Christian Journal for Global Health (Feb 2024)
Providing mental healthcare through faith-based entities in Africa: a systematic review
Abstract
Background: Psychological disturbances and mental illnesses are prevalent on the continent of Africa. There are shortages of mental health services and a lack of quality providers with limited training and supervision. It is perceived that faith-based entities for psycho-emotional health and wellbeing are filling the gap with positive impact. However, the risks associated with unconventional or extreme spiritual practices will be evaluated. The contributions of these entities, their roles in the global and African health system, and their implications for community development and policy making are highlighted. Methods: A mixed-methods systematic review was conducted in two phases to synthesise qualitative and quantitative data. The review sought evidence on faith-based health providers of mental health services in Africa looking at types, magnitude, and quality and included both peer-reviewed and grey literature published between 2007 and 2024 in English. A narrative thematic analysis was used for the qualitative part and meta-analyses was used for the quantitative part to back up the narrative element of this study. Results: This review identified 55 relevant items from 13 African countries. The results showed that faith-based, mental-health providers deliver a range of six types of alternative mental healthcare, faith-based, home care, and faith-based, biomedical, mental healthcare. The magnitude of these faith-based, mental health services were considered according to frequency of use and availability (accessibility, affordability, and acceptability), however evidence was limited. When the quality of the mental healthcare was assessed, some studies showed positive mental health outcomes from the utilisation of faith-based, mental healthcare, but some studies revealed bad quality practices due to harmful treatment. Conclusion: There are limitations regarding the vast array of faith-based, health providers and the mental healthcare they provide which include harmful practices used in Africa. Training interventions are needed to avoid harmful treatment. Faith-based, mental healthcare offers culturally influenced practices for mental-health which should be leveraged. Integration of faith-based, mental healthcare into any primary, health system is advised in order to attain universal health coverage. Finally, possible regulation of traditional and faith healing methods for emotional struggles could be implemented at a policy level.
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