Indigenous practices for the management of epilepsy by traditional and faith-based healers: A case study in selected rural communities of Mpumalanga and Limpopo Provinces

Abstract

Background: The prevalence of epilepsy is high in low- and medium-income countries, but more so in rural areas. There are efforts to assist people suffering of epilepsy at government hospitals, clinics, and non-governmental organizations (NGOs). Despite these efforts, studies have shown that there is less uptake of anti- epilepsy medication and more reliance on cultural and religious practices to manage the condition. Purpose: This study aimed to determine the indigenous practices used by traditional healers and faith-based healers in the selected rural communities of Mpumalanga and Limpopo Provinces.

Methodology: Manuscript 1 represents a systematic review was conducted to analyze the gaps regarding the management of epilepsy in Africa. The literature search was conducted electronically from 2000 to 2021. Manuscripts 2 and 3 were informed from the study findings of the systematic review. The reseach project adopted a qualitative, ethnographical approach that was exploratory and descriptive. Non-probability purposive and snowball sampling methods were used to sample 17 traditional healers and seven faith-based healers in the selected rural communities of Mpumalanga and Limpopo. Data were collected through in-depth individual interviews. Thematic analysis was used to analyze data by using six steps as outlined in Creswell (2014) and eight steps in forming codes by Tesch (1990). Trustworthiness was ensured using four criteria: dependability, confirmability, transferability, and credibility. Ethical considerations were adhered to, and the ethical clearance was received from the Ethics Committee of the University of Venda, then permission from the chief or ward counsellor to access the villages where data collection took place.

Findings of Manuscript 1: The findings for the systematic review demonstrated that there are two methods used to manage epilepsy in Africa, namely, a Western approach by using anti-epilepsy drugs, or a traditional approach through consultation with traditional doctors. Many people believe that epilepsy is spiritual and management should be traditional, resulting in less uptake of anti-epilepsy medication.

Findings of Manuscript 2: The findings show that traditional healers have a different perspective on the origins of epilepsy, and their treatment plans are based on their knowledge of the disease. Traditional healers use plants and alternative measures to treat epilepsy, in addition to Western medicine.

Findings of Manuscript 3: The findings revealed that faith-based healers use light tea, prayer, and fasting to manage epilepsy and have good collaboration with primary health care professionals.

Recommendations: Training in all aspects of epilepsy diagnosis and management is required for all health care workers. This includes epilepsy management knowledge, attitudes, and behaviours in the community. Health care providers should inform persons with epilepsy about the potential side effects of epilepsy drugs before they start taking them. Furthermore, health care providers must recognize the significance of indigenous religious beliefs in epilepsy management. They should urge primary and secondary health care personnel to interact with indigenous practitioners and encourage persons with epilepsy to seek Western medicine. They should accept non- harmful indigenous medicines while insisting on using biomedicine.