Ulwaluko (Customary Male Initiation) in the Eastern Cape: Stakeholder Perspectives on a Missing Social Work Role in Customary Initiation Act No. 2 of 2021

Abstract

Despite its significance, ulwaluko has continuously faced challenges, including, inter alia, fatalities, botched circumcisions, and psychosocial distress, which have often been linked to inadequate support. The enactment of the Customary Initiation Act No. 2 of 2021 represented a legislative effort to regulate, enhance safety, and create space for professional interventions, while explicitly excluding social workers. This qualitative study used focus group discussions with traditional leaders, medical practitioners, parents, recent initiates, and COGTA representatives in OR Tambo, Amathole, and Alfred Nzo districts of the Eastern Cape, South Africa. Six themes emerged: stakeholder roles and responsibilities; preparation and permission processes; psychological and mental health assessment; gender considerations in social work involvement; challenges, fatalities, and government interventions; and cultural competence and collaboration. The findings revealed support for the Act but identified limitations in its emphasis on medical assessments without corresponding psychosocial assessment. The study demonstrates the importance of integrating social workers to provide holistic, culturally sensitive psychosocial support within ulwaluko.

1. Introduction

Admittedly, ulwaluko (traditional male circumcision [TMC]) is a crucial practice that marks the transition from boyhood to manhood through rituals that involve circumcision, seclusion, and transmission of societal values and responsibilities while developing qualities of leadership in young men who undergo it (Diko 2025; Gqeba 2024; Gogela 2020). Ulwaluko extends beyond physical transformation and includes moral development, communal responsibility, and ancestral connection (Mbabane and Mabungela 2025). According to Gqeba (2024), it functions as a potent tool for leadership development, with those who undergo it gaining essential skills for their roles in society. Through ulwaluko, masculinity is constructed (Diko 2025), and positions men as providers, decision-makers, and custodians of cultural continuity.

Ulwaluko has been practised for centuries and has evolved within the changing social, political, and health landscapes. Despite its enduring core cultural meanings, contemporary contexts have introduced significant challenges, including commercialisation, unregulated initiation schools, inadequate regulation, poor environmental conditions, and failures in systematic enforcement (Mbabane and Mabungela 2025; Mdhluli et al. 2020). Arguably, these challenges have contributed to fatalities, infections, and psychological distress, which raises concerns about human rights, informed consent, and mental well-being (Kasa 2025; Mbabane and Mabungela 2025).

In response to these concerns, the provincial and national governments introduced and enacted laws, such as the Eastern Cape Circumcision Act No. 6 of 2001, which was later repealed and replaced by the Eastern Cape Customary Initiation Act No. 5 of 2016 and the Customary Initiation Act No. 2 of 2021. The former sought to strengthen oversight and was closely aligned with customary law, operating only in the Eastern Cape, hence its name, while the latter is national in nature and sought to consolidate the regulation of the rite of passage. This legislation should regulate the initiation practice, mandate health assessments, and safeguard initiates while respecting cultural traditions. Despite the increased recognition of social workers as critical actors within this framework and their expertise in psychosocial assessment, advocacy, and culturally responsive practices (Schroeder et al. 2022; Mtetwa and Muchacha 2020), both Acts have shunned social work in ulwaluko. In terms of outlook, these Acts reflect a regulatory and biomedical orientation that marginalises psychosocial and social development perspectives, as they make no explicit provision for social workers’ involvement, despite addressing issues central to social work practice. To this end, this study explores the stakeholder perspectives on the role of social workers in promoting psychosocial readiness, cultural safety, and the effective implementation of the Acts in ulwaluko.

2. Literature Review

Existing literature on ulwaluko has long recognised the practice as a formative institution through which masculinity, responsibility, social belonging and cultural identity are actively produced among amaXhosa communities (Gogela 2020; Gqeba 2024; Diko 2025). Evidently, some scholars reveal the structural vulnerabilities that threaten the rite’s integrity: unregulated schools, injuries, fatalities and health complications remain recurrent (Mpateni and Kang’ethe 2022; Moyer et al. 2022), while psychosocial sequelae, anxiety, stigma, behavioural maladjustment and post-initiation distress are well documented but rarely institutionalised as objects of systematic intervention (Bottoman et al. 2009; Gittings et al. 2021).

Admittedly, regulatory responses have privileged formal oversight and biomedical screening. The Customary Initiation Act No. 2 of 2021 consolidates registration, monitoring, and health assessment responsibilities largely within medical and traditional authority structures. This orientation has strengthened certain physical safeguards, yet it has also reproduced an enduring tension with state regulation, which frequently operates at a remove from indigenous custodianship and knowledge systems (Kepe 2010; Nomngcoyiya and Kang’ethe 2019). Collaborative models involving communities, traditional authorities, families and the state are widely advocated, but the concrete mechanisms through which such collaboration might incorporate specialised psychosocial expertise remain under-specified.

What is conspicuously absent is any sustained examination of social work’s potential contribution within this regulatory and psychosocial architecture. Existing studies concentrate on cultural meanings, health risks, masculinity, gender relations or state–customary relations. Even those that register psychosocial distress or call for multi-stakeholder partnership stop short of interrogating how traditional leaders, medical practitioners, parents, recent initiates, CoGTA officials, and social workers themselves understand or contest the specific role social workers could play under the Customary Initiation Act No. 2 of 2021. Spaumer et al. (2025) have begun to argue for culturally responsive and ecological approaches, yet empirical evidence integrating these stakeholder perspectives remains scarce. Therefore, this study focuses precisely on this lacuna, the absence of an explicit social-work role in the Act, and the conditions under which psychosocial expertise might be integrated without displacing Indigenous Knowledge Systems or the cultural custodians of ulwaluko.

2.1. Theoretical Framework

This study was grounded within the Indigenous Knowledge System (IKS). IKS recognises knowledge as culturally situated, relational and further transmitted through lived experiences and ritual. Gqeba (2024) argues that IKS, when viewed as a holistic framework encompassing intergenerational wisdom, spirituality, and community-based epistemologies, offers a culturally congruent lens for examining ulwaluko not as a mere ritual but as an educational and leadership development system. Centring this study in IKS avoids imposing Western models that may undermine the rites’ socio-cultural significance, such as constructing masculinity through resilience, respect (Ubuntu), and communal solidarity (Diko 2025). Ulwaluko embodies the education and apprenticeship subsystem of IKS, in which initiates learn moral and practical knowledge (Mugumbate 2025) through seclusion and guidance from elders, fostering independence and social responsibility. This approach, therefore, ensures that stakeholders’ perspectives on psychological assessments and social work involvement are interpreted through indigenous ontologies, which promote ethical research that respects the worldviews of those who practice ulwaluko and counters the colonial erasure of African rites of passage (Siswana 2017).

Integrating IKS strengthens alignment with the Acts by advocating for psychosocial support that harmonises traditional authority with modern safeguards, without in any way diluting cultural integrity. As argued by Mugumbate (2025), IKS subsystems, as spiritual and societal knowledge, emphasise restorative practices over punitive interventions, which can guide social workers in providing gender-sensitive care, community-embedded assessments during ulwaluko. As such, this grounding facilitated a balanced discourse in which fatalities and risks are addressed through indigenous conflict resolution and elder involvement, rather than through external impositions (Gqeba 2024). Moreover, embedding the study in IKS empowered amaXhosa voices, decolonised knowledge production, and enhanced ulwaluko’s sustainability as a vital mechanism for manhood and leadership in post-apartheid South Africa (Diko 2025; Siswana 2017).

Specifically, the study foregrounds relationality and collective responsibility, intergenerational knowledge transmission, culturally situated understandings of personhood and readiness, and respect for indigenous knowledge and cultural protocols. African IKS emphasises relationality and interconnectedness, locating knowledge within communal relationships rather than viewing knowledge as an individual possession (Carstens and Preiser 2024), while intergenerational transmission enables indigenous knowledge, values, and practices to be sustained across generations through lived and culturally embedded processes (Malapane et al. 2024). These dimensions are evident in ulwaluko, as it is collectively embedded in relationships among those undergoing it, families, elders, traditional leaders, and other stakeholders, through which culturally situated understandings of manhood, responsibility, and readiness are transmitted. Moreover, the study draws on the principle of cognitive justice, which Hoppers (2021) argues recognises indigenous ways of knowing as legitimate knowledge systems rather than subordinating them to dominant epistemologies. Evidently, all these aspects of IKS provided the lens through which the study interprets psychosocial readiness, stakeholder responsibilities, and the potential involvement of social workers, while recognising indigenous authority and the cultural protocols that govern ulwaluko.

2.2. Methodology

This study adopted a qualitative phenomenological research design to explore stakeholders’ lived experiences, meanings, and interpretations of the role of social workers in ulwaluko within the context of the Customary Initiation Act No. 2 of 2021. Phenomenology was considered appropriate because it enabled an in-depth understanding of participants’ subjective realities and culturally embedded perspectives on cultural practice, psychosocial readiness, safety, and professional roles in the initiation process. The study was conducted in three purposively selected districts of the Eastern Cape Province, OR Tambo, Amathole, and Alfred Nzo, where ulwaluko is widely practised, and initiation-related challenges are frequently reported.

Participants comprised key stakeholders directly involved in ulwaluko, including three traditional leaders (iinkosi), three medical practitioners, five social workers, three parents, five recent initiates (amakrwala), and two representatives from the Department of Cooperative Governance and Traditional Affairs (CoGTA), resulting in a total of 21 participants for this article. Purposive sampling was employed to ensure rich, diverse, and information-rich perspectives across different roles in the initiation process. The participants were selected based on their direct experience, knowledge, professional, and customary responsibilities relating to ulwaluko. Social workers were selected based on their professional experitise and their potential role they can play in ulwaluko; amakrwala were included because of their lived experience of the rite; iinkosi were selected because of their customary oversight responsibilies; medical practitioners were included based on their involvement in ulwaluko in line with Customary Initiation Act; CoGTA officials were selected based on their institutional responsibilities for ulwaluko; lastly, the inclusion of parents was owed to their direct experience of having children who had undergone ulwaluko.

Admittedly, the representation from each stakeholder was not intended to achieve numerical balance, but to capture diverse, information-rich perspective that is relevant to the objective of the study. To this end, the greater representation of social workers and amakrwala reflected their particular relevance to the focus of the study, which is psychosocial support and the potential role of social work, while iinkosi, parents, CoGTA and medical practitioners provided complementary perspectives on customary, familial, governance, and medical aspects.

Data were collected through focus group discussions conducted primarily in isiXhosa, with English used selectively where necessary for conceptual clarity. Each discussion lasted 60–90 min and was guided by semi-structured prompts focused on the Customary Initiation Act, psychological readiness, stakeholder responsibilities, and the potential role of social workers. All sessions were audio-recorded with informed consent, transcribed verbatim, and analysed using thematic analysis following Braun and Clarke’s (2006) six-phase process. Iterative coding, theme development, and refinement were undertaken to enhance analytic rigour, trustworthiness, and cultural credibility of the findings.

2.3. Ethical Considerations

Ethical approval was obtained from the University of Johannesburg Faculty of Humanities Research Ethics Committee with clearance number REC-02-794-2024. Participation was voluntary, informed consent was secured, and confidentiality was maintained through anonymisation of transcripts. Cultural sensitivity was prioritised throughout the research process.

3. Results

In this section, findings are presented to ensure that the researcher immerses himself in the role of a social worker within ulwaluko during the implementation of the Customary Initiation Act. Six themes emerged from the data analysis: Stakeholder Roles and Responsibilities; Preparation and Screening Process; Psychological and Mental Health Assessment; Gender and Cultural Protocols; Challenges, Risks, and Fatalities; and Cultural Competence, Collaboration, and Improvement Strategies.

3.1. Stakeholder Roles and Responsibilities

The stakeholders described ulwaluko as a collective process in which various stakeholders play complementary roles to ensure safety, legitimacy, and cultural continuity. Iinkosi were identified as custodians of cultural authority, while parents were responsible for consent and behaviour monitoring after initiation. Medical practitioners were identified as stakeholders focused on physical health, whereas social workers were viewed as central to psychosocial and community coordination roles. The latter is evident from the CoGTA representative, who emphasised the value of social work involvement as:

“The inclusion of social workers in ulwaluko is very important to ensure the safety of initiates, minimise fatal accidents that usually occur during the initiation season, and bring back the dignity of initiation schools and ulwaluko.”

This verbatim comment reflects a clear recognition of social work as a critical protective and restorative profession within ulwaluko. The emphasis on the inclusion of social workers as “very important” underscores the urgency of their involvement in ensuring the safety of initiations and addressing the recurring fatalities that often characterise initiation seasons, thereby implicitly critiquing the limitations of existing medical and regulatory mechanisms. By linking social work directly to the minimisation of fatal accidents, the above verbatim quote positions the profession as capable of addressing psychosocial and systemic gaps, such as inadequate preparation and a lack of emotional readiness, which contribute to preventable harm. In showing the importance of each stakeholder playing their own role, the following part of a parent shows the shared responsibility and collective purpose.”

“Kwababantu bakhankanyiweyo, wonke umntu unendima ayadlalayo eyenza ukuba ubudlelwane bubebuhle phakathi kwabo bonke. Eyonanto yenza ubudlelwane obuhle Phakathi kwethu sonke kukuyiqonda into yokuba into esidibanisayo kukukhulisa lomntwana abe yindoda.” Loosely translated: “Of the people mentioned, everyone has a role to play that makes the relationship good between all of them. What makes our relationship good is understanding that what unites us is raising this child to be a man.”

This statement reflects a collective and relational understanding of ulwaluko as a shared communal responsibility, rather than an individual and/or institutionally isolated process. The emphasis on “…unendima ayidlalayo” (…role to play), the parent foregrounds the interdependence among stakeholders as a foundation for harmonious relationships, suggesting that safety, legitimacy, and success in ulwaluko emerge through cooperation and not in hierarchy.

The reference to “…ubudlelwane obuhle” (good relationships) highlights the importance of social cohesion and mutual respect in sustaining the initiation process, while the assertion that what unites stakeholders is “…kukukhulisa lo mntwana abeyindoda” firmly situates ulwaluko within IKS, as it prioritises collective upbringing, moral formation, and communal accountability. Noting the importance of accountability, differentiation of roles and the importance of all stakeholders playing their designated roles, the medical practitioner noted that:

“Njengogqirha, ixesha elininzi basebenzisa izixhobo ukujonga isimo sengqondo yomntwana. Kuba sisebenzisa izixhobo, amaxesha amaninzi siye singafumani ngxelo yokuphazamiseka ngokwasengqondweni kwaye izixhobo azisixeleli ukuba umntwana ukulungele okanye akakulungelanga ukuya esuthwini psychologically. Ezizixhobo zezokujonga ukugula hayi enyinyinto. Yiyo ke lonto silisebe lezempilo siye sibandakanye noonontlalontle ukwenzela bakwazi ukwenzi ipsychological assessment emwntwaneni.” Meaning: “As doctors, we often use tools to assess a child’s mental health. Because we use tools, many times we do not get a report of a mental disorder and the tools do not tell us whether the child is ready or not to go to school psychologically. These tools are for diagnosing illness, not for diagnosing something. That is why we, the health department, involve social workers so that they can do a psychological assessment on the child.” Despite the participants’ recognition of ulwaluko as a communal responsibility grounded in collective upbringing, the above verbatim quote illustrates the absence of psychosocial assessment within medical practice, exposing a critical gap that disrupts this indigenous system of shared care and accountability. This account by a medical practitioner offers a nuanced reflection on the structural limitations of the biomedical screening in assessing an initiate’s readiness for ulwaluko and explicitly acknowledges the necessity of interdisciplinary collaboration. A closer analytic reading of “…ezi zixhobo zezokujonga ukugula hayi enye into…” (these tools are to assess physical health, not any other thing) reflects a fundamental mismatch between the biomedical instruments and the holistic demands of the initiation process. Moreover, the assertion that “…ezisixeleli ukuba umntwana ukulungele okanye akakulungelanga ukuya esuthwini psychologically…” portrays the invisibility of emotional vulnerability, coercion and mental unpreparedness within the health-centred assessments. Essentially, the medical practitioner situates this limitation within institutional practice by noting that the Department of Health involves social workers in conducting psychological assessments, positioning social work as a complementary and essential profession rather than an optional addition.

Reflecting on the importance of each stakeholder playing their designated and role they qualify for, a social worker expressed that:

“Psychological assessment is a role for social workers and psychologists; medical practitioners are trained for medical assessment therefore I believe that social workers should be included in the process of ulwaluko.”

This verbatim quote clearly delineates professional roles within ulwaluko and acknowledges the limits for medical expertise in addressing psychosocial readiness. The assertion that “psychological assessment is a role of social workers and psychologists…” clearly distinguishes between medical training, which prioritises physical health, and psychosocial assessment, which requires specialised skills for evaluating emotional, cognitive, and social preparedness. This reinforces the view that a safe and dignified ulwaluko cannot rely solely on biomedical screening but also requires interdisciplinary collaboration, aligning with Indigenous Knowledge Systems’ holistic understanding of personhood, where psychosocial readiness is integral to the transition to manhood.

Social workers emphasised that, their involvement is only possible when it is grounded in respect for indigenous belief system and cultural authority. Cultural humility explored in greater depth in Section 3.6.

This brief, yet powerful statement reflects a stance of cultural humility and ethical engagement, which is central to social work practice within indigenous contexts. The affirmation of “respect” for “their belief system” signals an approach grounded in acknowledgement rather than imposition, challenging the assumption that professional involvement necessarily undermines cultural authority. This reflects an awareness of ulwaluko as an Indigenous Knowledge System governed by deeply held spiritual and communal values. This underscores that effective psychosocial intervention in ulwaluko depends on social workers demonstrating cultural competence and respect for indigenous knowledge systems, not on replacing indigenous practices but on working within their epistemological and cultural boundaries, thereby reinforcing stakeholders’ perceptions that social workers can enhance safety and dignity without eroding tradition.

3.2. Preparation and Screening Process

Preparation for ulwaluko emerged as a structured, multi-layered process involving families, community structures, traditional leadership, and state-regulated health services. Participants consistently described preparation not as a single event, but as a sequential pathway through which legitimacy, readiness, and accountability are established before a child may proceed to the initiation school. Central to this process were parental consent, community endorsement, permission from traditional authorities, and medical screening, all of which were viewed as safeguards to protect both the initiate and the integrity of ulwaluko.

This structured process is evident in the account of one initiate, who explained that:

“Mna ndiqale ndacela ebazalini bam ekhaya, ukuba bendinoobhuti abadala nakubo bendizokucela ukubonakalisa intlonipho. Bakuba bendivumele abazali ukuba ndoluke, baye bandithumela kubafana basekuhlaleni ukuba ndicele nakubo baze ke bona bandithumela kwiNkosi zasekuhlaleni. Iinkosi emveni kokuba ndicelile kuzo, ziye zandenzela iimpepha mvume ezibubungqina bokuba ndiyile ndayocela ukwaluka. Emveni kokuba siye kwiiNkosi, siye sadluliselwa kooSibonda beenginqi esihlala kuzo.” Translation: “I first asked my parents at home, if I had older brothers, I would ask them to show respect. When my parents allowed me to get circumcised, they sent me to the local young men to ask them to, and they sent me to the local chiefs. After I asked them, the chiefs gave me permission documents that proved that I had gone to ask for circumcision. After we went to the chiefs, we were referred to the Sibondas in our areas.”

This verbatim account reflects the layered nature of consent within ulwaluko, where parental approval alone is insufficient without broader communal and traditional validation. The phrase “ndiqale ndacela ebazalini bam” (I first asked my parents…) positions the family as the first gatekeeper, while subsequent referrals to community members and traditional leaders reveal that ulwaluko is not an individual decision but a socially sanctioned process. This highlights how preparation functions as a mechanism of collective accountability embedded within Indigenous Knowledge Systems.

Further emphasising the formalisation of permission, the initiate’s statement of “…Iinkosi emveni kokuba ndicelile kuzo, ziye zandenzela iimpepha mvume ezibubungqina bokuba ndiyile ndayocela ukwaluka. Emveni kokuba siye kwiiNkosi, siye sadluliselwa kooSibonda beenginqi esihlala kuzo…” illustrates the bureaucratisation of customary practices through written authorisation, reflecting an intersection between indigenous governance and contemporary regulatory demands. The reference to “iimpepha mvume” (permission documents) signifies that preparation has evolved to include tangible proof of compliance, reinforcing legitimacy and traceability within the initiation process.

The role of intermediary structures was further highlighted when participants described referral to area leaders and health facilities:

“Ndiqale ndacela ebazalini bam ekhaya, bakuba bevumile bandithumela kubafana basekuhlaleni ukuba ndicele nakubo baze ke bona bandithumela kwiNkosi zasekuhlaleni. Iinkosi emveni kokuba ndicelile kuzo, ziye zavuma ukuba ndibeyinxalenye yamakhwenkwe azakubheka esuthini kuloonyaka ngenza yeminyaka nethambo. Emveni koko, iiNkosi ziye zasidlulisela kooSibonda beenginqi esihlala kuzo. OOsibonda baye basidlulisela eKlinikhi ukuze siyojongwa ukuba physically sikulungele na. Eklinikhi kulapho ujongwa zonke indindi zokugula ukuze ufumane okanye ulungiselelwe iipilisi ukuba ufumaniseke ugula. Enye yezinto esayijongwayo ngugqirha singamakhwenkwe azokwaluka sisimo sengqondo.” Translation: “I first asked my parents at home, when they agreed, they sent me to the local boys to ask them, and they sent me to the local Chiefs. After I asked them, the Chiefs agreed that I would be part of the boys who would be circumcised that year, as I was a year and a half old. After that, the Chiefs referred us to the Local traditional leader of the areas where we live. The Local traditional leader referred us to the Clinic for a physical check. At the clinic, you are checked for all the signs of illness so that you can get or be prescribed pills if you are found to be sick. One of the things the doctor checked for in boys who will be circumcised is their mental state.”

This quote reflects the procedural handover between traditional and state-linked structures, where preparation extends beyond cultural approval to include biomedical assessment. The sequencing conveyed in “zaye zasidlulisela” (they then referred us) underscores a regulated pathway intended to minimise risk, while simultaneously revealing the dependence of ulwaluko preparation on institutional coordination.

Medical practitioners confirmed their role within this preparatory stage, with one doctor stating:

“Mna ndingugqirha kubalulekile ukuba ndibandakanyeke kulwaluko, umsebenzi wam kukuqinisekisa ukuba phambi kokuba umntwana aye esuthwini kumele ndixilonge khona ukuze ndikwazi ukuqinisekisa ukuba umzimba lo wakhe kunyee nesimo sakhe sempilo sikulungele okanye siyamvumela kusini na ukuba aye esuthwini. Oluxilongo lubalulekile kuba ingxelo endiyendiyifumane yiyo enikeze umkhomba ndlela wokuba umntwana angaya esuthini.” Translation is: “As a doctor, it is important for me to be involved in circumcision. My job is to ensure that before a child goes to the initiation, I must examine them so that I can ensure that their body and health are ready, or not to allow them to go there. This examination is important because the report I receive provides direction regarding the child’s ability to attend the initiation school.”

This account reflects a narrow yet crucial understanding of preparation from a biomedical perspective, in which readiness is defined primarily in physical terms. The emphasis on “umzimba wakhe” (his body) illustrates how medical screening prioritises physical fitness, implicitly delimiting the scope of preparation and leaving psychosocial readiness less visible within this stage.

Parents also reflected on preparation as an emotionally demanding and extended process, as captured by one parent:

“Njengamzali okhe wolusa umntwana, mandiqale ngokuthi ukolusa umntwana yi process ende engekho lula kum ndingumzali nakuye umntwana. Eneneni kodwa ke xa sele ndimbona ukuba nyani uyoluka ndiye ndizive ndivuya kakhulu ngoba uyofunda ubudoda nendlela yokuziphatha. Ukugxininisa kubunzima balendlela, uye uthi sele uyobakroba entabeni njengamzali, ufike ubona ukuba bebengayiqondi ncam ubunzima bale process.” Translation: “As a parent who has circumcised a child, let me start by saying that circumcising a child is a long process that is not easy for me as a parent or for the child. In fact, when I see him truly circumcised, I feel very happy because he is learning about manhood and how to behave. By emphasising the difficulty of this process, you are almost like looking down on them as a parent, and you realise that they did not really understand the difficulty of this process.”

This statement highlights the affective dimension of preparation, framing it as a shared emotional journey for both parent and child. The use of “process ende” (a long process) reinforces that preparation is not merely administrative, but deeply relational, involving anticipation, anxiety, and responsibility.

Despite these multiple stages, participants identified gaps within the preparation process, particularly regarding behavioural and psychological readiness. This concern is evident in the view of one parent, who argued that:

“Hayi, andiboni kukuhle ukuba kubengugqirha ojongana nomntwana phambi kokuba aye esuthwini. Ugqirha akayijongi ncam indlela yokuziphatha komntwana, ujonga nje izigulo aphelele apho. Into ebangela nditsho, isimo sokuziphatha komntwana siso esifika sixake pha esuthwini, abuye nasekhayeni angaziphathi kakuhle. Ngoko ke ndicinga ukuba ukudibana nogqirha qha akusincedisi ncam, kungakuhle nokuba umtwana adibane noonontlalontle abazomeluleka ngokwenggqondo bambonise ukuba elinyathelo alithathayo lizamcedisa entwenini kwaye lifuna uziphathe njani.” Direct translation: “No, I don’t think it’s a good idea for a doctor to see a child before they go to the hospital. The doctor doesn’t really look at the child’s behaviour; he just looks at the illnesses, and that’s it. The reason, I mean, is the child’s behaviour that gets complicated in the hospital, and he comes home and doesn’t behave well. So I think that just seeing a doctor doesn’t really help, it would be good for the child to also meet with social workers who will counsel him psychologically and show him how this step he is taking will help him and how he needs to behave.”

This verbatim account reflects dissatisfaction with a preparation process that prioritises physical health while overlooking behavioural and psychological dimensions. The phrase “aphelele apho” (ends there) signals perceived insufficiency, suggesting that preparation remains incomplete when psychosocial factors are excluded.

These accounts demonstrate that while preparation for ulwaluko is highly structured and involves multiple stakeholders, it remains uneven in scope. The findings reveal a well-established pathway for permission and physical readiness, but also expose critical gaps in psychosocial preparation, which stakeholders believe undermine both initiate safety and the broader objectives of ulwaluko. This theme, therefore, foregrounds preparation as a contested yet foundational stage, in which the inclusion of social workers is repeatedly implied to be necessary to complete the preparatory process holistically and culturally congruently.

3.3. Psychological and Mental Health Assessment

Psychological and mental health assessment emerged as a central yet contested component of ulwaluko, with participants consistently emphasising that physical readiness alone is insufficient to prepare initiates for the demands of the initiation process. Stakeholders highlighted concerns related to emotional preparedness, coercion, peer pressure, and behavioural readiness, noting that failure to address these dimensions often results in psychological distress during and after initiation. Across groups, there was strong convergence that psychosocial assessment is necessary to safeguard initiates and uphold the dignity of ulwaluko.

Medical practitioners openly acknowledged the limitations of biomedical tools in assessing psychological readiness, as articulated by one doctor:

“Amaxesha amaninzi siye singafumani ngxelo yokuphazamiseka ngokwasengqondweni… izixhobo azisixeleli ukuba umntwana ukulungele psychologically.” Direct translation: Most times, we do not get reports of psychological challenges…our tools do not tell us whether the child is psychologically ready.This account reflects an awareness of the epistemic limits of medical screening instruments, which are designed to detect illness rather than emotional or psychological preparedness. The phrase “azisixeleli” (they do not tell us) underscores a diagnostic gap where internal states such as fear, anxiety, or coercion remain invisible, despite their relevance to initiation outcomes. This acknowledgement destabilises the assumption that medical clearance equates to holistic readiness.

Expanding on this limitation, another medical practitioner explained:

“Ezizixhobo zezokujonga ukugula hayi enyinyinto… yiyo ke lonto silisebe lezempilo siye sibandakanye noonontlalontle ukwenzela bakwazi ukwenzi ipsychological assessment emntwaneni.” Meaning: “These tools are for diagnosing illnesses, not for treating them... that’s why we, the health department, involve social workers so that they can conduct a psychological assessment on the child.”This statement offers a critical distinction between illness detection and psychological assessment, explicitly positioning social workers as necessary collaborators. The reference to the involvement of social workers indicates institutional recognition that psychological readiness falls outside the scope of medical practice. This reinforces the view that interdisciplinary assessment is not optional but essential for effective safeguarding.

Initiates themselves reflected on experiences of psychological screening, particularly regarding coercion and peer pressure. One initiate stated:

“Baye bakuphonononge bajonge ukuba azikho na ezinye izinto ezikunyanzelisayo ukuba uye esuthwini… nokuba akukho peer pressure ibangela ufune ukwaluka.” Translated to mean: “They will assess you and see if there are any other factors that are forcing you to go to the toilet… and if there is any peer pressure that is causing you to want to get circumcised.”This account highlights psychological assessment as a mechanism for protecting agency and voluntariness. The emphasis on “ezikunyanzelisayo” (things that force you) reveals awareness that initiation decisions may be shaped by social pressure rather than personal readiness. This underscores the preventative role of psychosocial assessment in identifying hidden vulnerabilities before initiation.

Parents also expressed concern that behavioural and psychological issues often emerge when such assessments are overlooked. One parent remarked:

“Isimo sokuziphatha komntwana siso esifika sixake pha esuthwini, abuye nasekhayeni angaziphathi kakuhle.” Meaning: The child’s behaviour is what gets him into trouble in school, and he comes home misbehaving. This statement links the absence of psychological screening to post-initiation behavioural difficulties, suggesting that unresolved emotional or behavioural issues manifest during seclusion and persist after return. The phrase “sifika sixake” (becomes problematic there) indicates that initiation environments may intensify pre-existing psychological challenges rather than resolve them.

Social workers strongly emphasised the need for holistic assessment, distinguishing their role from that of medical practitioners. One social worker explained:

“The holistic assessment can identify whether the child is going to the initiation school in his own accord, not because of peer pressure or being forced by the parent.”

This account frames psychological assessment as a safeguard for autonomy and informed participation. The emphasis on “his own accord” reflects a rights-based yet culturally sensitive approach that aligns with Indigenous Knowledge Systems, where readiness is understood as moral, emotional, and social preparedness rather than mere physical fitness.

Further reinforcing professional boundaries, another social worker stated:

“Doctors should end on medical assessment and refer to social workers and psychologists for psychological or psychosocial assessment.”

This assertion reflects stakeholder consensus that role clarity is essential for effective initiation governance. By advocating referral rather than role overlap, the participant highlights the dangers of conflating physical and psychological readiness, which can leave initiates unprotected from non-medical risks.

Collectively, these accounts demonstrate that stakeholders widely recognise psychological and mental health assessment as a critical yet insufficiently institutionalised component of ulwaluko. While medical screening is firmly embedded within the initiation process, psychological readiness remains unevenly addressed, despite its significance for safety, dignity, and behavioural outcomes. The convergence of views across doctors, parents, initiates, and social workers strengthens the argument that excluding social workers from formal initiation frameworks creates a structural gap that undermines both initiate well-being and the holistic foundations of ulwaluko as an Indigenous Knowledge System.

3.4. Gender and Cultural Protocols in Social Work Involvement

Gender and cultural protocols emerged as a sensitive, yet highly contested theme in relation to social workers’ involvement in ulwaluko. Participants consistently emphasised that ulwaluko is governed by sacred male-only rituals, particularly during seclusion, which necessitate strict adherence to cultural norms regarding gendered access and participation. At the same time, stakeholders acknowledged the importance of psychosocial support, creating tension between cultural preservation and professional inclusion.

Social workers themselves articulated clear boundaries regarding gendered participation, as one participant stated:

“Only male social workers should be included in ulwaluko… because those rituals observed there, they are confidential and sacred only to men.”

This statement reflects an explicit recognition of ulwaluko as a gendered Indigenous Knowledge System in which access to ritual space is regulated by cultural authority rather than professional qualification alone. The emphasis on “confidential and sacred” underscores the epistemic weight of ritual knowledge, signalling that violation of gender protocols is perceived as a threat to cultural legitimacy. Rather than rejecting social work involvement outright, the quote redefines inclusion as conditional upon cultural conformity.

A similar view was echoed by another social worker, who emphasised cultural boundaries over professional entitlement:

“As social workers, we must understand that ulwaluko is not a space for everyone; it is a sacred space for men.”

This verbatim quote reflects professional reflexivity and cultural humility, positioning social workers as guests within indigenous systems rather than authoritative outsiders. The phrase “not a space for everyone” highlights that inclusion is governed by cultural rules that precede and supersede professional frameworks.

However, other stakeholders advocated for a more flexible, phased approach to gender inclusion. A CoGTA representative argued:

“I think before the boys go to the initiation school, they need to see both genders, a male and a female social worker.”

This statement introduces a temporal distinction among the stages of ulwaluko, suggesting that cultural restrictions apply most strongly during seclusion, while the preparatory and post-initiation phases allow greater gender inclusivity. The emphasis on “before” signals an attempt to reconcile cultural protocol with psychosocial support needs, without violating ritual boundaries.

Parents similarly supported differentiated roles for social workers based on timing and context. One parent noted:

“Kubalulekile ukuba unontlalontle angene ngaphambi kokuba umntwana aye esuthwini, ngoba khona apho kungathethwa ngezinto zengqondo.” Translation: It is important that a social worker comes in before the child goes to the hospital, because that is where mental health issues can be discussed.

This account frames psychosocial intervention as preparatory rather than intrusive, reinforcing the idea that psychological readiness can be addressed without entering sacred ritual spaces. The phrase “phambi kokuba” (before) reinforces temporal respect for cultural boundaries.

Some participants also drew on comparative cultural contexts to legitimise gendered differentiation. One social worker explained:

“In some cultures, like in Lesotho, women do go to the mountain for initiation… but here in the Eastern Cape, the rules are different.”

This statement highlights cultural specificity within Indigenous Knowledge Systems, rejecting homogenised or universal approaches to initiation practices. By contrasting regional norms, the participant demonstrates that gender protocols are context-bound and must be interpreted locally rather than imposed externally.

Despite these constraints, stakeholders consistently rejected the notion that cultural protocol should exclude psychosocial care altogether. A parent articulated this balance by stating:

“Isiko malihlonitshwe, kodwa ukhuseleko lomntwana nalo lubalulekile.” Meaning: Tradition must be respected, but the child’s safety is also important.

This account reflects an integrative perspective in which cultural respect and child protection are not mutually exclusive. The use of “kodwa” (but) signals a negotiation rather than a rejection of tradition, emphasising that cultural systems are capable of adaptation when safety is at stake.

These accounts reveal that gender and cultural protocols do not constitute resistance to social work involvement per se but rather define the conditions under which such involvement is considered legitimate. Stakeholders advocate for culturally congruent inclusion that respects sacred male-only spaces while allowing psychosocial support at appropriate stages. This theme reveals that the exclusion of social workers from formal legislative frameworks does not stem from cultural incompatibility, but from a failure to recognise differentiated, culturally grounded roles that align with Indigenous Knowledge Systems governing ulwaluko.

3.5. Challenges, Fatalities, and Government Intervention

Challenges associated with ulwaluko, particularly fatalities, injuries, and psychosocial harm, were consistently linked by participants to systemic failures rather than cultural inadequacy. Stakeholders identified unregulated initiation schools, lack of coordination, insufficient role clarity, and strained relationships between government structures and traditional authorities as central contributors to preventable harm. While government intervention was widely acknowledged as necessary, participants emphasised that its effectiveness depends on how it engages with indigenous governance systems.

Parents expressed concern about high-risk initiation sites, with one parent stating:

“Ndicinga ukuba ikhona into urhulumente angayenza… ngokujonga iindawo ezidla ngokuba neengozi zokubhubha okanye ukulimala kwabakhwetha.” Translation being: I think there is something the government can do… by looking at places that are prone to death or injury to initiates. This account reflects an expectation that state intervention should be anticipatory and protective rather than reactive. The reference to “iindawo ezidla ngokuba neengozi” (places prone to danger) suggests that fatalities are patterned and predictable, reinforcing the need for targeted monitoring rather than blanket interference.

Another parent elaborated on the consequences of poorly coordinated intervention:

“Urhulumente ufika afune kwenziwe ngendlela yakhe nokuba zange kwabonwa siphene kule bekuhleli kuqhutywa ngayo.” This is translated to mean: The government comes in and demands things be done its way, even if no flaws have been seen in the way things have always been done. This statement reflects resistance to top-down governance approaches that disregard long-standing indigenous systems that have historically functioned without fatalities. The phrase “indlela yakhe” (his way) signals perceived epistemic dominance, undermining trust and cooperation among stakeholders.

Concerns about tension between state and traditional leadership were echoed by another participant, who stated:

“Lonto ixabanisa urhulumente neeNkosi.” Meaning: This is causing conflict between the government and the Chiefs.

Although brief, this statement captures the relational breakdown that arises when interventions are perceived as intrusive. It highlights that the conflict between authorities weakens collective accountability and compromises the initiative of safety.

A CoGTA representative acknowledged institutional shortcomings, noting:

“I think there are fatalities because there is some lack of knowledge on who should be involved on legal bases; therefore, I think we need to do more roadshows.”

This quote frames fatalities as consequences of informational and coordination gaps rather than cultural practices. The emphasis on “who should be involved” reflects uncertainty around stakeholder roles, reinforcing calls for education and structured collaboration.

Another parent clarified what they perceived as the appropriate scope of government involvement:

“Urhulumente indima yakhe kukuba aqinisekise ukuba amakhankatha ayingobophuli bomthetho, aphele apho.” Meaning: The government’s role is to ensure that the traditional nurses are not criminals, and that’s it.

This statement delineates a regulatory rather than cultural role for the state, suggesting that safety can be enhanced through enforcement of legal compliance without encroaching on ritual authority. The phrase “aphele apho” (should end there) underscores the importance of boundaries in intervention.

Participants further highlighted that ineffective intervention is often linked to inadequate consultation. One parent remarked:

“Urhulumente akathethi nathi kuqala, ufike sele enezigqibo.” Meaning: The government doesn’t talk to us first, it arrives with its decisions already made.

This account reflects exclusion from decision-making processes, reinforcing perceptions of imposed governance. The absence of consultation weakens collective ownership of safety measures and exacerbates resistance.

Finally, stakeholders repeatedly returned to collaboration as the primary solution to fatalities. One participant stated:

“Ukuba sonke siyasebenzisana, abantwana bangabuyela bephila.” Translated to mean: If we all work together, the children can come back alive.

This statement reflects convergence across stakeholder groups that safety is relational and collective. The phrase “sonke siyasebenzisana” (if all of us work together) situates responsibility across families, traditional leaders, professionals, and government, reinforcing the view that no single actor can prevent fatalities in isolation.

Collectively, these accounts demonstrate that stakeholders accept government intervention per se, but critique its form and execution. Fatalities are understood as outcomes of fractured relationships, unclear roles, and exclusionary governance rather than failures of ulwaluko as an Indigenous Knowledge System. Participants advocate for collaborative, culturally respectful interventions that strengthen indigenous authority while ensuring accountability and safety, thereby restoring confidence in ulwaluko and protecting initiates’ lives.

3.6. Cultural Competence, Collaboration, and Improvement Strategies

Cultural competence and collaboration emerged as central pillars for strengthening ulwaluko and improving initiate safety without eroding cultural integrity. Stakeholders consistently emphasised that effective interventions must be grounded in respect for indigenous belief systems, traditional authority, and community knowledge. Rather than advocating for the replacement of customary practices, participants highlighted culturally informed collaboration, dialogue, and professional humility as key strategies for restoring dignity and preventing harm.

Social workers explicitly articulated cultural humility as foundational to their involvement. One social worker stated:

“I respect them and their belief system.”

Although brief, this statement reflects a deliberate ethical positioning in which professional authority is subordinated to indigenous epistemologies. Respect here functions not merely as an attitude, but as a practice principle that governs engagement, trust-building, and legitimacy within sacred cultural spaces.

Expanding on this relational stance, another social worker emphasised collaborative engagement with traditional authority:

“Inkosi noBhodi ngabona babaziyo abantu babo ekuhlaleni… ukusebenzisana nabo kusincedisa.” Meaning: The Chief and the Local leader know their people best in the community… working with them helps us.

This account situates traditional leadership as the primary custodians of knowledge and social regulation, reinforcing that culturally competent practice requires alignment with indigenous governance structures rather than parallel or competing systems.

Parents similarly stressed the importance of balance between respect for culture and child protection. One parent stated:

“Isiko malihlonitshwa, kodwa ukhuseleko lomntwana nalo lubalulekile.” This means: the tradition must be respected; however, the safety of our children is also important.

The use of “kodwa” (but) signals negotiation rather than opposition, reflecting an understanding that cultural continuity and safety are mutually reinforcing when addressed through respectful collaboration.

Another parent further emphasised the need for cooperation rather than confrontation:

“Xa kusenziwa izinto ngokusebenzisana, abantu bayazivula iingqondo.” Translation: “When people are working together, they open their minds.”

This statement highlights collaboration as a relational process that facilitates openness and mutual understanding. It suggests that resistance often arises not from opposition to safety measures, but from exclusionary or imposed approaches.

Stakeholders also identified education as a culturally congruent improvement strategy. A CoGTA representative remarked:

“I think we need to do more roadshows so that people understand what is required by the Act and who should be involved.”

Roadshows are framed here as dialogical platforms rather than enforcement tools, aligning with Indigenous Knowledge Systems that privilege communal learning, consultation, and collective sense-making.

Another CoGTA representative reinforced the importance of early engagement with communities:

“Ukuba urhulumente uthethe nabantu kwangethuba, izinto zingahamba ngcono.” Meaning: “If the government were to engage people in time, things would be better.”

This account positions consultation as preventative rather than reactive, suggesting that timely engagement can mitigate conflict and enhance compliance without undermining cultural authority.

Medical practitioners also contributed to improvement strategies by emphasising role clarity and referral pathways Between medical and psychosical practitioners. This collaborative approach was seen as essential for ensuring holistic care rather than fragmented interventions.

Parents further emphasised the value of community-based monitoring, noting:

“Abantu ekuhlaleni mababandakanywe, kuba bayazazi ezi ndawo nezinto ezenzekayo.” Direct translation: people in our communities should be involved because they know these places and what happens there.

This statement foregrounds local knowledge as a protective resource, positioning communities as active agents in safeguarding initiatives rather than passive recipients of regulation.

Finally, stakeholders consistently linked collaboration to the restoration of dignity in ulwaluko. One participant stated:

“Xa sisebenzisana sonke nonontlalontle, ulwaluko luyahlonitshwa kwaye lukhuseleke.” Directly translated to mean: When we all work together with social workers, circumcision is respected and safe.

This concluding account encapsulates convergence among participant groups, reinforcing the idea that dignity, safety, and legitimacy are co-produced through culturally grounded collaboration rather than unilateral control. These accounts demonstrate that stakeholders envision the strengthening of ulwaluko through culturally competent collaboration, education, role clarity, and community engagement. Social workers are positioned as respectful partners who enhance psychosocial safety while honouring Indigenous Knowledge Systems, and improvement strategies are framed as relational, inclusive, and restorative rather than regulatory or punitive.

4. Discussion

The findings from this study reveal the critical yet overlooked role of social workers in ulwaluko, highlighting how their integration could address psychosocial gaps within the Customary Initiation Act No. 2 of 2021. While ulwaluko remains a cornerstone of amaXhosa cultural identity, fostering masculinity, responsibility, and communal bonds (Diko 2025; Gqeba 2024), the persistent challenges of fatalities, psychological distress, and inadequate preparation reveal systemic limitations in current regulatory frameworks. Grounded in Indigenous Knowledge Systems, the study reveals stakeholder consensus on the need for holistic assessments that extend beyond biomedical screening, aligning with calls for decolonised approaches to child protection and cultural rites (Mugumbate 2025; Siswana 2017).

Stakeholder roles and responsibilities in ulwaluko reflect a collective, interdependent framework rooted in communal accountability, where traditional leaders, parents, medical practitioners, and social workers each contribute to the rite’s legitimacy and safety. This mirrors broader African initiation practices, where rites serve as mechanisms for moral and leadership development (Gqeba 2024). However, the findings indicate a biomedical bias in the Act, which marginalises psychosocial expertise, as evidenced by medical practitioners’ admissions of limitations in assessing emotional readiness. Bottoman et al. (2009) similarly noted that peri-rite psychological issues, such as anxiety and behavioural maladjustment, often go unaddressed in traditional male circumcision (TMC) contexts, leading to long-term distress among initiates. The involvement of social workers in ulwaluko, as participants advocated, could incorporate culturally sensitive interventions that foster “good relationships” (ubudlelwane obuhle) and align with IKS principles of ubuntu and shared responsibility (Diko 2025). Nomngcoyiya and Kang’ethe (2019) argued that policy shortcomings in the Eastern Cape exacerbate these gaps and recommended interdisciplinary collaboration to enhance dignity and reduce risks.

The preparation and screening process emerged as a structured yet incomplete pathway, emphasising sequential consent from families, communities, and authorities, but lacking robust psychosocial evaluation. Participants described this as a “long process” (process ende) involving parental approval, traditional endorsement, and medical checks, yet highlighted its insufficiency in addressing behavioural and emotional preparedness. This resonates with Kepe’s (2010) analysis of ritual male circumcision crises in the Eastern Cape, where inadequate preparation contributes to fatalities due to unaddressed vulnerabilities like coercion or peer pressure. Gittings et al. (2021) found that young men’s engagement with health services during ulwaluko is often hindered by cultural secrecy and biomedical focus, suggesting that pre-initiation psychosocial assessments could mitigate these issues without violating ritual integrity. Integrating social workers here would enable holistic evaluations, as supported by Mpateni and Kang’ethe (2022), who documented poor standards in unlicensed schools leading to physical and emotional harm, underscoring the need for regulatory reforms that prioritise IKS-informed consent and readiness.

Psychological and mental health assessment was identified as a vital yet marginalised component, with stakeholders noting that medical tools fail to detect emotional unpreparedness or coercion, potentially exacerbating post-initiation behavioural issues. This finding aligns with Bottoman et al.’s (2009) exploration of peri-rite psychological challenges among amaXhosa men, including mood instability and internalised trauma, which persist without targeted interventions. Ntozini and Ngqangweni (2016) further highlighted how marginalised groups, such as gay initiates, experience heightened distress during ulwaluko due to unaddressed identity conflicts, advocating for inclusive psychosocial support. Participants’ calls for social workers to conduct these assessments reflect a rights-based approach, ensuring initiates proceed “on their own accord,” as one social worker noted. Such integration could recalibrate the Act toward open, restorative practices, countering the oppressive dynamics observed in closed initiation models (Nomngcoyiya and Kang’ethe 2019) and promoting emotional resilience in line with IKS subsystems of moral education (Mugumbate 2025).

Gender and cultural protocols present a nuanced tension: stakeholders advocate male-only social worker involvement during seclusion to preserve ritual sanctity, while allowing flexible inclusion in preparatory phases. This conditional inclusion respects ulwaluko as a “sacred space for men,” as articulated by participants, echoing Siswana’s (2017) emphasis on decolonising masculinity constructions without external imposition. Makupula (2026) explored Xhosa women’s subjugation during ulwaluko, noting patriarchal restrictions that extend to professional roles, yet the findings suggest adaptive strategies, such as phased gender involvement, could balance cultural humility with child protection. Kepe (2010) similarly critiqued state interventions that disregard custodianship, arguing for collaborative models that honour indigenous authority. The prioritisation of male social workers and cultural competence, as recommended, would allow the profession to avoid epistemic dominance and enhance trust, aligning with Afrocentric perspectives that value relational epistemologies (Gqeba 2024).

Challenges, fatalities, and government interventions were attributed to systemic failures, such as unregulated schools and exclusionary governance, rather than inherent cultural flaws. Participants linked high mortality to poor coordination and lack of consultation, calling for roadshows and community-embedded monitoring. This corroborates Mpateni and Kang’ethe’s (2022) documentation of unlicensed Eastern Cape schools contributing to infections and dehydration, with over 20 deaths reported in 2019 alone (Moyer et al. 2022). Gittings et al. (2021) highlighted how stigma and secrecy exacerbate health risks, particularly for HIV-positive initiates, demonstrating the need for integrated psychosocial and medical responses. Stakeholders’ emphasis on “working together” (siyasebenzisana) supports Nomngcoyiya and Kang’ethe’s (2019) policy recommendations for stakeholder partnerships, framing government roles as regulatory rather than intrusive, to restore ulwaluko’s dignity within a democratic framework.

Finally, cultural competence, collaboration, and improvement strategies reveal the potential for social workers to bridge indigenous and modern paradigms through humility, education, and role clarity. Participants’ advocacy for respecting belief systems aligns with Spaumer et al.’s (2025) social work perspective on TMC, which calls for ecological systems approaches that integrate family, community, and state levels. As such, fostering dialogue through roadshows and referrals, as suggested, could harmonise IKS with the Act, reducing fatalities while preserving cultural integrity (Kepe 2010; Mugumbate 2025). These reforms would empower amaXhosa voices, decolonise knowledge production, and sustain ulwaluko as a vital rite of manhood and leadership (Diko 2025; Siswana 2017) in contemporary South Africa, in general, and the Eastern Cape province in particular.

5. Implications for the Customary Initiation Act No. 2 of 2021

The findings of this study reveal critical gaps in the Customary Initiation Act No. 2 of 2021 (RSA 2021), particularly its biomedical and regulatory orientation, which excludes explicit provisions for social workers and psychosocial assessments, despite addressing safety, consent, and health risks in ulwaluko. While the Act establishes oversight structures, such as the National Initiation Oversight Committee (NIOC) and Provincial Initiation Coordinating Committees (PICCs), and mandates registration of initiation schools, traditional surgeons, and caregivers, it prioritises physical health screenings by medical practitioners (sections 24 and 30) and traditional authority (sections 20–23), without institutionalising holistic psychosocial readiness evaluations. This omission perpetuates systemic vulnerabilities, as stakeholders consistently highlighted that medical tools fail to detect emotional unpreparedness, coercion, peer pressure, or behavioural issues that contribute to fatalities, psychological distress, and post-initiation challenges.

The Act’s emphasis on voluntary consent (section 28), prohibitions on abduction or abuse, and requirements for water, sanitation, food, and healthcare (section 30) partially aligns with stakeholder calls for safer, accountable processes. However, the absence of mandated psychosocial screening undermines these safeguards, as unprepared initiates may face intensified risks during seclusion, leading to preventable harm (Kepe 2010; Mpateni and Kang’ethe 2022). Participants advocated for social workers’ involvement in preparatory assessments to ensure initiates proceed on their “own accord,” reflecting a rights-based approach that complements the Act’s constitutional grounding in life, bodily integrity, cultural rights, and child protection (Preamble; Children’s Act 2005). Integrating such assessments would address the Act’s limitations in tackling psychosocial dimensions, fostering culturally congruent interventions rooted in Indigenous Knowledge Systems and ubuntu principles (Mugumbate 2025; Siswana 2017).

Gender and cultural protocols further expose tensions within the Act’s framework. While the legislation respects customary authority and prohibits harmful practices, it does not explicitly accommodate differentiated professional roles, such as male-only social workers during sacred male spaces, to balance cultural preservation with psychosocial support. Stakeholders proposed phased involvement (preparatory phases open to broader input, seclusion restricted), which could inform amendments without violating ritual sanctity (Spaumer et al. 2025). This approach would enhance the Act’s implementation by promoting collaboration among traditional leaders, medical practitioners, parents, and professionals, reducing relational fractures that contribute to fatalities and unregulated schools (Nomngcoyiya and Kang’ethe 2019).

Challenges like ongoing deaths, mutilations, and poor coordination, evident in Eastern Cape reports of high fatalities despite the Act, stem from enforcement gaps, lack of stakeholder clarity, and limited community engagement (Centre for Human Rights 2021; COGTA strategic plans). The Act’s provisions for monitoring (section 36), regulations (section 35), and provincial peculiarities (section 37) offer mechanisms for improvement, yet stakeholders emphasised the need for roadshows, education, and inclusive consultations to build awareness and compliance. Explicit inclusion of social workers could strengthen these by providing counselling, trauma support, and advocacy for marginalised initiates, aligning with the Act’s objectives of accountability and harm prevention.

Policy implications call for targeted amendments to the Act, including, inter alia:

• Mandating psychosocial assessments by qualified social workers as part of pre-initiation screening and consent processes.
• Clarifying interdisciplinary referrals between medical practitioners and social workers.
• Incorporating culturally sensitive guidelines for gender protocols in professional involvement.
• Enhancing community education and monitoring through PICCs to address enforcement shortfalls.

Such reforms would decolonise the regulatory framework by centring amaXhosa epistemologies, harmonising tradition with modern protections, and reducing oppressive dynamics in initiation governance (Diko 2025; Gqeba 2024). Ultimately, embedding social work expertise would advance the Act’s goal of safer, dignified ulwaluko, protecting initiates’ rights while sustaining cultural integrity in contemporary South Africa.

Implications for Social Work Practice

The findings of this study carry significant implications for social work practice in the context of ulwaluko and the Customary Initiation Act No. 2 of 2021, particularly in promoting culturally congruent, rights-based, and holistic interventions that bridge IKS with professional expertise. Stakeholders’ broad support for integrating social workers reveals the profession’s potential to address psychosocial gaps in current biomedical and regulatory frameworks, thereby enhancing initiate safety, dignity, and well-being without eroding cultural integrity.

Social workers are uniquely positioned to conduct culturally sensitive psychosocial assessments during the preparation phase, identifying emotional vulnerabilities, coercion, peer pressure, or behavioural unreadiness that medical tools overlook (Spaumer et al. 2025). This aligns with anti-oppressive practice principles, which call for social workers to advocate for initiates’ autonomy and informed consent while respecting gendered cultural protocols, such as limiting involvement to male practitioners during seclusion (Kasa 2025). By facilitating referrals from medical practitioners and collaborating with iinkosi and CoGTA, social workers can foster interdisciplinary partnerships that strengthen collective accountability and ubuntu-based relationships, as participants emphasised.

In addressing challenges like fatalities and psychological distress, social workers can provide pre- and post-initiation counselling, trauma support, and family mediation, particularly for initiates experiencing stigma from health complications or behavioural issues (Mpateni and Kang’ethe 2022). This restorative approach counters oppressive dynamics by prioritising emotional resilience and community reintegration, drawing on IKS to promote moral education and leadership development rather than punitive measures (Mugumbate 2025). For marginalised groups, such as those facing identity conflicts, social workers can advocate for inclusive adaptations that mitigate exclusion while upholding human rights (Ntozini and Ngqangweni 2016).

Practice implications extend to capacity building and advocacy. Social workers should engage in cultural humility training to navigate sacred spaces respectfully, avoiding epistemic imposition (Siswana 2017). They can support community education through roadshows, as recommended by participants, to clarify stakeholder roles, raise awareness of the Act’s provisions, and promote licensed initiation schools (Nomngcoyiya and Kang’ethe 2019). Policy advocacy is crucial: social workers should lobby for amendments to the Act that explicitly include psychosocial assessments and social work roles, ensuring alignment with child protection mandates under the Children’s Act and broader human rights frameworks (Spaumer et al. 2025).

Eventually, embedding social work in ulwaluko advances decolonised practice by centring amaXhosa voices, harmonising tradition with modern safeguards, and restoring the rite’s dignity as a mechanism for manhood and communal solidarity (Diko 2025; Gqeba 2024). This positions the profession as a respectful partner in cultural preservation and risk reduction, contributing to safer, more equitable outcomes for initiates in post-apartheid South Africa.

6. Conclusions

This qualitative phenomenological study has illuminated stakeholder perspectives on the absence of a professional role for social workers in ulwaluko under the Customary Initiation Act No. 2 of 2021 (RSA 2021). Through centring amaXhosa voices, traditional leaders, medical practitioners, parents, amakrwala, CoGTA representatives, and social workers, the study reveals a shared recognition that ulwaluko, as a profound rite of passage rooted in Indigenous Knowledge Systems, embodies moral education, leadership development, communal responsibility, and the construction of masculinity. However, persistent challenges, including fatalities, botched circumcisions, psychological distress, coercion, and inadequate psychosocial preparation, expose structural limitations in the Act’s predominantly biomedical and regulatory focus, which marginalises holistic, culturally sensitive intervention.

Evidently, the study concludes that, despite the Customary Initiation Act No. 2 of 2021 providing a critical regulatory framework, ulwaluko and safeguarding abakhwetha remain insufficiently addressed in its current form. Stakeholders viewed the inclusion of social workers as an opportunity to complement existing traditional and medical structures through psychosocial assessment, counselling, family engagement, referral and post-initiation support. Importantly, such involvement should be culturally grounded, respect indigenous authority, establish cultural protocols and strengthen rather than displace the responsibilities of existing stakeholders. Therefore, safeguarding ulwaluko requires a holistic and collaborative approach that addresses the physical, psychological, social, and cultural well-being of abakhwetha while preserving the rite’s cultural integrity.

The study contributes to decolonising knowledge production by amplifying amaXhosa epistemologies and challenging biomedical dominance in cultural regulation (Nomngcoyiya and Kang’ethe 2019). It calls for policy reforms, including amendments to mandate psychosocial assessments, clarify referral pathways, respect gendered protocols, and promote community education via roadshows and stakeholder partnerships. Such changes would foster safer, more inclusive ulwaluko, restoring its dignity as a mechanism for manhood, leadership, and communal solidarity in post-apartheid South Africa (Diko 2025; Gqeba 2024).

In summary, the integration of social work expertise harmonises indigenous traditions with modern safeguards, advancing human rights without cultural erasure. Future research should explore longitudinal outcomes of integrated models and conduct comparative analyses across South African provinces to further inform evidence-based, culturally responsive practice in customary initiation. This work underscores social work’s transformative potential to bridge tradition and protection, ensuring that ulwaluko remains a life-affirming rite for generations to come.