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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 3/2019

01-03-2019 | Original Paper

A survey of traditional and faith healers providing mental health care in three sub-Saharan African countries

Authors: Oluyomi Esan, John Appiah-Poku, Caleb Othieno, Lola Kola, Benjamin Harris, Gareth Nortje, Victor Makanjuola, Bibilola Oladeji, LeShawndra Price, Soraya Seedat, Oye Gureje

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 3/2019

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Abstract

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.
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Metadata
Title
A survey of traditional and faith healers providing mental health care in three sub-Saharan African countries
Authors
Oluyomi Esan
John Appiah-Poku
Caleb Othieno
Lola Kola
Benjamin Harris
Gareth Nortje
Victor Makanjuola
Bibilola Oladeji
LeShawndra Price
Soraya Seedat
Oye Gureje
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 3/2019
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-018-1630-y

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