Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia.
BMJ Open. 2024 Sep 25;14(9):e083004. doi: 10.1136/bmjopen-2023-083004.
In areas with limited and unaffordable biomedical mental health services, such as sub-Saharan Africa (SSA), traditional healers are an incredibly well-used source of mental healthcare. This systematic review synthesises the available evidence on traditional healing practices, factors to access it and its effectiveness in improving people's mental health in SSA.
Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach.
PubMed, MEDLINE, CINAHL and Scopus studies published before 1 December 2022.
Qualitative and quantitative studies reported traditional healing practices to treat mental health problems in SSA countries published in English before 1 December 2022.
Data were extracted using Covidence software, thematically analysed and reported using tables and narrative reports. The methodological quality of the included papers was evaluated using Joanna Briggs Institute quality appraisal tools.
In total, 51 studies were included for analysis. Traditional healing practices included faith-based (spiritual or religious) healing, diviner healing practices and herbal therapies as complementary to other traditional healing types. Objectively measured studies stated that people's mental health improved through collaborative care of traditional healing and biomedical care services. In addition, other subjectively measured studies revealed the effect of traditional healing in improving the mental health status of people. Human rights abuses occur as a result of some traditional practices, including physical abuse, chaining of the patient and restriction of food or fasting or starving patients. Individual, social, traditional healers, biomedical healthcare providers and health system-related factors were identified to accessing traditional healing services.
Although there is no conclusive, high-level evidence to support the effectiveness of traditional healing alone in improving mental health status. Moreover, the included studies in this review indicated that traditional healing and biomedical services collaborative care improve people's mental health.
CRD42023392905.
在生物医学心理健康服务有限且负担不起的地区，例如撒哈拉以南非洲（SSA），传统治疗师是一个非常常用的心理健康护理来源。本系统评价综合了关于传统治疗实践、获得传统治疗的因素以及其在改善 SSA 人群心理健康方面的有效性的现有证据。
使用系统评价和荟萃分析首选报告项目的系统评价。
在 2022 年 12 月 1 日之前，在 PubMed、MEDLINE、CINAHL 和 Scopus 上发表的研究。
在 SSA 国家发表的报告传统治疗方法治疗心理健康问题的定性和定量研究，语言为英语，发表时间在 2022 年 12 月 1 日之前。
使用 Covidence 软件提取数据，使用表格和叙述报告进行主题分析和报告。使用 Joanna Briggs 研究所质量评估工具评估纳入论文的方法学质量。
共有 51 项研究被纳入分析。传统治疗方法包括基于信仰的（精神或宗教）治疗、占卜治疗实践和草药疗法，作为其他传统治疗类型的补充。客观测量的研究表明，人们的心理健康通过传统治疗和生物医学治疗服务的协同护理得到改善。此外，其他主观测量的研究揭示了传统治疗在改善人们心理健康状况方面的作用。由于一些传统做法，如身体虐待、患者被锁链束缚、限制食物或禁食或使患者挨饿，会发生侵犯人权的行为。确定了个人、社会、传统治疗师、生物医学保健提供者和卫生系统相关因素，以获得传统治疗服务。
虽然没有确凿的、高水平的证据支持传统治疗单独改善心理健康状况的有效性。此外，本综述中的纳入研究表明，传统治疗和生物医学服务的协同护理可以改善人们的心理健康。
CRD42023392905。
