Providing mental healthcare through faith-based entities in Africa: a systematic review

Abstract

Background: Psychological disturbances and mental illnesses are prevalent on the continent of Africa. There are shortages of mental health services and a lack of quality providers with limited training and supervision. It is perceived that faith-based entities for psycho-emotional health and wellbeing are filling the gap with positive impact. However, the risks associated with unconventional or extreme spiritual practices will be evaluated. The contributions of these entities, their roles in the global and African health system, and their implications for community development and policy making are highlighted. Methods: A mixed-methods systematic review was conducted in two phases to synthesise qualitative and quantitative data. The review sought evidence on faith-based health providers of mental health services in Africa looking at types, magnitude, and quality, and included both peer-reviewed and grey literature, published between 2007 and 2024, in English. A narrative thematic analysis was used for the qualitative part and meta-analyses was used for the quantitative part to back up the narrative element of this study. Results: This review identified 55 relevant items from 13 African countries. The results showed that faith-based mental health providers deliver a range of six types of alternative mental health care, faith-based home care and faith-based biomedical mental health care. The magnitude of these faith-based mental health services was considered according to frequency of use and availability (accessibility, affordability, and acceptability), but evidence was limited. When the quality of these mental health care was assessed, some studies showed positive mental health outcomes from the utilisation of faith-based mental health care, but some studies revealed bad quality practices due to inhumane treatments. Conclusion: There are limitations regarding the vast array of faith-based health providers and the mental health care as they provide which include harmful practices used in Africa. Training interventions are needed to avoid some of the inhumane treatments. Faith-based mental health care offers culturally influenced practices for mental health which should be leveraged. Integration of faith-based mental health care into primary health system is advised in order to attain universal health coverage. Finally, possible regulation of traditional and faith healing methods for emotional struggles could be implemented at a policy level.