The ‘flip-side’ of medical pluralism on the HIV and AIDS epidemic: Reflections from rural Limpopo Province, South Africa

Abstract

South Africa has a medically pluralistic health care environment. Medical pluralism is a phenomenon that refers to multiple health systems co-existing within a specific environment. It is widely accepted that the co-existence of different health systems can generate some adverse health-related consequences at both individual and societal levels. In the context of the HIV and AIDS epidemic, these adverse consequences have been associated with delays in testing and interruption of treatment. It has also been argued that integrating different health systems within medically pluralistic societies could improve health outcomes. This study reflects on findings from individual interviews relating to the diagnosis and treatment of HIV with faith healers in the rural Ga-Dikgale community, Capricorn district of the Limpopo Province, South Africa. The narratives were analysed using both a thematic content analysis — based on the Triadic Streams of Influence Framework — and a grounded theory approach. The findings indicate that the faith healers, in collaboration with their congregation/s, are providing people living with HIV with individual and social forms of support to enter and remain within the biomedical continuum of care. This ‘flip-side’ perspective provides indicators that — in the context of faith healers — medical pluralism generates beneficent health related impacts at both individual and societal levels. Indirectly, the findings may also represent an opportunity to improve collaboration between the two health systems.

Keywords: Faith healers, health systems strengthening, linkage and retention in HIV care, Triadic Streams of Influence Framework, traditional health practitioner