Collaboration between traditional and Western practitioners for mental health in Malawi

16 December, 2022

Dear HIFA colleagues,

This is an interesting paper in the Malawi Medical Journal. Citation, abstract and comment from me below.

CITATION: Kokota D et al. Views and experiences of traditional and Western medicine practitioners on potential collaboration in the care of people living with mental illness in Malawi

Malawi Medical Journal

Vol. 34 No. 4 (2022)


Introduction: Collaboration between traditional and biomedical medicine can lead to holistic care and improved health outcomes for people with mental illnesses. The current study aimed to explore the views and experiences of traditional and western medicine practitioners on potential collaboration in the care of people living with mental illness in Blantyre, Malawi.

Method: A phenomenological qualitative research design was used. Data were collected using both one-on-one in-depth interviews (IDIs) and focus group discussions (FGDs). Participants were traditional healers and western medicine practitioners in Blantyre, Malawi. We conducted 10 in-depth interviews with traditional healers, 4 focus group discussions (2 for traditional healers and 2 for western medicine practitioners) and 6 key informant interviews with leaders of the two groups. The sample was determined based on data saturation. Thematic analysis was used to analyse the data. We used a combination of deductive and inductive coding.

Results: Five broad themes were identified from the data: experiences with collaboration, views on collaboration, models of collaboration, barriers to collaboration, and factors that can facilitate collaboration. participants had no experience of formal collaboration between traditional healers and western healthcare workers in the management of mental illness. However, some reported experience of successful collaborations in other health areas such as safe motherhood, tuberculosis and HIV/AIDS. Many participants showed a positive attitude toward collaboration and were in support of it. Barriers to collaboration included negative attitudes and a lack of

resources. Factors that can facilitate collaboration were dialogue, training and respect. Referral and training were the preferred forms of collaboration.

Conclusion: With proper structures and respectful dialogue, a collaboration between traditional and western medicine practitioners is possible in Blantyre, Malawi.

COMMENT (NPW): It's notable there was general positivity about the potential for collaboration from both western and traditional practitioners, although a few of the quotes from western practitioners were sceptical of the effectiveness of traditional medicine. Respondents noted that successful collaborations already existed for maternity care and HIV.

'According to many western healthcare workers, some of the negative practices that traditional healers do are because of a lack of knowledge. This can be rectified by training traditional healers on how to handle mentally ill patients, the signs and symptoms of mental illnesses and how to refer patients.'

The references to training seemed to be restricted to training of traditional practitioners. True collaboration is two-way, and it would be good to explore what Western practitioners can learn from traditional practitioners, especially in the area of mental health where culture and belief are so important.

Dr Neil Pakenham-Walsh, HIFA Coordinator

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