Improving surgical care in rural South Africa: exploring collaboration between Indigenous and formal health sectors.

INTRODUCTION: South Africans use both Indigenous and formal health care to address surgical conditions; however, these sectors are often siloed, leaving care for the individual disjointed. This study aimed to improve person-centered surgical care in rural South Africa by identifying community-prioritized surgical conditions and exploring Indigenous and formal healthcare stakeholder buy-in to collaborative solutions. METHODS: This phenomenological qualitative study used focus group discussions and a multi-stakeholder workshop. Study participants included Indigenous knowledge healers, clinic and hospital staff, community members, and community health workers. Perceived barriers and facilitators to collaboration and solutions improving care within a dual health system were explored. Data were collected and analyzed using Rapid Research, Evaluation and Appraisal Lab sheets. RESULTS: Three focus group discussions of different stakeholder groups were held with five to eight participants each (18 participants total). A total of 33 participants attended the multi-stakeholder workshop. All stakeholders agreed that Indigenous knowledge healers could play a role in improving surgical care. Collaborative solutions included bilateral referral systems and cross-sector education. Barriers included lack of communication and transparency between Indigenous and formal health sectors. CONCLUSION: Person-centered care includes acknowledging that many people in rural South Africa with surgical conditions will seek care in both the Indigenous and formal health sectors. Improving communication and referrals between the sectors may streamline care and improve health outcomes and community wellbeing.