Jonathan Burns|Andrew Tomita
Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis
University of KwaZulu-Natal|University of KwaZulu-Natal
resourcelimited contexts low middleincome countries lmics considerable proportion individuals seeking care mental disorders consult traditional religious healers pathway mental health care reports africa suggest early involvement healers may result delays care pathway potential barrier early identification interventiona systematic review conducted evaluate proportion patients attending formal health services making first contact treatment mental disorders traditional religious healers informal formal care providers within published research africa electronic databases searched period january 1990 february 2014 quality assessment included studies conducted saqor toolfourteen papers identified data category first care provider utilizing random effects modelling inverse variance method pooled proportion participants making first contact treatment mental disorders two broadly categorised providers informal formal 481 95 ci 364600 492 95 ci 380604 respectively pooled proportion participants making first contact specific providers traditional healers 170 95 ci 109241 religious healers 262 95 ci 181351 general health services 243 95 ci 169325 mental health services 130 95 ci 51235 substantial regional variation patterns first provider choice evidentconclusions review must qualified light several limitations approximately half individuals seeking formal health care mental disorders africa choose traditional religious healers first care provider previous reports suggest choice associated delays accessing formal mental health services strategies improve pathways mental health care africa must include innovative programmes aimed fostering collaboration biomedical mental health services key communitybased providers