An Educational Conceptual Framework for Reducing Epilepsy-Related Stigma in Primary Schools of Limpopo and Mpumalanga Province, South Africa

Abstract

Education about epilepsy plays a vital role in reducing stigma, improving seizure response, and preventing school dropout among affected learners. Despite this importance, there is a lack of a structured conceptual framework guiding epilepsy education in primary schools, where children’s foundational learning and social development take place. This study aims to develop a conceptual framework that integrates epilepsy education into the life skills curriculum to reduce epilepsy-related stigma from an early age. A qualitative multi-methods approach was employed during the empirical phase, which was conducted in two stages using an exploratory–descriptive design. Data were collected from teachers, life skills education advisors (LEAs), and learners to explore their views on incorporating epilepsy education into the life skills curriculum of primary schools. The findings informed the development of a conceptual framework guided by the Three-Legged Stool Model and Dickoff’s Practice-Oriented Theory. This educational framework is tailored for primary school settings and highlights the roles of learners and teachers in promoting self-esteem through knowledge acquisition, value formation, and skill development, all underpinned by the Ubuntu philosophy.

1. Introduction

Epilepsy is a chronic neurological condition characterized by recurrent seizures and affects approximately 50 million people worldwide, with around 80% residing in low- and middle-income countries [1]. Children with epilepsy often face substantial challenges that affect their academic, emotional, and social well-being, including stigma, discrimination, and exclusion from peers and school activities [2,3]. Limited public knowledge about epilepsy contributes to negative attitudes, which in turn reinforce prejudice and isolation of people with epilepsy [4,5]. Common misconceptions include beliefs that epilepsy is caused by witchcraft or demonic possession, or that it is contagious [6,7,8]. These misconceptions are typically rooted in inadequate education and cultural myths [9,10].

In South Africa, these issues are particularly significant in provinces such as Limpopo and Mpumalanga, which consist of a mix of rural and peri-urban school environments that often face limited access to healthcare services, uneven educational resources, and challenges in teacher development. These provinces are marked by persistent structural inequalities, including poverty, low health literacy, and under-resourced schools, which together exacerbate the stigma and social exclusion experienced by learners with chronic conditions like epilepsy [8,11,12]. In these two provinces, primary schools have large classes, which makes it difficult for teachers to give individual attention. Disparities between rural and urban infrastructure, coupled with cultural misconceptions and inadequate health education, further limit the provision of inclusive and supportive educational services in these settings [12,13]. These social determinants compound the vulnerability of children with epilepsy and heighten the risk of school dropout and stigma.

Approximately 17% of learners with epilepsy drop out of school, often due to stigma and misunderstanding by both peers and educators [14]. These findings are consistent with international research showing that learners with epilepsy commonly discontinue their education due to social exclusion and lack of understanding from others [9,14,15]. Addressing this issue requires improving the public’s understanding of epilepsy to dispel myths and misconceptions [9].

Life Skills education, which is part of the national curriculum for Grades R to 7 under the South African Department of Basic Education (DBE), includes components on health promotion, safety, social responsibility, and emotional development [16]. However, epilepsy education is not explicitly included, despite its significant public health impact [17]. Research indicates that learners continue to believe epilepsy is either contagious or a spiritual curse [9,11].

Educating all learners about epilepsy is not only for those diagnosed with it; it can promote a more inclusive school environment, empower peers to respond appropriately during seizures, and reduce discriminatory behaviors [18]. However, there remains a gap in formal strategies or curricula to deliver such education in South African primary schools. Additionally, the role of Life Skills Education Advisors (LEAs), who support curriculum development and teacher training, is not clearly defined in relation to epilepsy education. Given the significant effect of epilepsy on learners’ educational outcomes and social integration, there is a pressing need to integrate targeted epilepsy education into the Life Skills curriculum. Primary school teachers play an important role in promoting inclusive education for students living with epilepsy, addressing stigma, and improving overall educational outcomes [19]. It is important to educate learners on how to provide adequate support and care for individuals experiencing seizures, fostering a sense of security and inclusion within the school environment [11].

Given this gap, this study introduces a conceptual framework designed to guide the inclusion of epilepsy education within the life skills curriculum in Limpopo and Mpumalanga Provinces. This framework aims to build learner and teacher capacity, reduce stigma, and improve inclusion of children with epilepsy by using culturally grounded, context-appropriate strategies.

2. Material and Methods

The investigation employed a qualitative multi-method approach, guided by an exploratory-descriptive design to explore the feasibility and significance of incorporating epilepsy into the Life Skills curriculum in South African primary schools. The participants in this study included primary school teachers, Life Skills Educational Advisors (LEAs), and learners. Drawing data from these diverse sources enabled a rich, context-sensitive understanding of perceptions and experiences related to epilepsy education [8,18,20,21].

The research was carried out in public primary schools located in Limpopo and Mpumalanga Provinces, regions known for their predominantly rural and peri-urban demographics. The study was conducted in a single empirical phase, which was organized into two sequential stages. Stage 1 focused on teachers and LEAs, while Stage 2 engaged learners directly. Insights gathered during both stages informed the development of a conceptual framework (CF) aimed at reducing epilepsy-related stigma through structured Life Skills education.

2.1. Study Setting

Limpopo and Mpumalanga are two predominantly rural provinces located in the northern and eastern regions of South Africa, respectively. These provinces are characterized by widespread poverty, with unemployment rates estimated at 58.7% in Limpopo and 64.4% in Mpumalanga [22,23]. Many households rely on subsistence farming, informal trading, or seasonal labor to support their livelihoods [24,25]. These socioeconomic challenges are accompanied by limited access to quality education and healthcare infrastructure, particularly in remote rural areas [18,24].

The population in both provinces is culturally diverse, comprising ethnic groups such as the Pedi, Tsonga, Venda, Swati, and Ndebele people. Understanding this cultural heterogeneity is essential when designing school-based health education interventions, especially around sensitive issues such as epilepsy [11]. In terms of education, both provinces struggle with poorly resourced schools, a shortage of qualified teachers, overcrowded classrooms, and limited access to teaching and learning materials [21]. These challenges have been found to affect learner outcomes, especially in rural settings.

In South Africa, Life Skills is a compulsory subject taught from Grade R to Grade 7 as part of the national Curriculum and Assessment Policy Statement (CAPS), introduced in 2012 [26]. The subject includes content on health promotion, emotional well-being, safety, and social values [16]. However, epilepsy is not currently included in the Life Skills curriculum, despite its public health relevance and the stigma associated with it. Integrating epilepsy education into this curriculum would be a logical and beneficial extension of existing health topics [18].

Given the intersection of poverty, health inequities, and widespread misinformation about epilepsy, Limpopo and Mpumalanga represent suitable contexts for school-based interventions. Including epilepsy education in primary schools may help promote health literacy, reduce stigma, and empower both learners and their communities with accurate knowledge.

2.2. Sampling Procedure, Data Collection, and Analysis

Stage 1: Perspectives of Teachers and Life Skills Education Advisors

A non-probability purposive sampling strategy was used to select 20 primary school teachers, based on the rationale that their classroom experience and familiarity with the Life Skills subject made them appropriate participants. The inclusion criteria were:

• Holding a recognized teaching qualification as defined in the Employment of Educators Act (Act 76 of 1998).
• Teaching or having taught Life Skills for a minimum of 12 months.
• Employed in public primary schools located in Limpopo or Mpumalanga.

For LEAs, a snowball sampling method was used to identify eight participants, with the assumption that their direct involvement in Life Skills curriculum support, especially regarding health topics like HIV, TB, and sexual health, made their insights essential. Only LEAs working in the relevant educational districts were considered.

2.3. Data Collection Process

Semi-structured interviews were conducted using an interview guide developed from literature and reviewed by subject experts. Key guiding questions included:

• “What do you know about epilepsy?”
• “Do you think epilepsy should be part of Life Skills education? Why?”
• “What topics about epilepsy should be taught in each grade level?”
• “What teaching methods would you suggest for epilepsy education?”

Interviews were conducted in private, quiet locations, at schools for teachers and at district offices for LEAs, during working hours arranged with participants’ availability. Interviews were conducted in Tshivenda, Xitsonga, or Swati, depending on participant preference, and each session lasted between 30 and 45 min. Participants provided written informed consent, including permission to record the sessions.

2.4. Data Analysis

Recordings were transcribed verbatim and translated into English by certified language professionals. Data were analyzed using ATLAS.ti software version 22 following the Notice–Collect–Think (NCT) method. Transcripts were read multiple times, and initial codes were generated. Codes were grouped by similar meaning and highlighted with color tags to generate themes and sub-themes.

To enhance credibility, the coded data were also reviewed by an independent coder. A comparison meeting was held between the lead researcher and the independent coder to resolve discrepancies and agree on final themes. This process ensured confirmability and reduced potential bias.

Stage 2: Learners’ Perspectives

The second stage focused on understanding how learners themselves perceive epilepsy and the potential inclusion of epilepsy education in the Life Skills curriculum. This was essential since learners are the primary recipients of such content and their perceptions could reveal knowledge gaps or cultural beliefs influencing stigma.

2.5. Sampling and Participants

A purposive sampling strategy was employed to select 36 learners (six per group) from Grades 4 to 7 across multiple rural public primary schools in Limpopo and Mpumalanga provinces. The inclusion of learners from Grades 4 to 7 was based on the informed judgment that children within this age range possess sufficient cognitive and communicative abilities to comprehend and respond meaningfully to the research questions [22]. Both male and female learners were included to ensure gender representation. The participating schools were selected following the acquisition of formal approval from school principals and governing bodies. Learners were included based on:

• Being enrolled in Grades 4 to 7;
• Regular school attendance;
• Aged between 9 and 13 years;
• Able to provide written assent, with parental/guardian written consent.

2.6. Data Collection Process

Data were collected through Focus Group Discussions (FGDs), conducted at school premises in safe and confidential environments. FGDs were guided by an age-appropriate interview schedule, adapted from Stage 1 and simplified in language. Discussions were conducted in local languages (Tshivenda, Xitsonga, and Swati), and each session lasted around 40–60 min.

Sample FGD questions included:

• “What have you heard or learned about epilepsy?”
• “Would you like to learn about epilepsy in school? Why?”
• “What would help learners understand epilepsy better?”
• “How should teachers teach about epilepsy?”

Each session was facilitated by the lead researcher, supported by trained research assistants. Learners were assigned pseudonyms (e.g., Learner A–F) to maintain anonymity. Discussions were recorded only after consent and assent had been obtained. In both stages, the final sample sizes were determined through data saturation, the point at which no new information emerged during data collection. This was confirmed through repetition of themes and participant responses, as supported by recent literature on saturation thresholds in educational and health-related qualitative research [27,28].

2.7. Data Analysis

FGD recordings were transcribed and translated, following the same NCT coding technique used in Stage 1. A different independent coder was used to analyze the learner data, ensuring impartiality. A comparison of codes and themes was conducted during a validation session, where consensus was reached on the final thematic structure.

Table 1. Qualitative Multimethod Design.

Stage	Participants	Sampling Method	Data Collection	Analysis Approach
Stage 1	Teachers (n = 20), LEAs (n = 8)	Purposive and Snowball	Semi-structured interviews	NCT method using ATLAS.ti version 22 (independent coder)
Stage 2	Learners (n = 36, Gr 4–7)	Purposive	Focus Group Discussions	NCT method using ATLAS.ti version 22 (different coder from stage 1)

summarizes empirical phase.

2.8. Ethical Consideration

The investigation was conducted with the approval of the Human and Clinical Research Ethics Committee at the University of Venda (SHS/19/PH/37/2101). In addition, permission to conduct the study was obtained from the Departments of Education in both Limpopo and Mpumalanga provinces. Following departmental approval, permission was also requested and granted by the relevant circuit offices, and subsequently by the principals of the selected primary schools. All participants and legal guardians provided written informed consent and assent forms prior to their involvement in the study. Participation was strictly voluntary, and participants were informed of their right to withdraw at any time without any penalty. Data collection, including any recordings, was conducted only after obtaining full participant consent. Throughout the research process, privacy and confidentiality were maintained in accordance with ethical standards.

2.9. Measure to Ensure Trustworthiness

Throughout the study, measures to ensure trustworthiness were strictly followed, encompassing aspects such as credibility, transferability, and dependability. Credibility was enhanced through triangulation of data sources (teachers, learners, LEAs) and member checking. Dependability was ensured through audit trails and reflexive journaling.

3. Results

This section presents findings from 64 participants comprising 20 Life Skills teachers, 8 Life Skills Educational Advisors (LEAs), and 36 learners from Grades 4–7 in Limpopo and Mpumalanga. The analysis yielded four major themes and multiple sub-themes, providing insights into the perceptions, knowledge, and suggestions related to epilepsy education within the Life Skills curriculum. Direct participant quotations are used to substantiate each theme, highlighting the diverse and culturally grounded views of stakeholders.

Theme 1:

Knowledge and Perceptions of Epilepsy.

Participants across all stakeholder groups demonstrated varying degrees of understanding about epilepsy. While some identified it as a health condition, others held misconceptions rooted in cultural beliefs.

Sub-Theme 1.1.

Epilepsy as a Health Condition.

Teachers and LEAs commonly acknowledged epilepsy as a chronic condition requiring medical attention. Many correctly associated it with neurological disruptions and physical manifestations such as seizures or fainting. However, this understanding was often superficial, with few able to articulate causes, types, or management strategies beyond seizure control. The following is one of the participants’ quotations.

“What I know is it’s a health condition. They sometimes fall or become unconscious, but with medication, they can be okay.”

(LEA, P1)

Sub-Theme 1.2.

Epilepsy as a Supernatural or Cultural Phenomenon.

Cultural interpretations of epilepsy emerged strongly among participants, especially in rural contexts. Several respondents associated epilepsy with witchcraft, ancestral calling, or spiritual punishment.

“In our culture, when the moon is half, they say someone with epilepsy will fall sick, that’s when they say it’s witchcraft.”

(Teacher, P2)

These beliefs contribute to stigma, discrimination, and a reluctance to engage in medical management or open discussion.

Sub-Theme 1.3.

Myths and Misinformation.

Teachers described persistent myths, such as the belief that epilepsy is contagious or that placing objects in the mouth can prevent tongue injuries. These misconceptions illustrate gaps in health literacy.

“We were told to put a spoon in their mouth to stop them from biting their tongue. I didn’t know that was wrong until now.”

(Teacher, P13)

Theme 2.

Importance of Including Epilepsy in Life Skills Education.

There was strong consensus across all groups that integrating epilepsy education into the Life Skills curriculum would be beneficial in reducing stigma and enhancing peer support and community awareness.

Sub-Theme 2.1.

Learner Impact.

LEAs, teachers and learners agreed that introducing epilepsy education would foster empathy, reduce mockery, and empower children to provide support during seizures.

“If a learner gets a seizure and I’m not in class, others will know how to help, not just laugh.”

(LEA, P2)

“It will help people understand. Some of us didn’t know epilepsy before—now I can help.”

(Learner, FG3)

Sub-Theme 2.2.

Teacher Preparedness.

Teachers emphasized the need for formal training and curriculum inclusion to guide appropriate responses during epileptic episodes. Most admitted feeling underprepared.

“Teachers need this training. We’re with learners most of the time. If we don’t understand epilepsy, we can’t help.”

(Teacher, P10)

Sub-Theme 2.3.

Community Outreach.

Participants recognized that learners could influence community beliefs, especially in rural areas where traditional misconceptions remain widespread.

“Children take what they learn to their parents. That way, even the community learns it’s not witchcraft.”

(LEA, P5)

Theme 3.

Suggested Content for Life Skills Curriculum.

Participants outlined the topics they believed should be included in epilepsy education to build health literacy and reduce misinformation.

Sub-Theme 3.1.

Basic Knowledge of Epilepsy

Stakeholders advocated for foundational education on epilepsy, including definitions, symptoms, and causes suitable for primary learners.

“They should be taught what epilepsy is, the signs, what to expect, and how to respond.”

(Teacher, P3)

Sub-Theme 3.2.

Types of Epilepsy

Teachers noted the diversity in seizure types and expressed the need for learners to understand these variations.

“Some just fall asleep, others scream or shake violently. They must know there are different types.”

(Teacher, P14)

Sub-Theme 3.3.

Management and First Aid

Practical guidance on what to do during a seizure was a universally recommended component. Participants called for clarity on safe and unsafe practices.

“Learners must know not to put anything in the mouth and to keep the person safe.”

(Teacher, P6)

Sub-Theme 3.4.

Diet and Self-Care

Teachers encouraged teaching preventive and self-care strategies, such as diet, medication adherence, and rest, to support epilepsy management.

“They should know about diet and avoid alcohol. These things help reduce seizures.”

(Teacher, P14)

Theme 4.

Suggested Teaching Methods for Epilepsy Education

Participants emphasized the importance of engaging, child-friendly methods of teaching epilepsy content, consistent with existing Life Skills pedagogy.

Sub-Theme 4.1.

Visual Media (Videos and Pictures)

Learners and educators suggested that videos and illustrated materials would simplify complex concepts and maintain engagement.

“Children learn better with pictures and videos show them how to respond.”

(LEA, P1)

Sub-Theme 4.2.

Dramatization and Role Play

Role play and dramatizations were endorsed as experiential learning strategies that promote memory retention and real-life readiness.

“Let learners act out what happens. If they’re involved, they won’t forget.”

(Teacher, P20)

Sub-Theme 4.3.

Group Discussions and Storytelling

Interactive discussions and peer engagement were seen as essential to unpack myths and reinforce accurate knowledge.

“If they discuss it together, it will stay in their minds and they can help others.”

(LEA, P4)

Sub-Theme 4.4.

Awareness Campaigns and Guest Speakers

Teachers recommended occasional awareness events or inviting healthcare professionals to lend credibility to lessons.

“Invite nurses to explain epilepsy. Even parents will listen and believe them more.”

(Teacher, P12)

The findings highlight a clear gap in epilepsy awareness and education in primary schools. Stakeholders across all groups strongly supported the inclusion of epilepsy in the Life Skills curriculum and proposed culturally sensitive, practical, and engaging teaching strategies. By empowering learners, educators, and communities with accurate knowledge, such a curriculum could significantly reduce epilepsy-related stigma in Limpopo and Mpumalanga.

4. Conceptual Framework

This study proposes an integrated conceptual framework for embedding epilepsy education into the Life Skills curriculum in primary schools across Limpopo and Mpumalanga, South Africa. The framework synthesizes the study’s empirical findings and is grounded in three theoretical foundations: the Three-Legged Stool Model, Dickoff et al.’s Practice-Oriented Theory [29], and the Ubuntu Philosophy. These theories were deliberately selected for their collective ability to address cognitive, behavioral, and cultural dimensions of stigma reduction and health promotion.

4.1. Application of the Three-Legged Stool Model

The Three-Legged Stool Model was selected to underpin the foundational logic of this conceptual framework. This model, commonly used in life skills and values education, conceptualizes effective learning as a balance between three essential elements: Knowledge and Understanding, Values and Attitudes, and Skills. The metaphor implies that just as a stool cannot stand if one leg is weak or missing, holistic education cannot succeed if any of these three components is underdeveloped [21,30,31].

In the context of epilepsy education, the model aligns directly with findings from teachers, learners, and educational advisors:

• Learners need accurate knowledge about epilepsy, including causes, symptoms, and appropriate responses during seizures.
• Attitudinal change is essential, especially in communities where epilepsy is misattributed to witchcraft or spiritual causes. Promoting empathy and acceptance fosters inclusive classroom environments [32].
• Skill-building, including first-aid response and seizure management, empowers learners to act confidently and supportively when a peer experiences an epileptic episode.

These three elements must be rooted in a foundation of learner self-esteem, which allows children to process information positively, engage with peers respectfully, and take initiative when needed [21]. Teachers and Life Skills Educational Advisors act as key agents in reinforcing all three pillars by designing learning activities that encourage critical thinking, collaborative learning, and values-driven reflection. The interpretation, this model supports not only knowledge transmission but also transformative learning, where students internalize values and develop meaningful competencies [33]. This makes it especially relevant for epilepsy education in South Africa’s culturally diverse and often underserved rural settings.

4.2. Operationalization Through Dickoff et al.’s Practice-Oriented Theory [29]

To move beyond theory into actionable programming, Dickoff et al.’s Practice-Oriented Theory was employed. This theory supports structured intervention design through six key components: Agent, Recipient, Context, Procedure, Dynamics, and Terminus [29]. Its strength lies in bridging theoretical concepts with practical action, making it highly relevant for educational implementation, especially in health-related programming. This framework provides a systematic lens through six core elements:

• Agent: Life Skills Teachers and Educational Advisors.
• Recipient: Primary school learners.
• Context: Rural with cultural base/under-resourced primary schools with limited health literacy in Limpopo and Mpumalanga.
• Procedure: Active teaching strategies: storytelling, role-play, visual media, group discussions.
• Dynamics: Training, motivation, collaboration, and institutional support for educators.
• Terminus: Knowledgeable, empathetic learners capable of reducing stigma and responding effectively.

This theory was chosen because it bridges design and implementation, offering guidance for curriculum planners and school administrators. It is also frequently used in conceptual designs in South African health education [34]. It ensures the framework is not only educationally valid but practically deployable in rural, under-resourced school settings.

4.3. Cultural Relevance Through Ubuntu Philosophy

The integration of Ubuntu, a Southern African worldview emphasizing human dignity, compassion, and community is crucial to grounding the framework in local cultural values. Ubuntu aligns with the principle of “a person is a person through other people” and serves to enhance empathy and mutual care in education [35,36].

In the school context, Ubuntu enables respectful dialog around culturally sensitive topics like epilepsy, community collaboration with parents, elders, and traditional healers, and reduction in isolation and bullying experienced by learners with epilepsy. Ubuntu emphasizes interconnectedness and solidarity with all participants striving towards a common goal with the end results being the feeling of belonging by all people involved. Its relevance is particularly strong in rural Limpopo and Mpumalanga, where traditional belief systems often shape learners’ understanding of health. By embedding Ubuntu, the framework reflects local values and promotes social cohesion, dignity, and communal learning.

4.4. Integrated Epilepsy Education Conceptual Framework

By integrating the Three-Legged Stool Model, Dickoff’s Practice-Oriented Theory, and the Ubuntu philosophy, the conceptual framework facilitates the structured and culturally grounded inclusion of epilepsy education into the Life Skills curriculum. Each theoretical component contributes a unique dimension to the framework’s overall functionality: the Three-Legged Stool Model ensures that learners gain balanced development through accurate knowledge, positive attitudes, and essential skills; Dickoff’s Theory provides a practical, step-by-step guide for implementation by clarifying roles, context, procedures, and expected outcomes; and Ubuntu anchors the framework in a culturally resonant value system that emphasizes empathy, compassion, and community cohesion. Together, these models create a holistic and contextually responsive structure for delivering epilepsy education in under-resourced primary schools.

The ultimate goal of the framework is to transform schools into inclusive and supportive environments where learners are not only knowledgeable about epilepsy, but also confident, empathetic, and capable of supporting peers affected by the condition. The structure of the integrated conceptual framework is visually represented in Figure 1, which illustrates how the theoretical foundations converge to support effective and sustainable epilepsy education in primary schools. By integrating the three-legged stool model, Dickoff’s Practice-Oriented Theory, and the Ubuntu philosophy, the conceptual framework facilitates the structured and culturally grounded inclusion of epilepsy education into the Life Skills curriculum [22]. Ultimately, this contributes to breaking down stigma and improving the quality of life for people with epilepsy [18,21].

5. Discussion

The conceptual framework developed in this study is grounded in the synthesis of empirical data from learners, teachers, and Life Skills Educational Advisors (LEAs), and is informed by three theoretical perspectives: the Three-Legged Stool Model, Dickoff et al.’s Practice-Oriented Theory, and the Ubuntu philosophy. This integrated framework provides a culturally resonant and educationally practical model to address epilepsy-related stigma through structured Life Skills education in primary schools.

The application of the Three-Legged Stool Model highlights the interdependence of three essential educational components knowledge, attitudes, and skills each necessary for promoting effective epilepsy education. Empirical findings from this study demonstrate a lack of basic epilepsy knowledge among learners and educators, widespread cultural misconceptions, and limited preparedness in handling seizures or supporting affected learners. These findings align with similar studies in sub-Saharan Africa, which reveal that epilepsy continues to be misunderstood due to low health literacy and entrenched traditional beliefs [37,38,39,40]. By enhancing accurate knowledge, fostering inclusive attitudes, and equipping learners with basic seizure management skills, the framework aims to disrupt the stigma cycle.

Dickoff et al.’s Practice-Oriented Theory [29] provides operational guidance by defining key roles and processes. In the proposed framework, teachers and LEAs act as agents of change, delivering content and facilitating learning. The primary school context, characterized by socioeconomic disparities and cultural diversity, serves as a dynamic educational setting. The theory enables structured implementation by identifying procedures (active learning), dynamics (training, support), and outcomes (informed, empathetic learners). Frameworks that translate theoretical concepts into practical educational strategies are essential for successful health education delivery in schools [41]. This approach is critical for addressing existing knowledge gaps and misconceptions about epilepsy among school teachers and students, which have been consistently reported in various contexts [42,43]. The continued prevalence of misconceptions and stigmatizing cultural beliefs about epilepsy in sub-Saharan Africa underscores the urgent need for scalable and effective interventions [6]. The incorporation of Ubuntu philosophy adds cultural and moral depth to the framework. Ubuntu underscores interconnectedness, compassion, and dignity, values critical to reducing stigma and enhancing empathy [35]. In South African schools, especially in rural provinces like Limpopo and Mpumalanga, these values resonate with community norms and educational goals. Teachers, learners, and families can collaborate to foster inclusive classrooms where epilepsy is not feared or misunderstood, but rather recognized as a manageable condition requiring support and understanding [44]. Ubuntu can enrich inclusive education by anchoring pedagogy in ethical relationships and shared humanity [36,45]. Culturally sensitive approaches are vital for effective epilepsy education and stigma reduction because cultural beliefs strongly influence how epilepsy is perceived and managed within families and communities.

While this framework is locally rooted, it reflects global strategies for school-based health interventions. Comparative research from other low- and middle-income countries (LMICs) shows that school programs which combine factual knowledge with cultural sensitivity are more successful in reducing epilepsy stigma [46,47,48]. Therefore, this study contributes not only to local practice but to broader global discussions on inclusive, culturally adaptive health education.

6. Implications of the Study

The implications of this research are significant and far-reaching, providing valuable insights for various stakeholders in the educational sector. The study presents an evidence-based framework that serves as a practical guide for curriculum designers and educational policymakers, focusing on enhancing Life Skills education to ensure relevance and impact for learners. It introduces a culturally aligned pedagogical model adaptable by schools facing stigma-related challenges, particularly regarding epilepsy, fostering inclusivity and addressing the specific needs of diverse learner populations. Central to this framework is the emphasis on collaboration among stakeholders, including schools, families, healthcare professionals, and community leaders. This collaboration ensures that epilepsy education is integrated into broader community health promotion strategies, normalizing discussions around the condition and reducing stigma.

Additionally, the research contributes to the global discourse on inclusive education and health equity. Interventions that are culturally tailored and context-sensitive are more likely to lead to sustained behavior change. The framework incorporates Ubuntu principles and empowers teachers as change agents, promoting learner transformation beyond academic achievements and fostering empathy, safety, and social responsibility. The implications extend into educational policy and practice, offering a comprehensive, theoretically grounded approach that equips education departments with tools for curriculum and training development. This ensures the creation of culturally relevant teaching materials and standardized training protocols, fostering consistent messaging and quality education about epilepsy throughout the educational system.

Moreover, integrating epilepsy education into life skills curricula can significantly benefit learners, teachers, and communities by increasing awareness, promoting positive attitudes, and reducing stigma. Ultimately, this research presents a robust framework that enhances education about epilepsy and contributes to the overall well-being and inclusivity of communities.

7. Recommendations

To enhance the effectiveness of the proposed framework, it is recommended that future research include a piloting phase in selected schools. This initial implementation should be followed by a thorough evaluation utilizing both qualitative and quantitative methods. Recommended outcome measures should focus on assessing changes in learners’ knowledge, attitudes, seizure response skills, and reductions in peer discrimination. These efforts will help assess whether the conceptual framework achieves its intended outcomes and, if successful, will support its adoption as a practical tool for informing curriculum development. Furthermore, it is recommended to incorporate feedback from teachers and life skills educational advisors (LEAs) to inform the iterative refinement of the framework.

8. Conclusions

This study proposes a transformative conceptual framework designed to effectively integrate epilepsy education into the Life Skills curriculum for primary schools in Limpopo and Mpumalanga. By focusing on knowledge acquisition, attitude shifts, and skill development, the framework aims to combat stigma and also enhances health literacy and fosters social inclusion for children living with epilepsy. Grounded in the principles of Ubuntu and informed by practical pedagogical methods, it takes a significant step forward in addressing the educational and health disparities affecting these children.

Additionally, the framework’s responsiveness to empirical data and sociocultural realities of rural South African schools highlights its relevance and applicability. Its multidimensional approach, melding theoretical insights with contextual understanding and practical action, positions it as a valuable model that can be adapted and implemented in other low- and middle-income countries facing similar challenges. Ultimately, this initiative is a crucial move toward creating a more equitable and inclusive educational environment for all learners.