The indigenous perspective of the meaning and treatment modalities of dysmenorrhea among the Batlokwa women of Limpopo province

Abstract

The world, including developing countries such as South Africa, is burdened with deeply rooted women sexual health challenges such as dysmenorrhea. Dysmenorrhoea, also known as, "period pains", while not life-threatening, has been troubling many women of childbearing age since ancient times. Many interventions and drugs are available and approved for use in the treatment of dysmenorrhea. However, dysmenorrhea remains least understood, many cultures and religions of the African countries still regard it as a "taboo" subject because it is a sexual and reproductive issue, and means of coping are considered indigenously "women’s knowledge”, as such increasingly, women negotiate with cultural beliefs and practices in the management of dysmenorrhea. South Africa, as a multicultural society, allows the practice of different types of health care systems such as dysmenorrhea management. Extensive efforts are being made by the government and the healthcare sector to understand and document the indigenous health knowledge for safe practices in improving the overall health of South Africans. Moreover, this study was conducted.

This study aimed to understand the indigenous perspectives of the meaning and treatment modalities of dysmenorrhea among Batlokwa women. Purposive and snowball sampling was used to select participants. The findings were used to develop strategies to empower Batlokwa women with dysmenorrhea knowledge. This study was premised on a conviction that Batlokwa women have a unique perspective on dysmenorrhea meaning and treatment modalities based on their ethnicity background.

The study was conducted in two phases. Phase 1 was the empirical phase which was qualitative and was divided into two parts to address the first two objectives of the study. The population for Phase 1 constituted of the Batlokwa Traditional Health Practitioners (THPs) and Indigenous Knowledge Holders (IKHs). In part one modified photovoice approach was used to collect data in four different stages:

• • Stage 1 – brainstorming and photograph taking training • • Stage 2 – taking photographs • • Stage 3 – Individual interviews • Stage 4 – modified Lekgotla discussion

Data analysis for part one followed steps of photovoice data analysis guided by questioning the acronym “PHOTO” (Hussey 2006). The process involved photograph selection, contextualising and codifying. Photovoice enabled Batlokwa women (Traditional Health Practitioners and Indigenous Knowledge Holders) to share indigenous dysmenorrhea knowledge. Photographs taken by the participants were used to understand their perspectives regarding the meaning and treatment modalities of dysmenorrhea. Part two used in-depth interviews to collect data from women. In-depth interviews were conducted with different women to enhance the knowledge gained from the photovoice study. It was also to capture additional information that should have been missed during the photovoice study. Content data analysis was used in part two to provide detailed guidance for the coding process and analysis.

The Africana Womanism theory was used as a framework to guide the study process and discussion of the findings and was grounded within critical realism worldview. This provided means to follow a systematic structure of understanding how the indigenous dysmenorrhea knowledge surfaced and maintained within the Batlokwa ethnicity. Five major themes were identified: holistic understanding of dysmenorrhea meaning; self-naming and definition of dysmenorrhea; diagnostic processes in indigenous health care practices; treatment modalities of dysmenorrhea; roles of THPs and IKHs in treatment and prevention of dysmenorrhea.

Phase 2 addressed the third objective, which developed strategies to empower Batlokwa women with dysmenorrhea knowledge. Experts from indigenous knowledge holders, traditional health practitioners, health and education sectors. To reach consensus, a modified Lekgotla discussion utilising an expert panel reviewed items for importance, clarity, applicability, validity and reliability, with items subsequently amended or removed as such clear strategies which apply to the demographic group was developed to empower Batlokwa women with dysmenorrhea knowledge