An Examination of the Role of Traditional Medicine in Primary Health Care in Bushbuckridge Region, Mpumalanga Province, South Africa

Abstract

The historical stigmatization and demonization of African traditional practices, including traditional medicine, is well explored in scholarly discourse. However, the renaissance of scholarly de-colonial and Afro-centric research frameworks re-awakens the need to generate knowledge systems and analytical lenses that pragmatically and sustainably address global challenges using contextually relevant resources that have been maligned for centuries due to colonialism. The 21st Century presents opportunities and challenges that call for a re-think on the role of indigenous knowledge systems in holistically contributing towards primary health care. In the South African context, quality primary health care is inaccessible to the larger populace that is mainly domiciled in rural contexts, due to challenges such as long distances to primary health care centres, shortages of medicines, inadequate health equipment, insufficient drugs and poor health infrastructure caused by the legacy of apartheid, and ineffective policy systems in post-apartheid political administrations. Traditional medicine, which is reportedly used by more than 70% of the population, can provide pertinent solutions to the current rural primary health care system dilemmas in rural settings. However, there are scant scholarly and contextually relevant frameworks which are points of reference in terms of being orientated towards harnessing and optimizing the role of traditional medicine in primary health care in rural settings. The aim of the study was to examine the role of traditional medicine in primary health care in Allandale, Bushbuckridge, and develop a framework for systematically optimizing the role and usage of traditional medicine in primary health care. To achieve the aim, the study’s specific objectives entailed examining perceptions on the inclusion of traditional medicine in primary health care, exploring the types and characteristics of traditional medicine, determining the primary health care imperatives of traditional medicine, exploring factors influencing the uptake of traditional medicine in primary health care, and establishing the challenges associated with the adoption of primary health care in traditional medicine. The study adopted Afro-centric and ethno-medical approaches as theoretical frameworks. Framed within the qualitative research method, the study adopted an explorative qualitative design using semi-structured interviews to generate data. The study’s participants consisted of traditional health practitioners, traditional leaders, selected community members and medical doctors who operate in hospitals using allopathic modern medicine. The study findings reveal that traditional medicine deserves a more prominent role in primary health care as it carries advantages such as affordability, ease of access, socio-cultural relevance, spiritual significance, and a holistic approach and potency which could address some of the key challenges facing the primary health care system in South Africa. Responses from the participants unearthed expectations, concerns, commendations, possibilities and impediments which should all be factored in to place traditional medicine on a sustainable trajectory and distinguished status in primary health care and not as an appendage of Western traditional medicine. The study’s main contribution is in developing a systems-oriented framework consisting of contextual factors and inputs required for traditional medicine in primary health care. The proposed framework also consists of key activities that determine the optimum usage of traditional medicine in primary health care, strategic primary health care outcomes that result from using traditional medicine, and the potential impact that traditional medicine has in broader society. The envisaged application of the framework involves the development of traditional medicine health centers or ecosystems in villages, with each consisting of a variety of traditional medicine practitioners with various skill sets operating within a self-contained referral unit.