Incorporation of the traditional healers into the national health care delivery system
Pinkoane, Martha Gelemete
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The process for the incorporation, integration or collaboration of traditional healers into the National Health Care Delivery System of South Africa was marred by an array of mixed attitudes from all the parties concerned, namely traditional healers, patients, biomedical personnel, and the policy makers. The variety of approaches for inclusion of the traditional healers into the National Health Care System of South Africa was a further indication of the complexity of the situation. The possibility of functioning together between traditional healers and biomedical personnel existed before 1990 when the two groups met in Johannesburg in 1986 to discuss ways by which functioning together can be established. A series of meetings and discussions followed after which came the promulgation of the Chiropractors Homeopaths and Allied Health Services Professionals Act of 1996, which gives traditional healers their due recognition but does not include them as part of health care providers. The process of functioning together is a recommendation made by the World Health Organization and the most used terms for this functioning together is, incorporation, integration and collaboration. The process of incorporation can be realised by ensuring that both biomedical personnel and traditional healers remain autonomous, not controlling each other, respecting the existence of one another, as well as each other's own methods of healing. Integration was another method whereby the two health care systems can function together, even though integration differs in context from incorporation. Integration means that the traditional healers will have to function within the health care system under the directions of the biomedical personnel, whereby the patient receives a combination of both treatment methods depending on the problem or diagnosis. The third modality of getting the two health care systems to function together could be by collaboration. Collaboration was seen as a two sided effort whereby the healing methods of one are brought to fore and the most effective one is chosen to cure the patient's identified problem at that time. For the process of functioning together to be meaningful, it was necessary to get the government to review licensing the traditional healer's practices, so as to identify the healing techniques that are of value and use these to treat the patients. It was not really possible to clearly separate the three approaches because they all addressed the issue of having the two health care systems function together to increase health care services and fulfil the patients' health needs. For the purpose of this research the word incorporation was used. In South Africa the traditional healer is identified as the health care choice of 80-9036 of the black population. If this large number of black people uses traditional healing, then it becomes necessary to investigate the manner in which the traditional healer can be utilized effectively in the National Health Care Delivery System of South Africa to render the services that the patient needs for his/her health needs. It is for this reason that the researcher aimed at investigating the existing models of incorporation of traditional healers, the perceptions and attitudes of the traditional healers, biomedical personnel, patients and the policy makers regarding incorporation, their views on how this incorporation should be achieved, as well as how the incorporation of traditional healers into the National Health Care Delivery System of South Africa could be realised. A qualitative research design and theory generating approach was followed, and the research was conducted in two stages. In stage one qualitative research, participants were traditional healers, biomedical personnel, patients and policy makers, selected by means of non-probable purposive voluntary sampling. Data was collected by means of conducting semi-structured interviews with all the participants in the three identified provinces of South Africa. Field notes were recorded after each interview session. Data analysis was achieved by open coding. A co-coder and the researcher analysed the data independently after which consensus discussions took place to finalise the analysed data. Ethical principles were applied according to the guidelines of the Democratic Nurses Organisation of South Africa and the Department of Health. The second stage which was a theory generation approach, was used to formulate a model for the incorporation of the traditional healers into the National Health Care Delivery System of South African.
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