The relationship between Indigenous and allopathic health practitioners in Africa and its implications for collaboration: a qualitative synthesis

Abstract

Background: There have been increasing calls for collaboration between Indigenous health practitioners (IHPs) and allopathic health practitioners (AHPs) in Africa. Despite this, very few successful systems exist to facilitate formal collaboration. Direct relationships between providers, and at a health systems level are crucial to successful collaboration, but the nature and extent of these relationships have yet to be adequately explored. Objective: To explore the relationship between IHPs and AHPs in Africa, and to discuss the implications of this for future collaboration. Methods: An interpretive qualitative synthesis approach, combining elements of thematic analysis, meta-ethnography, and grounded theory, was used to systematically bring together findings of qualitative studies addressing the topic of collaboration between Indigenous and allopathic health practitioners in Africa. Results: A total of 1,765 papers were initially identified, 1,748 were excluded after abstract, full text and duplicate screening. Five additional studies were identified through references. Thus, 22 papers were included in the final analysis. We found that the relationship between Indigenous and allopathic health practitioners is defined by a power struggle which gives rise to lack of mutual understanding, rivalry, distrust, and disrespect. Conclusion: The power struggle which defines the relationship between IHPs and AHPs in Africa is a hindrance to their collaboration and as such could partly account for the limited success of efforts to foster collaboration to date. Future efforts to foster collaboration between IHPs and AHPs in Africa must aim to balance the power disparity between them if collaboration is to be successful. Since this would be a novel approach, decision-makers and organisations who trial this power balancing approach to facilitate collaboration should evaluate resultant policies and interventions to ascertain their feasibility and efficacy in fostering collaboration, and the lessons learnt should be shared.

Integrating traditional and allopathic child health: A healthcare transformation opportunity

“…These worries might be well founded because, in certain cases, traditional healthcare practitioners act unethically, endangering patient safety in the absence of regulation. Another study by Oseni and Shannon ( 2020 ) found that there was a problem with accepting the spiritual aspect of traditional health practitioners among participants. Participants in this study also indicated that there was a lack of respect and negative attitudes towards traditional healthcare practices, and this was similarly found in Van Rooyen et al (2017) who found that the lack of referral practices from allopathic to traditional healthcare practices was because allopathic health practitioners had a negative attitude towards traditional health practitioners.…”

Experiences and practices of traditional healers on snakebite treatment and prevention in rural Malawi

“…THs in Neno strongly recommend a collaborative approach with HCWs to ensure that they are educated about danger signs that guarantee a straight referral of snakebite victims to the hospital. There is extensive literature on the integration of THs and modern medicine for various diseases and conditions, snakebites could equally benefit [ 61 , 62 ]. Further research is needed to investigate how THs in Neno can be integrated into the healthcare system, particularly in the management of snakebites.…”