South African women's use of African traditional medicine during pregnancy: A scoping review.

In South Africa, about 72% of black South Africans are said to rely on traditional medicine. This contributes to a high prevalence of traditional medicine (TM) used by women during pregnancy, especially in rural areas. This paper explored literature knowledge on the use and reasons of using African traditional medicine in pregnant women who reside in South Africa. This was a scoping review search conducted in October 2021. The search was done with the aid of PubMed, Science Direct, JSTOR and EBSCOHost. This study included only studies on pregnant women's use of traditional African medicine, conducted in South Africa which were published between 2011 and 2021, written in English. Six studies were found to be relevant to the phenomenon. Lack of research and regular health education on the safety and efficacy of traditional medicine during pregnancy is a major cause of traditional medicine induced pregnancy-related complications in South Africa.

En Afrique du Sud, environ 72 % des Sud-Africains noirs auraient recours à la médecine traditionnelle. Cela contribue à une forte prévalence de la médecine traditionnelle (MT) utilisée par les femmes pendant la grossesse, en particulier dans les zones rurales. Cet article a exploré les connaissances documentaires sur l'utilisation et les raisons de l'utilisation de la médecine traditionnelle africaine chez les femmes enceintes résidant en Afrique du Sud. Il s'agit d'une recherche d'examen exploratoire menée en octobre 2021. La recherche a été effectuée avec l'aide de PubMed, Science Direct, JSTOR et EBSCOHost. Cette étude comprenait uniquement des études sur l'utilisation de la médecine traditionnelle africaine par les femmes enceintes, menées en Afrique du Sud et publiées entre 2011 et 2021, rédigées en anglais. Six études se sont révélées pertinentes pour le phénomène. Le manque de recherche et d'éducation sanitaire régulière sur la sécurité et l'efficacité de la médecine traditionnelle pendant la grossesse est une cause majeure des complications liées à la grossesse induites par la médecine traditionnelle en Afrique du Sud.

Traditional healers, faith healers and medical practitioners: the contribution of medical pluralism to bottlenecks along the cascade of care for HIV/AIDS in Eastern and Southern Africa.

OBJECTIVES: There are concerns that medical pluralism may delay patients' progression through the HIV cascade-of-care. However, the pathways of impact through which medical pluralism influence the care of people living with HIV (PLHIV) in African settings remain unclear. We sought to establish the manifestation of medical pluralism among PLHIV, and explore mechanisms through which medical pluralism contributes bottlenecks along the HIV care cascade. METHODS: We conducted a multicountry exploratory qualitative study in seven health and demographic surveillance sites in six eastern and southern African countries: Uganda, Kenya, Tanzania, Malawi, Zimbabwe and South Africa. We interviewed 258 PLHIV at different stages of the HIV cascade-of-care, 48 family members of deceased PLHIV and 53 HIV healthcare workers. Interviews were conducted using shared standardised topic guides, and data managed through NVIVO 8/10/11. We conducted a thematic analysis of healthcare pathways and bottlenecks related to medical pluralism. RESULTS: Medical pluralism, manifesting across traditional, faith-based and biomedical health-worlds, contributed to the care cascade bottlenecks for PLHIV through three pathways of impact. First, access to HIV treatment was delayed through the nature of health-related beliefs, knowledge and patient journeys. Second, HIV treatment was interrupted by availability of alternative options, perceived failed treatment and exploitation of PLHIV by opportunistic traders and healers. Lastly, the mixing of biomedical healthcare providers and treatment with traditional and faith-based options fuelled tensions driven by fear of drug-to-drug interactions and mistrust between providers operating in different health-worlds. CONCLUSION: Medical pluralism contributes to delays and interruptions of care along the HIV cascade, and mistrust between health providers. Region-wide interventions and policies are urgently needed in sub-Saharan Africa to minimise potential harm and consequences of medical pluralism for PLHIV. The role of sociocultural beliefs in mediating bottlenecks necessitate adoption of culture-sensitive approaches intervention designs and policy reforms appropriate to the context of sub-Saharan Africa.