Browsing by Author "Nortje, G."

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A survey of traditional and faith healers providing mental health care in three sub-Saharan African countries
(Springer Science + Business Media, 2019) Esan, O.B.; Appiah-Poku, J.; Othieno, C.; Kola, L.; Harris, B.; Nortje, G.; Makanjuola, V.; Oladeji, B.; Price, L.; Seedat, S.; Gureje, O.
Background: Traditional and faith healers constitute an important group of complementary and alternative mental health service providers (CAPs) in sub-Sahara Africa. Governments in the region commonly express a desire to integrate them into the public health system. The aim of the study was to describe the profile, practices and distribution of traditional and faith healers in three sub-Saharan African countries in great need for major improvements in their mental health systems namely Ghana, Kenya and Nigeria. Materials and methods: A mapping exercise of CAPs who provide mental health care was conducted in selected catchment areas in the three countries through a combination of desk review of existing registers, engagement activities with community leaders and a snowballing technique. Information was collected on the type of practice, the methods of diagnosis and the forms of treatment using a specially designed proforma. Results: We identified 205 CAPs in Ghana, 406 in Kenya and 82 in Nigeria. Most (> 70%) of the CAPs treat both physical and mental illnesses. CAPs receive training through long years of apprenticeship. They use a combination of herbs, various forms of divination and rituals in the treatment of mental disorders. The use of physical restraints by CAPs to manage patients was relatively uncommon in Kenya (4%) compared to Nigeria (63.4%) and Ghana (21%). CAPs often have between 2- to 10-fold capacity for patient admission compared to conventional mental health facilities. The profile of CAPs in Kenya stands out from those of Ghana and Nigeria in many respects. Conclusion: CAPs are an important group of providers of mental health care in sub-Saharan Africa, but attempts to integrate them into the public health system must address the common use of harmful treatment practices.
Collaboration Between Biomedical and Complementary and Alternative Care Providers: Barriers and Pathways
(SAGE Publishing, 2017) "Van der Watt, A.S.J.; Nortje, G.; Kola, L.; Appiah-Poku, J.; Othieno, C.; Harris, B.; Oladeji, B.D.; Esan, O.B.; Makanjuola, V.; Price, L.N.; Seedat, S.; Gureje, O.
We examined the scope of collaborative care for persons with mental illness as implemented by traditional healers, faith healers, and biomedical care providers. We conducted semistructured focus group discussions in Ghana, Kenya, and Nigeria with traditional healers, faith healers, biomedical care providers, patients, and their caregivers. Transcribed data were thematically analyzed. A barrier to collaboration was distrust, influenced by factionalism, charlatanism, perceptions of superiority, limited roles, and responsibilities. Pathways to better collaboration were education, formal policy recognition and regulation, and acceptance of mutual responsibility. This study provides a novel cross-national insight into the perspectives of collaboration from four stakeholder groups. Collaboration was viewed as a means to reach their own goals, rooted in a deep sense of distrust and superiority. In the absence of openness, understanding, and respect for each other, efficient collaboration remains remote. The strongest foundation for mutual collaboration is a shared sense of responsibility for patient well-being.
The perceived effectiveness of traditional and faith healing in the treatment of mental illness: a systematic review of qualitative studies
(Springer Science+Business Media, 2018) Van der Watt, A.S.J.; van de Water, T.; Nortje, G.; Oladeji, B.D.; Seedat, S.; Gureje, O.; Partnership for Mental Health Development in Sub-Saharan Africa (PaM-D) Research Team, Collaborators; Kola, L.; Appiah-Poku, J.; Othieno, C.; Harris, B.; Esan, O.B.; Makanjuola, V.; Price, L.N.
Purpose: This work complements a quantitative review by Nortje et al. (Lancet Psychiatry 3(2):154–170, 2016) by exploring the qualitative literature in regard to the perceived effectiveness of traditional and faith healing of mental disorders. Method: Qualitative studies focusing specifically on traditional and/or faith healing practices for mental illness were retrieved from eight databases. Data were extracted into basic coding sheets to facilitate the assessment of the quality of eligible papers using the COREQ. Results: Sixteen articles met the inclusion criteria. Despite methodological limitations, there was evidence from the papers that stakeholders perceived traditional and/or faith healing to be effective in treating mental illness, especially when used in combination with biomedical treatment. Conclusion: Patients will continue to seek treatment from traditional and/or faith healers for mental illness if they perceive it to be effective regardless of alternative biomedical evidence. This provides opportunities for collaboration to address resource scarcity in low to middle income countries.