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Original research
Legislative landscape for traditional health practitioners in Southern African development community countries: a scoping review
  1. Amber Louise Abrams1,2,
  2. Torkel Falkenberg3,
  3. Christa Rautenbach4,
  4. Mosa Moshabela5,
  5. Busisiwe Shezi1,
  6. Suné van Ellewee4,
  7. Renee Street1
  1. 1 Environment and Health, South African Medical Research Council, Durban, South Africa
  2. 2 Future Water institute, University of Cape Town, Cape Town, Western Cape, South Africa
  3. 3 Department of Neurobiology, Caring Sciences, Karolinska Institutet, Stockholm, Sweden
  4. 4 Faculty of Law, North-West University, Potchefstroom, South Africa
  5. 5 School of Nursing and Public Health, University of KwaZulu-Natal College of Health Sciences, Durban, South Africa
  1. Correspondence to Dr Amber Louise Abrams; amberabrams{at}gmail.com

Abstract

Background and objectives Globally, contemporary legislation surrounding traditional health practitioners (THPs) is limited. This is also true for the member states of the Southern African Development Community (SADC). The main aim of this study is to map and review THP-related legislation among SADC countries. In order to limit the scope of the review, the emphasis is on defining THPs in terms of legal documents.

Methods This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews methods. Two independent reviewers reviewed applicable legal definitions of THPs by searching the Southern African Legal Information Institute (SAFLII) database in April 2018 for legislation and bills. To identify additional legislation applicable in countries not listed on SAFLII and/or further relevant SADC legislation, the search engines, Google and PubMed, were used in August 2018 and results were reviewed by two independent reviewers. Full texts of available policy and legal documents were screened to identify policies and legislation relating to the regulation of THPs. Legislation was deemed relevant if it was a draft of or promulgated legislation relating to THPs.

Results Four of 14 Southern African countries have legislation relating to THPs. Three countries, namely South Africa, Namibia and Zimbabwe, have acknowledged the roles and importance of THPs in healthcare delivery by creating a council to register and formalise practices, although they have not operationalised nor registered and defined THPs. In contrast, Tanzania has established a definition couched in terms that acknowledge the context-specific and situational knowledge of THPs, while also outlining methods and the importance of local recognition. Tanzanian legislation; thus, provides a definition of THP that specifically operationalises THPs, whereas legislation in South Africa, Namibia and Zimbabwe allocates the power to a council to decide or recognise who a THP is; this council can prescribe procedures to be followed for the registration of a THP.

Conclusions This review highlights the differences and similarities between the various policies and legislation pertaining to THPs in SADC countries. Legislation regarding THPs is available in four of the 14 SADC countries. While South Africa, Tanzania, Namibia and Zimbabwe have legislation that provides guidance as to THP recognition, registration and practices, THPs continue to be loosely defined in most of these countries. Not having an exact definition for THPs may hamper the promotion and inclusion of THPs in national health systems, but it may also be something that is unavoidable given the tensions between lived practices and rigid legalistic frameworks.

  • traditional healing
  • policy
  • regulation
  • legislation
  • indigenous health
  • SADC
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors ALA drafted the protocol, with input from RS, BS, TF and CR. BS, RS, SvE, ALA and CR were involved in data collection. ALA, RS, BS, TF, CR, SvE and MM were involved in data analysis, workshopping findings and developing discussion points. ALA drafted the manuscript, with extensive input from all authors. ALA attended to reviewers comments with input from all authors. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. Data (the publicly available legal documents) will be happily shared with anyone who requests it. They are also publicly available. No patient data sets or individual records were used to do this research.

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