The Place of Spiritual and Traditional Beliefs in Stroke Rehabilitation in Sub-Saharan Africa: A Scoping Review

Abstract

Aims: This systematic scoping review aimed at mapping evidence available on the impact of spiritual and traditional beliefs on perception of stroke vis-a-vis stroke rehabilitation in sub-Saharan Africa. Study Design: Systematic scoping review. Place and Duration of Study: This study was conducted in June, 2019 as a preliminary step to study underway in the University of Nigeria Enugu Campus. Methodology: Literature search was undertaken of PubMed, CINAHL, EBSCOhost Academic Search Complete and PsycINFO. The selection process was aided with use of EndNote X8. A total of 17 peer-reviewed articles were included. Thematic contents analysis was done using NVIVO 12. Five emerging themes were synthesized. Results show that a small but significant number of the respondents possessed poor knowledge and perception of stroke, and this affected the health seeking behaviors. Results: Although many of the participants would seek formal healthcare when a stroke occurs, some believed stroke is purely a spiritual event and should be addressed spiritually, while a few advocated for integration of traditional and orthodox healthcare approaches. Being a clinical worker, educated or a Christian was associated with good knowledge of stroke. For the participants who preferred spiritual or traditional approach to formal healthcare, traditional or religious inclination, level of education, hospital cost and hospital-related ill-treatment are the propelling factors. Conclusion: Spiritual and traditional beliefs possess a significant place in stroke rehabilitation in sub-Saharan Africa. We commend that holistic approach with a spiritual component be adopted in stroke rehabilitation across sub-Saharan Africa.