health practitioners”Participant 5, THP-FGD
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Area | Question |
---|---|
Knowledge | What are the different traditional health practitioners you know of? |
Which traditional services do you provide to pregnant women? | |
Traditional practices | How do you ascertain your competence of the service you provide to the pregnant women? |
How are your working relationships with other health providers? |
Theme | Subthemes |
---|---|
1. Categories of Traditional Health Practitioners | 1.1: Divine healers 1.2: Herbalists 1.3: Faith-based healers |
2. Roles of THPs in proving traditional health services to pregnant women | 2.1: Pre-conception and antenatal care |
2.2: Diagnosis, treatment or preventive health | |
2.3: Management of pregnancy complications | |
2.4: Maintenance and restoration of health | |
3. Challenges faced by THPs in proving traditional health services to pregnant women | 3.1: Unregistered traditional practitioners |
3.2: Lack of transparency about the traditional products used by traditional health practitioners | |
3.3: Concerns of traditional health practitioners about protection of their practice |
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Thipanyane, M.P.; Nomatshila, S.C.; Musarurwa, H.T.; Oladimeji, O. The Roles and Challenges of Traditional Health Practitioners in Maternal Health Services in Rural Communities of Mthatha, South Africa. Int. J. Environ. Res. Public Health 2022, 19, 13597. https://doi.org/10.3390/ijerph192013597
Thipanyane MP, Nomatshila SC, Musarurwa HT, Oladimeji O. The Roles and Challenges of Traditional Health Practitioners in Maternal Health Services in Rural Communities of Mthatha, South Africa. International Journal of Environmental Research and Public Health. 2022; 19(20):13597. https://doi.org/10.3390/ijerph192013597
Chicago/Turabian StyleThipanyane, Mvulakazi Patricia, Sibusiso Cyprian Nomatshila, Hannibal Tafadzwa Musarurwa, and Olanrewaju Oladimeji. 2022. "The Roles and Challenges of Traditional Health Practitioners in Maternal Health Services in Rural Communities of Mthatha, South Africa" International Journal of Environmental Research and Public Health 19, no. 20: 13597. https://doi.org/10.3390/ijerph192013597
APA StyleThipanyane, M. P., Nomatshila, S. C., Musarurwa, H. T., & Oladimeji, O. (2022). The Roles and Challenges of Traditional Health Practitioners in Maternal Health Services in Rural Communities of Mthatha, South Africa. International Journal of Environmental Research and Public Health, 19(20), 13597. https://doi.org/10.3390/ijerph192013597