Institute of Global Health, University College London , London, UK.
Stema Health Systems Innovation , London, UK.
Glob Health Action. 2020 Dec 31;13(1):1838241. doi: 10.1080/16549716.2020.1838241.
There have been increasing calls for collaboration between Indigenous health practitioners (IHPs) and allopathic health practitioners (AHPs) in Africa. Despite this, very few successful systems exist to facilitate formal collaboration. Direct relationships between providers, and at a health systems level are crucial to successful collaboration, but the nature and extent of these relationships have yet to be adequately explored.
To explore the relationship between IHPs and AHPs in Africa, and to discuss the implications of this for future collaboration.
An interpretive qualitative synthesis approach, combining elements of thematic analysis, meta-ethnography, and grounded theory, was used to systematically bring together findings of qualitative studies addressing the topic of collaboration between Indigenous and allopathic health practitioners in Africa.
A total of 1,765 papers were initially identified, 1,748 were excluded after abstract, full text and duplicate screening. Five additional studies were identified through references. Thus, 22 papers were included in the final analysis. We found that the relationship between Indigenous and allopathic health practitioners is defined by a power struggle which gives rise to lack of mutual understanding, rivalry, distrust, and disrespect.
The power struggle which defines the relationship between IHPs and AHPs in Africa is a hindrance to their collaboration and as such could partly account for the limited success of efforts to foster collaboration to date. Future efforts to foster collaboration between IHPs and AHPs in Africa must aim to balance the power disparity between them if collaboration is to be successful. Since this would be a novel approach, decision-makers and organisations who trial this power balancing approach to facilitate collaboration should evaluate resultant policies and interventions to ascertain their feasibility and efficacy in fostering collaboration, and the lessons learnt should be shared.
非洲越来越呼吁本土医疗从业者（IHPs）与传统西医从业者（AHPs）之间开展合作。尽管如此，几乎没有成功的系统可以促进正式的合作。提供者之间以及在卫生系统层面上的直接关系对于成功的合作至关重要，但这些关系的性质和程度尚未得到充分探讨。
探讨非洲本土医疗从业者与传统西医从业者之间的关系，并讨论这对未来合作的影响。
采用解释性定性综合方法，结合主题分析、元民族学和扎根理论的元素，系统地汇集了关于非洲本土和传统西医从业者合作主题的定性研究的发现。
最初确定了 1765 篇论文，经过摘要、全文和重复筛选后排除了 1748 篇。通过参考文献又确定了另外 5 项研究。因此，最终分析共纳入了 22 篇论文。我们发现，本土和传统西医从业者之间的关系是由权力斗争定义的，这导致了相互理解、竞争、不信任和不尊重的缺乏。
非洲本土医疗从业者与传统西医从业者之间关系中的权力斗争是他们合作的障碍，这可以部分解释迄今为止促进合作的努力为何有限。未来在非洲促进本土医疗从业者与传统西医从业者之间的合作，必须旨在平衡他们之间的权力差距，以实现合作的成功。由于这将是一种新方法，因此尝试这种权力平衡方法以促进合作的决策者和组织应该评估由此产生的政策和干预措施，以确定其在促进合作方面的可行性和效果，并且应分享所吸取的经验教训。
