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Abstract Introduction: In sub-Saharan Africa, including in Zimbabwe, 80% of the population continues to use African Traditional Medicine (ATM) as a source of primary health care that includes the treatment of mental illnesses, but little is known about what motivates their health seeking behaviour. The study aimed at understanding why patients use ATM treatment of mental disorders. Methods: Using exploratory qualitative methods in a semi-urban community near Harare, we conducted 30 indepth interviews with patients from ATM sites using convenience sampling, and three focus-group discussions with 18 participants from the community recruited from three food distribution depots in the settlement. Data were coded and analysed using the constant comparative method to identify key themes. Results: We found that patients preferred the use of ATM for witchcraft, religious, psychological and psychosocial conditions and believed the causes of their sickness stemmed from witchcraft. Many patients reported high levels of confidence and satisfaction with the ATM received. Conclusion: The findings suggest that supernatural and psychosocial factors play a major role in health seeking behaviour of the communities. Therefore, ATM is a relevant point of referral and rehabilitation for mental health patients and ATM should be integrated with BM.
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Keywords: African traditional medicine, Mental illness,
Health-seeking behaviours.
In sub-Saharan Africa, 80% of the population continues to use
African Traditional Medicine (ATM) as a source of primary health
care that includes the treatment of common mental illnesses [1]. To
address the global burden of mental health issues in low-income
countries (LICs), the World Health Organization has called for the
optimization of all available resources to bolster the delivery of
mental health treatment in primary care [2]. The recently launched
mental health Global Action Program also focuses on forging
strategic partnerships to enhance countries’ capacity to combat
stigma, reduce the burden of mental disorders and promote health [3].
Health care in Zimbabwe, like most African countries, is provided
by both biomedical and traditional health care providers [4].
Treatment seeking behaviors in Zimbabwe can be characterized as
a system of alternate treatment paths that intersect and overlap [5].
For patients (though not all), the rst assumption is that an illness
is natural and normal and can be treated with standard remedies,
such as over the counter medications or herbal remedies. When
conventional efforts fail to relieve normal symptoms, patients
might then suspect that their illness is not normal or natural, and
turn to traditional medicine, known as Hun’anga in Zimbabwe, to
identify the underlying cause or culprit for sickness and disease
[6]. In general there is a paucity of research available concerning
health seeking behaviour in traditional healing for mental illness
Volume 1 | Issue 1 | 1 of 6
Int J Psychiatry, 2016
Why Do People Use Traditional Healers in Mental Health Care in Zimbabwe?
Research Article
1Department of Psychiatry, College of Health Sciences, University
of Zimbabwe
2Department of Sociology, University of Zimbabwe
3BA, Institute of Psychiatry, King’s College London, London, UK
and Harvard Medical School, Boston, USA
4Department of Psychology, University of Cape Town
5Department of Medicine/Special Treatment & Research
Program, SUNY Downstate Medical Center, Brooklyn, USA
Introduction: In sub-Saharan Africa, including in Zimbabwe, 80% of the population continues to use African
Traditional Medicine (ATM) as a source of primary health care that includes the treatment of mental illnesses, but
little is known about what motivates their health seeking behaviour. The study aimed at understanding why patients
use ATM treatment of mental disorders.
Methods: Using exploratory qualitative methods in a semi-urban community near Harare, we conducted 30 in-
depth interviews with patients from ATM sites using convenience sampling, and three focus-group discussions
with 18 participants from the community recruited from three food distribution depots in the settlement. Data were
coded and analysed using the constant comparative method to identify key themes.
Results: We found that patients preferred the use of ATM for witchcraft, religious, psychological and psychosocial
conditions and believed the causes of their sickness stemmed from witchcraft. Many patients reported high levels
of condence and satisfaction with the ATM received.
Conclusion: The ndings suggest that supernatural and psychosocial factors play a major role in health seeking
behaviour of the communities. Therefore, ATM is a relevant point of referral and rehabilitation for mental health
patients and ATM should be integrated with BM.
International Journal of Psychiatry
Lazarus Kajawu1*, Sunungurai D Chingarande2, Helen Jack3, Catherine Ward4 and Tonya Taylor5
*Corresponding author
Lazarus Kajawu, Department of Psychiatry, College of Health
Sciences, University of Zimbabwe, P.O. Box A178, Avondale,
Harare, Zimbabwe, Tel: 0772 278 468; E-mail:
Submitted: 18 Sep 2016; Accepted: 01 Oct 2016; Published: 05 Oct 2016
Volume 1 | Issue 1 | 2 of 6Int J Psychiatry 2016
Very little is known about why patients continue to use Hun’anga,
in parallel or in conjunction with western psychotherapy [8,9].
The objective of this study was to characterize why patients and
community seek therapy in hun’anga in the treatment of common
mental disorders at community health care. An understanding of
the treatment seeking behaviors of patients who use Hun’anga
will help identify aspects of traditional medicine that need to be
integrated into mainstream therapy, and make traditional medicine
a relevant point of referral and rehabilitation for mental health
In this paper, we sought to explore, using qualitative research
methods, why some Shona people in Zimbabwe use Hun’anga
for the treatment of common mental disorders. Findings from this
study will be used to develop more culturally appropriate mental
health training for both lay and professional Zimbabwean health
Purpose and objectives
This study aimed to explore, using qualitative research methods,
why some Shona people in Zimbabwe use Hun’anga for the
treatment of common mental disorders. The study was conducted
in a settlement located 16km Northeast of Harare. A qualitative
design was selected because this was an exploratory study [10].
Sampling and Measures
We conducted 30 in-depth interviews and three focus group
discussions, using a semi-structured questionnaire to guide the
process. A total of 68 participants from seven wards of the Epworth
community were enrolled in the study. The in-depth interviews
were conducted with the patients of traditional healers and the
three focus group discussions sessions were held with the general
members of the community.
We recruited patients from traditional healers who were
registered with Zimbabwe National Traditional Healing
association (ZINATHA). The traditional healers were recruited
using community health workers. Community Health Workers
approached all eligible healers and explained the study
objectives, procedures and obtained informed consent to use their
healing ofces (matare) to recruit patients. Investigators used a
convenience sampling strategy to recruit eligible patients from the
healers’ ofces. Community members were recruited at general
mass gathering points which were food distribution depots in
the community. The Community Health Workers also explained
the study objectives, procedures and the investigator obtained
informed consent from the participants.
Participants were excluded from the study if they did not speak
the Shona language and if they were: minors, prisoners, mentally
disabled or severely mentally ill individuals who had severe
psychosis, severe depression, or those who were hyper manic.
We excluded the aforementioned special populations because of
their vulnerable status as human subjects. Recruitment continued
until substantive saturation, or the point at which new data did not
produce more ndings.
Data collection
From January of 2013 to December of 2013, we conducted 3
focus group discussions (FGD) with community members and 30
in-depth interviews (IDI) with the patients of traditional healers.
All interviews were conducted in a private room. The investigator
facilitated the discussion. Two research assistants were available;
one was helping with notes taking while the second was helping
with recording of information during focus group discussions and
in-depth interviews. Each FGD discussion lasted about one hour.
We used a semi-structured interview questionnaire to explore
the community’s views about healing practices, about visiting
traditional healing, and the causes of illness among the people
visiting traditional healers, and the reasons for choice of traditional
therapy over conventional medicine.
The in-depth interviews were conducted one-on-one in a private
room and lasted approximately one hour. The investigator
conducted the interviews with the aid of two research assistants.
To guide the interviews we used a semi-structured interview
questionnaire, to explore the patient’s views about what caused
their illness, the treatment strategies used, the changes in health as a
result of therapy, the patients’ attitude toward traditional therapies,
their personal feelings toward the treatment received, the levels of
improvement as a result of therapy, the patient’s satisfaction with
the therapy, and the limits of the approach. Some key questions
were provided in the table. The researcher asked further probing
questions to generate more discussion before closing questions.
A summary of the major points was given in the end. The focus
group discussions and in-depth interviews were audiotaped and
professionally transcribed.
Ethical concerns
Written permission was obtained from Kunaka District Hospital
before the study was started and concern was also obtained from
all participants. Permission was acquired to conduct the interviews
and audio-recording of the interview was allowed. The interviews
took place in the healer’s shrine.
Data analysis
Data were analysed using the constant comparison method [11].
Essential concepts were coded and compared to extract recurrent
themes across data. While the principal investigator was leading the
process in writing, the other members of the research team reviewed
coded transcripts to validate the outcomes. This process of rening
codes and describing the properties of each code continued until
no new concepts emerged. An analysis comparing and contrasting
the themes was made across the two groups of participants. Data
was manually coded and translated into English. It was then back
translated and checked for consistency. Analysis of the interviews
and focus group discussions explored the subjective meaning of
mental illness and treatment seeking behaviours. Quotations used
throughout this paper reect participants’ typical comments unless
otherwise noted.
Volume 1 | Issue 1 | 3 of 6Int J Psychiatry 2016
Sample characteristics of the in-depth interview and focus group
Table 1 and Figure 1 present selected socio-demographic variables
used to characterize the sample of in-depth and focus group
discussant participants. Women (70%) were the majority and
the men were only 30%. Focus group discussions were held at
3 food distribution depots and each focus group had 7, 6 and 5
participants, respectively. The mean ages for the 3 groups were 43,
28 and 29, 2 respectively, while the mean for the 3 groups was 34,
17 years (SD: 13, 63). The mean number of years of education was
9.28years (SD: 2, 89) for all participants in the 3 groups.
interviews N= 30
Focus groups
N= 18
M (SD) or %, N M (SD) or % (N)
Age 40,40 (SD: 13,61) 34,17 (SD:13,63)
Gender Female 68,97% (20) 32% (6)
Male 31,03% (9) 68% (13)
Muzezuru 33,33% (10) 27,78% (5)
Munyika 3,33% (1) 11,11% (2)
Mukaranga 20% (6) 5,56% (1)
Mundau 13,35% (4) 11,11% (2)
Malawi 23,33% (7) 16,67% (3)
Zambian 3,33% (1) 5,56% (1)
Mozambican 3,33% (1) 16,67% (3)
Education 6,97 (SD: 3,6) 9,28 (SD: 2,89)
Divorced 10,34% (3) 16% (3)
Married 72,4% (21) 74% (14)
Single 3,45% (1) 1% (2)
Windowed 13,79% (4)
Christian 55,17% (16) 84% (16)
Traditional 13,79% (4) 16% (3)
NR 31,03% (9)
Number of
people living
in household
2 16,67% (5) -
3 16,67% (5) 27,78% (5)
4 16,67% (5) 11,11% (1)
5 16,67 (5) 16,67% (2)
6 16,67 (5) -
7 10,00 (3) 5,56% (1)
8 3,33% (1) 11,11% (2)
11 3,33% (1) -
14 5,56% (1)
Number of
1 16,00% (16) 16,67% (3)
2 28,00% (28) 16,67% (3)
3 18,00% (18) 11,11% (2)
4 16,00% (16) 11,11% (2)
5 10,00% (10) 5,56% (1)
Number of
6 2,00 (2) 5,56% (1)
9 1,00% (1) -
of people
0 60% (18) 27,78% (5)
1 40% (12) 72,22% (13)
Employed 2 32% (6)
Self-employed 3 16% (3)
Unemployed 24 48% (9)
Table 1: Characteristics of the in-depth interview and focus group
Figure 1: Marital status, Demographic Characteristics of Patients of
Traditional Healers.
Emergent topics
From the focus group discussions and in-depth interviews emerged
two topics: patients’ explanatory models for mental illness and
why Zimbabwean patients use Hun’anga (traditional healing) for
common mental health disorders.
Shona Explanatory Models for Mental Illness
The main causes of illnesses that emerged from data analysis of
participants were supernatural factors. This response was further
categorized into illnesses caused by perceived spiritual causes
(zvemweya), or witchcraft (zvouroyi), or culture (zvemagariro),
and illnesses affecting mental health with unidentied causes
(zvisinganzwisisiki kuchipatara).
Description of causes and symptoms of illness
Both groups of participants attributed the causes of mental illness
to spirituality “zvomweya”. Nearly all participants reported
causes due to ancestral spirits (zvemidzimu), or possession by evil
(kusvikirwa nemweya yetsvina) or an aggrieved spirit (kubatwa
nengozi), and people who had been beaten by goblins (vakarohwa
Many of the participants reported cultural issues (zvechivanhu) as
the causes of mental illness. Many patients mentioned the pains
which were perceived to have arisen from unidentied traditional
Volume 1 | Issue 1 | 4 of 6Int J Psychiatry 2016
practices (zvemadzinza). For example, when relatives are believed
to have been inciting ancestral spirits (midzimu) to stop extending
protection and as a result, the sufferer becomes a victim of bad airs
(mamhepo) and become psychotic.
Almost all community members reported the causes of illness as
when people had stopped observing their cultural prescriptions
(tarasa tsika nemagariro) resulting in their ancestors withdrawing
their protection from them (midzimu yafuratira) and thereby,
making them prone to illness. However, some of the community
members believed illness was a form of request from ancestors,
asking the living to perform cultural rituals on their behalf. Many
community members mentioned that mental illness in a family
member was believed to be a sign an ancestral spirit (mudzimu)
was seeking to talk through a host (patient); a 30-year- old
community member whose friend had depression had this to say;
The healing spirit (mudzimu) rst makes its host ill as a way
of alerting the relatives so that they may nd out what the
problem is all about, you see, my friend doesn’t want to talk
with anyone and looks sad all the time with tears all over the
place” (community member FGD).
Many community members spoke about witchcraft issues as
causing a number of mental health problems. Examples given
were: those who are bewitched (vakaroyiwa) and may become
depressed, patients presenting with psychosis (kupenga) and
confusion (kuvhiringika) through witchcraft (huroyi), some are
struck by witchcraft birds (zvishiri) and become unconscious,
some patients were inserted witchcraft objects (zvipotswa) in their
bodies which would make them suffer from untold pain, and many
similar issues.
Patients’ reasons for the use of Hun’anga
From our data, we identied specicity as the main reason why
Zimbabwean patients use Hun’anga for common mental health
Most participants reported that they used Hun’anga because mental
illness with a supernatural cause can only be xed by Hun’anga.
This means conditions which were perceived to derive from
culture or witchcraft could be treated only in traditional healing. A
community member observed,
Those people with bad luck and nding it difcult to get
married (munyama) for them to go to the hospital complaining
that they need to get married, is not possible (Community
member, FGD)”.
The aetiology of mental illness was strongly linked to spiritual
factors by both study groups. Most of the community members
believed that the spiritual problems (matambudziko ezvemweya)
were believed to respond more positively to methods of traditional
medicine rather than in western medicine when, generally, doctors
failed to make a diagnosis. This was noted by a 37-year-old female
community member, who was living with a 42-year old female
patient suffering from mental psychosis,
“When we went to see the doctors, we were told the diagnosis
was not clear, when the person was molested by evil spirits”
(Community member).
Many participants mentioned their choice of treatment was
determined by the perceived causes of illness. Many patients
mentioned they visited traditional healers because they perceived
only traditional medicine (chivanhu) could resolve witchcraft
(huroyi) problems, as one 47 years old female patient suffering
from hysteria (mamhepo) observed;
“Because people thought that my illness was due to black
magic (mishonga yechibhoyi) which could only be treated in
traditional medicine” (Patient).
Nearly all community members reported supernatural causes
for unidentied illnesses (zvisinganzwisisiki) where nobody
understood the illness affecting the patient. A 40-year-old female
community member observed,
If the illness is arising from (mushonga wechibhoyi)
black magic, or after getting beaten by goblins (varohwa
nezvidhoma), a person may go to a western trained doctor
who may fail to see what happened” (Community member).
Almost all the community members who used traditional medicine
and patients felt they were consulting traditional medicine because
the healers provided holistic care–healing the mind, body and spirit
(kushandirwa zvose nemweya). A 26-year-old female community
member who uses traditional medicine for her anxiety noted,
Some traditional healers may start by chanting (kudeketera)
to your ancestral spirits (midzimu) for their support in the
treatment before they start healing. This is different from the
hospital set up where ancestors (midzimu) are not recognized
and no nurse will refer to any of your ancestors (kudeketera
kumidzimu) for their protection. It feels good to be connected
with your ancestors and I feel better” (Community member,
However in assessing the impact of traditional therapy they had
received, many participants had different feelings. Many patients
reported they derived complete satisfaction, but a few patients
thought they’d only experienced partial satisfaction or even no
satisfaction. However many participants felt traditional healing
was better than no treatment.
This was the rst study of why Zimbabwean patients use traditional
healing (Hun’anga) for common mental health disorders. The
ndings in this study are limited by difculties in selection of
traditional healing sites that represent diverse backgrounds and
viewpoints, scheduling interviews with hard to reach respondents
and the study site which was a peri-urban settlement and
Volume 1 | Issue 1 | 5 of 6Int J Psychiatry 2016
commonalities may differ in other areas, particularly in low and
middle income countries. There was also a risk the validity of the
data was (or could have been) compromised because respondents
did not answer the questions openly and honestly. To minimize
biases and sources of error, we took certain precautions and the
steps outlined above regarding the selection of subjects, their
comparability, and a calculation of sample size. In spite of the
above, some important ndings are noteworthy.
Explanatory models for mental health illness were largely
supernatural. Our results supported a Nigerian study which found
supernatural reasons to be the most popular explanations for
mental illness amongst carers and patients, a notable difference
from psychosocial issues found in international ndings [12].
The study showed that witchcraft played a central role in the
causation of mental health problems. Although witchcraft is
outlawed in Zimbabwe, this category continues to be used as an
important way of explaining misfortune and requires attention.
A similar result was established in Sub-Saharan Africa [13-
15]. The problems created by witchcraft were not identiable
to practitioners of conventional medicine, and could only be
identied in Hun’anga. What was surprising from our data was
that traditional healers served both the roles of providing therapy
for those affected as well as being used to cause illness when
requested by their patients to do so, for example, they cast bad
spells on their patient’s enemies. This implies that some traditional
healers (but not all) practise unethical behaviours. There is need to
train traditional healers the ethics of preventing public harm.
In addition, our study showed people who sought Hun’anga were
perceived to have developed mental health problems from their
lack of following their culture or their relatives were perceived
to have incited ancestral spirits to turn against them to either
withdraw their perceived protection from bad spirits, or cause bad
spirits to inict harm on them. Our result corroborated previous
studies [16,17]. Their study found spiritual possession is believed
to inuence the brain directly. What was surprising, however, was
that most of the illnesses that arose, including those with apparent
physical causes, were often attributed to the supernatural factors.
The implication of the ndings is that patient treatments in
Zimbabwe should focus beyond the physical manifestations of
the problems to include the underlying spiritual issues, which
is the mind. It is important to inform clinicians, policy makers
and other stakeholders that the understanding of the aetiology
of mental health illness from a Zimbabwean traditional healing
perspective may inform the management of patients at the primary
care level. This can be tackled by involving both the healers who
are well versed in the traditional approach and training nurses
at the primary health care level. More research should focus on
exploring this possibility. Our ndings corroborate the previous
research ndings.
Our ndings reveal that attending to perceived supernatural factors
should improve motivation of people with mental health issues to
seek therapy. However, further research is required to establish how
to integrate cultural and spiritual context of a patient in therapy.
What was surprising was, while community members mentioned
seeing patients with the more orid psychotic symptoms, the
patients reported benign symptoms of mental illness. This
could probably be a result of the stigma associated with mental
illnesses where people do not open up about their mental illness,
and this implies there should be deliberate effort to ght stigmas
surrounding having a mental illness.
Our study further revealed that participants made a choice to
use Hun’anga because they rated traditional healers’ skills high.
Participants also felt secure traditional healers would refer them to
other healing agents if it was necessary. Our ndings contradicted
results of previous research which found traditional healers
were not willing to refer patients to biomedical practitioners
[18]. Perhaps the difference was because we used a more robust
qualitative design as opposed to the quantitative methods used in
previous research.
Finally, our ndings suggested that people were satised by using
hun’anga. Our results supported previous research [6,19,20]. The
implication is that hun’anga indeed helps in the treatment of some
people (but not all) with mental health problems. Two questions
that remain to be answered are: how Hun’anga works for different
types of patients and how it can complement biomedicine in the
treatment of mental health problems [21,22].
We conclude that in our study location in Zimbabwe (and
potentially in most developing countries) community health
seeking behaviour is motivated mainly by supernatural factors.
Therefore, we are suggesting, in order to plan for a holistic,
culturally appropriate mental health programme, efforts must
be made to address these factors. Specically for the purpose of
incorporating cultural and spiritual needs in order to cater for
physical and spiritual being of a patient. Such an approach could
make traditional medicine more relevant as referral point as well
as rehabilitation and after care. Above all there must be continuous
mental health education for both mental health and mental illness.
Furthermore, research is needed to identify efcacy of traditional
methods and incorporate them into mainstream therapy. These
ndings can be used to optimize the health choices available in
low-income countries (LICs).
Author Contributions
Conceptualized the study: LK; Designed the interview: LK;
Conducted the interviews: LK; Participated in data analysis: LK,
CW, DC, TT, HJ; Drafted the manuscript: LK; Gave manuscript
input: LK, CW, DC, TT, HJ.
Ethical approval
All procedures performed in studies involving human participants
were in accordance with the ethical standards of the University
of Zimbabwe and Parirenyatwa Joint Research Ethics Committee
Volume 1 | Issue 1 | 6 of 6Int J Psychiatry 2016
Copyright: ©2016 Kajawu L. is is an open-access article distributed
under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited.
(JREC) and the Medical Research Council of Zimbabwe (MRCZ);
and with the 1964 Helsinki declaration and its later amendments or
comparable ethical standards.
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... Processes of care and treatments can greatly vary among these societies. It might depend on different cultural representations of health and illness, local healers' knowledge, nature and world-view perceptions shared by healers and patients, spiritual and mythological conceptualizations (Kajawu, 2016), rituals and symbols that legitimize the efficacy of treatments as well as botanical approaches or knowledge of the healers itself. TM is also a wide heterogeneous area. ...
Introduction: Mental health in indigenous communities is a relevant issue for the World Health Organization (WHO). These communities are supposed to live in a pure, clean and intact environment. Their real condition is far different from the imaginary; they are vulnerable populations living in difficult areas, exposed to pollution, located far from the health services, exposed to several market operations conducted to extract natural resources, facing criminal groups or illegal exploitation of land resources. These factors may have an impact on mental health of indigenous population. Methods: We reviewed all papers available on PubMed, EMBASE and The Cochrane Library until December 2018. We focused on those factors affecting the changes from a traditional to a post-modern society and reviewed data available on stress-related issues, mental distress affecting indigenous/aboriginal communities and the role of Traditional Medicine (TM). We reviewed articles from different countries hosting indigenous communities. Results: The incidence of mental distress and related phenomena (e.g. collective suicide, alcoholism and violence) among indigenous populations is affected by political and socio-economic variables. The mental health of these populations is poorly studied and described even if mental illness indicators are somewhat alarming. TM still seems to have a role in supporting affected people and may reduce deficiencies due to poor access to medical insurance/coverage, psychiatry and psychotherapy. It would be helpful to combine TM and modern medicine in a healthcare model to face indigenous populations' health needs. Conclusion: This review confirms the impact of societal changes, environmental threats and exploitation of natural resources on the mental health of indigenous populations. Global Mental Health needs to deal with the health needs of indigenous populations as well as psychiatry needs to develop new categories to describe psychopathology related to social variance as recently proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).
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Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi. A cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the "World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia". 210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%). This was closely followed by brain disease (92.8%), spirit possession (82.8%) and psychological trauma (76.1%). There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample. Our study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue.
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Qualitative methods are now widely used and increasingly accepted in health research, but quality in qualitative research is a mystery to many health services researchers. There is considerable debate over the nature of the knowledge produced by such methods and how such research should be judged. Antirealists argue that qualitative and quantitative research are very different and that it is not possible to judge qualitative research by using conventional criteria such as reliability, validity, and generalisability. Quality in qualitative research can be assessed with the same broad concepts of validity and relevance used for quantitative research, but these need to be operationalised differently to take into account the distinctive goals of qualitative research.
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Zimbabwe is experiencing one of the most severe AIDS epidemics in the world, with an estimated one out of seven people infected with HIV. For both palliative care and pragmatic treatment of HIV-related opportunistic infections, people turn to Un'anga (the traditional system of health and healing), not as a substitute for Western therapeutics but as an alternative explanatory model for the diagnosis and management of illness. Through the use of highly charged symbols and ritualized communication, n'angas (traditional healers) seek to transform patients' understandings and experiences of HIV-related illness. Using performance theory and discourse analysis, this article seeks to expand our understanding of how competing therapeutic goals in the performance of healing affect the structure and content of performance, its subsequent meaning, and the therapeutic effect on those afflicted with HIV.
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Objective: Anecdotal reports and research findings have suggested that religious healers are widely consulted by many Nigerians in time of mental health crisis.The study aimed at examining the knowledge, attitude and practice of mental health care among a syncretic Church's healers, and their readiness to cooperate with Psychiatrists. Method: A modified, pilot-tested, selfcompleted questionnaire was used to obtain information from consenting spiritual healers who satisfy the inclusion criteria. Focus group discussions (FGDs), Participatory Observation (PO) and Key Informant Interviews (KII) were used to corroborate or refute the findings. Results: The respondents' knowledge of mental disorders was limited to psychotic disorders; their explanatory model was similar to beliefs of the populace. In practice, they combined some modern medical approach, some native methodology and some eclectic religious practices such as prophecy, trance and dream. Only 6% of them ever referred their clients to medical practitioners. Conclusion: Religious healers still constitute an important route to access mental health care providers to some Nigerians.
Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data--systematically obtained and analyzed in social research--can be furthered. The discovery of theory from data--grounded theory--is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications. In Part I of the book, "Generation Theory by Comparative Analysis," the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data," the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, "Implications of Grounded Theory," Glaser and Strauss examine the credibility of grounded theory. The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena--political, educational, economic, industrial-- especially If their studies are based on qualitative data.
In this paper we present the Karanga traditional system of therapy of illness and disease manifest in the treatments administered by the medical practitioners. In order to establish the traditional system of therapy of illness and disease, numerous interviews were carried out with healers, herbalists and elders in the field area. This enabled a systematic compilation of cases. There was also the pressing need to be present at rituals and instances where healing was effected and to observe therapeutic processes.