The role of traditional and faith healers in the treatment of dementia in Tanzania and the potential for collaboration with allopathic healthcare services.
Low diagnostic rates are a barrier to improving care for the growing number of people with dementia in sub-Saharan Africa. Many people with dementia are thought to visit traditional healers (THs) and Christian faith healers (FHs) and these groups may have a role in identifying people with dementia. We aimed to explore the practice and attitudes of these healers regarding dementia in rural Tanzania and investigate attitudes of their patients and their patients’ carers.



This was a qualitative study conducted in Hai district, Tanzania. Semi-structured interviews were conducted with a convenience sample of THs and FHs and a purposive-stratified sample of people with dementia and their carers. Interview guides were devised which included case vignettes. Transcripts of interviews were subject to thematic analysis.



Eleven THs, 10 FHs, 18 people with dementia and 17 carers were recruited. Three themes emerged: (i) conceptualisation of dementia by healers as a normal part of the ageing process and no recognition of dementia as a specific condition; (ii) people with dementia and carer reasons for seeking help and experiences of treatment and the role of prayers, plants and witchcraft in diagnosis and treatment; (iii) willingness to collaborate with allopathic healthcare services. FHs and people with dementia expressed concerns about any collaboration with THs.



Although THs and FHs do not appear to view dementia as a specific disease, they may provide a means of identifying people with dementia in this setting.
The Medical School, Newcastle University, Newcastle upon Tyne, UK.
Guy
G
Hindley
Hai District Hospital, Boman'gombe, Kilimanjaro Region, United Republic of Tanzania.
John
J
Kissima
Research & Development, Northumbria Healthcare NHS Foundation Trust, North Shields, UK.
Lloyd
L
L Oates
Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK|Department of Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
Stella-Maria
SM
Paddick
Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro Region, United Republic of Tanzania.
Aloyce
A
Kisoli
Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro Region, United Republic of Tanzania.
Christine
C
Brandsma
Research & Development, Northumbria Healthcare NHS Foundation Trust, North Shields, UK.
William
W
K Gray
Department of Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK|Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
Richard W
RW
Walker
Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro Region, United Republic of Tanzania.
Declare
D
Mushi
Department of Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK|Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
Catherine L
CL
Dotchin
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology; D003071:Cognition; D000066492:Cognitive Aging; D003299:Cooperative Behavior; D003466:Cultural Characteristics; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D003704:Dementia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D029221:Faith Healing / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008297:Male; D016488:Medicine, African Traditional / Q000379:methods*; D008875:Middle Aged; D008517:Phytotherapy / Q000523:psychology; D010936:Plant Extracts / Q000627:therapeutic use; D010946:Plants, Medicinal; D036301:Qualitative Research; D012068:Religion and Medicine; D019035:Rural Health Services; D013636:Tanzania; D018599:Witchcraft / Q000523:psychology
D010936:Plant Extracts