Creating a model of convergence and engagement between African indigenous health and biomedical system regarding tuberculosis (TB) treatment

Abstract

Introduction: Around 80% of the population in sub-Saharan Africa use indigenous medicine when ill, before consulting biomedical health practitioners, and many only consult doctors when their disease is at an advanced stage or the indigenous medicine has failed. The rise in TB infection has led the South African government to consider collaboration between African indigenous health and biomedical health practitioners in order to counter a pandemic among communities. The World Health Organisation (WHO) advocates incorporating African indigenous health and biomedical health practitioners to promote quality service delivery among the communities. Support for cooperation between these health practitioners was promoted in South Africa with the passing of the Traditional Health Practitioners Act of 2007 (Act. 22 of 2007) to promote collaboration. The government introduced programmes and models of health promotion related to TB management but they focussed on the prevention of the disease, promotion of health, and programmes about HIV/AIDS rather than on how a model of convergence and engagement between the African indigenous health and biomedical health practitioners regarding treatment of TB should be created. Research design and methods: A qualitative, exploratory, descriptive and contextual research design was used. The study conducted within the biomedical health and African indigenous health practitioner's context and was conducted in three phases. Non-probability, purposive sampling was used to choose a population that comprised three groups of participants, namely, biomedical health practitioners, African indigenous health practitioners and supporters of direct observed treatment (DOT).The sample size was large enough to determine differences between groups. The researcher conducted in-depth individual interviews and focus group to explore and describe their views regarding convergence and engagement about the treatment of TB. Questions were asked following the interview guide until data saturation occur. Data analysis was conducted following Tesch method. Findings: The study found they perceived the treatment of TB differently, largely because of cultural diversity, for instance, differing beliefs and worldviews that had an impact on understanding the meaning of concepts such as disease, illness and wellness. Some believed that it was caused by witchcraft, others the result of cleansing rituals not having been carried out. It was also believed that Isidliso entered the victim while sleeping, in the form of food. Thus, the development of the model of convergence and engagement between the biomedical health and African indigenous health practitioners will sort out the myths that is in the mind of the people regarding the cause of TB. Conclusion: The model of convergence and engagement between the biomedical health and African indigenous health practitioners regarding the tuberculosis (TB) treatment was developed following the steps proposed by Dickoff, James and Wiedenbach and Walker and Avant.