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Guidelines to promote proper use of African traditional medicine in people living with HIV in selected districts of Limpopo province

African Traditional Medicine is the sum total of skills and practices based on beliefs and experiences of traditional to African cultures that are used to prevent, diagnose, improve or treat physical and mental illnesses. Traditional medicine used to be the dominant medical system available to millions of people in Africa in both rural and urban communities. Indeed, it was the only source of medical care for a greater proportion of the population (Romero-Daza, 2002). There are strong indications that traditional health care systems are still in use by the majority of people not only in Africa, but across the world. In African traditional communities, traditional healers are well known for treating patients holistically. In many of these communities, traditional healers often act, in part, as an intermediary between the visible and invisible worlds, between the living and the dead or ancestors, sometimes to determine which spirits are at work and how to bring the sick person back into harmony with the ancestors.
The study consisted of two phases, namely, the empirical phase and the development of guidelines phase. In Phase 1, which was the empirical phase, a qualitative approach was employed. The study utilised phenomenological and explorative designs. The study population comprised of male and female traditional healers as well as people living with HIV (PLWH) in selected districts of Limpopo. Ten traditional healers were purposively selected and three PLWH were interviewed. Data were collected from participants using semi-structured interviews. Field notes as well as observations were also used as methods of data collection. Data analysis was done using Interpretative Phenomenological Analysis (IPA). Several ethical principles were adhered to in order to maintain the anonymity of the traditional healers and PLWH. All participants voluntarily participated in the study. Furthermore, informed consent was sought from participants prior to the commencement of the study. The study further maintained the aspects of confidentiality and privacy since it was dealing with human subjects and sensitive issues. Trustworthiness, credibility, dependability, transferability and confirmability were insured. The findings of the study showed that many PLWH have poor or no insight into their illness and they are not aware of the symptoms and consequences of their illness and this lack of illness insight was associated with adulteration of ATM. Traditional healers rated poor illness insight as the most important contributing factor. Another finding revealed that PLWH who dealt with stress of their illness by ignoring their illness, try to move from one healer to the next in order to get a third or fourth opinion about the illness. PLWH would find that the medicine that are given to them require them to frequently need food, they go to another healer thinking that the medicine would be different only to find out that the medicines are the same and they give them appetite to eat more food.
Recommended guidelines were developed to promote proper use of ATM in PLWH in selected districts of Limpopo Province, using the WHO (PICOS and GRADE) model. The researcher recommends that traditional healers should provide treatment to all patients, irrespective of the length of their illness.

Keywords: African traditional medicine (ATM), traditional healers, people living with HIV, adulteration of ATM, development of guidelines

Full Name
Dr Lufuno Mashamba