Exploring the Integration of Traditional Healers into Hospital-based Health Care in Sierra Leone

Abstract

This study aimed to examine stakeholder perceptions, feasibility, and challenges associated with integrating traditional healers into hospital-based healthcare systems in Sierra Leone, with the objective of identifying opportunities for collaboration and informing policy and practice. A cross-sectional mixed-methods design was employed involving 400 participants drawn from Bo District, Western Area Urban District, and Kenema District. Quantitative data were collected using a structured questionnaire consisting of 35 closed-ended items assessing perceptions of integration feasibility, trust, safety, and institutional readiness, and were analyzed using IBM SPSS version 27. Qualitative data were obtained through 40 key informant interviews and eight focus group discussions and analyzed thematically using NVivo version 12. The results indicated that 86% of respondents supported the integration of traditional healers into hospital-based healthcare, citing cultural relevance, accessibility, and patient trust as key advantages. However, major barriers included the absence of regulatory frameworks, concerns about herbal safety and dosage, limited research capacity, and lack of mutual professional trust. The study concludes that integration is both feasible and necessary for strengthening culturally competent healthcare delivery and advancing Universal Health Coverage in Sierra Leone. It recommends the development of a national integration policy, hospital-based pilot programs, strengthened research and quality assurance mechanisms, and targeted capacity-building initiatives.