Barriers and facilitators of traditional health practitioners’ regulation requirements: A qualitative study

Abstract

Background Regulations could create benefits and opportunities for traditional health practitioners (THPs) and traditional medicine (TM) users in this new era of traditional medicine systems (TMS) as the growing international popularity propels this. The 1978 International Conference on Primary Health Care played a significant role in recognising THPs. To date, millions of people across the globe continue to utilise THPs. The issues of safety and scientific validation led the WHO to recommend regulations of TM. This was also supported by pressures from the realisation that culture and spiritual life is associated with traditional healing. This paper seeks to understand barriers and facilitators surrounding THP regulation implementation. Methods The qualitative research approach involved five focus group discussions sampled from five Kwazulu-Natal district municipalities (one in each district). Participants were selected using district THP councils and a snowballing technique to recruit non-functional THP councils. Data collection tools included case summaries and a focus group discussion guide. Data was analyzed using Braun & Clarke’s (2017) six-phase thematic analysis framework. Results Themes identified included purposes of being registered with the THP council; registration being viewed as a tax collection instrument; and recognition and legitimacy of THPs. Most THPs were uncertain about why they should be registered and therefore struggled to identify benefits of being registered. Moreover, several THPs viewed registration as tactic to oppress and squeeze them to contribute towards the countries taxation system. Recognition and legitimacy were the only benefits identified, as THPs saw registration as a gateway into mainstream health and believed it would separate them from charlatans. Conclusions THPs generally had mixed feelings about being registered; most saw very little, if any, potential benefits in being registered, except for recognition and legitimacy. THPs who found registration beneficial, remained sceptical about how it would impact their intellectual property and belief systems. Further exploration of the role of THP associations, their history and evolution and the influence they could have in driving THP regulation implementation process is warranted, especially since THPs found registering with such associations to be beneficial.