Revitalising Traditional Health Practice Education in South Africa: Three Years After My PhD

 

When I completed my PhD three years ago, my focus was on a question that remains both urgent and unresolved: how do we recognise and legitimise the education of Traditional Health Practitioners (THPs) in South Africa within the national system of qualifications?

Traditional healers have always stood at the heart of African communities. Research consistently shows that between 70–80% of South Africans consult a THP as a first or complementary source of healthcare. For many, this is not only about medical treatment but also about spiritual grounding, cultural continuity, and community trust. And yet, despite their central role, THPs continue to exist at the margins of formal recognition in our education and health systems.

In this post, I revisit the findings of my doctoral research and reflect on where South Africa now stands—three years later—in bridging the gap between indigenous apprenticeship-based systems of training and the requirements of the National Qualifications Framework (NQF).

The Promise of Recognition

The Traditional Health Practitioners Act (Act 22 of 2007) was a watershed moment. It provided legal recognition for THPs and established the Traditional Health Practitioners Council of South Africa (THPCSA) as the regulatory body. Over the years, regulations in 2015 and most recently in 2024 have deepened the Council’s authority, mandating oversight of training institutions, quality assurance of curricula, and standards for professional registration.

On paper, South Africa is a global leader. Few countries have taken such deliberate steps to legislate the regulation of indigenous health practices. The World Health Organization’s Traditional Medicine Strategy 2014–2023, now extended into a draft 2025–2034 strategy, urges member states to do exactly this: invest in education, develop competency frameworks, and establish accreditation pathways.

And yet, the reality on the ground is sobering. Despite legal recognition, there is still no nationally standardised educational pathway that maps the rigorous apprenticeship systems of THPs onto qualifications within the NQF. This creates a strange contradiction: THPs are both recognised and invisible, central and marginal, legitimate in law but excluded in practice.

What My Research Found

My doctoral study set out to bridge this contradiction. I immersed myself in policy documents, international frameworks, and fieldwork with healers, educators, and regulators. Four insights emerged clearly.

First, apprenticeship systems already produce sophisticated competencies. Initiation processes, mentorship by experienced healers, and community validation transmit a body of knowledge that is wide-ranging: herbal pharmacopoeia, divination, diagnostic skills, counselling, and ritual practice. These are not random practices but structured pedagogies that have endured for generations.

Second, none of these competencies are formally mapped to NQF descriptors. The result is that even though a healer may have practised for decades with deep expertise, their skills cannot be “translated” into a certificate, diploma, or degree recognised by SAQA, CHE, or QCTO.

Third, the existing regulations of 2015 and 2024 promise institutional accreditation and quality assurance, but there has been little evaluation of how these mechanisms actually work. To date, no higher education institution offers a fully accredited, nationally recognised qualification in traditional health practice that meets the requirements of the NQF.

Fourth, Recognition of Prior Learning (RPL)—the pathway that could allow practising healers to enter the qualifications framework—remains underdeveloped. Without it, thousands of THPs remain outside formal recognition, despite their vital role in public health.

Why This Matters

Some may ask: why should traditional healers be drawn into the formal structures of the NQF? Why not allow apprenticeship to continue as it always has?

The answer is not about undermining apprenticeship but about ensuring epistemic justice and patient safety. On one hand, formal recognition safeguards the rights of THPs by acknowledging that their knowledge systems are equal in value to biomedical knowledge. It affirms that African healing is not folklore but a discipline with its own intellectual rigour. On the other hand, competency-based accreditation ensures that training standards are clear, consistent, and accountable—protecting patients, especially in contexts where THPs are engaged in managing HIV, TB, mental health, and other critical conditions.

Without this recognition, THPs remain vulnerable to marginalisation, stigma, and even criminalisation. Worse, patients are denied the security of knowing that the healers they consult are accredited under a recognised national framework.

Three Years Later: Where Are We?

Since I completed the study, several developments have unfolded. The 2024 regulatory amendments tightened the Council’s authority over traditional health practitioner education. WHO’s draft 2025–2034 strategy continues to push for competency-based integration of traditional medicine. And in higher education, conversations about decolonising curricula have gained traction, opening space for indigenous knowledge systems.

But progress has been uneven. To this day, the competency framework I argued for in my thesis—mapping apprenticeship outcomes to NQF levels—remains absent. Interprofessional education initiatives, where medical and traditional trainees learn together, are still scarce. And the regulatory bodies face resource constraints that limit their ability to enforce accreditation processes.

South Africa continues to stand at a crossroads: the legislative foundation is strong, the global momentum is aligned, but the translation of policy into practice remains elusive.

What Needs to Happen

If South Africa is to honour its own legislation and global commitments, three shifts are urgent:

  1. Develop a national competency framework that translates apprenticeship-based learning into NQF-aligned qualifications. This is the cornerstone for everything else.

  2. Operationalise Recognition of Prior Learning (RPL) for practising THPs. Without this, thousands remain locked out of formal recognition.

  3. Strengthen interprofessional education and dialogue between biomedical and indigenous systems. Integration cannot happen in policy alone—it requires practitioners to learn and practise alongside one another.

These are not abstract tasks. They are actionable, achievable, and necessary.

Closing Reflections

Three years on, I remain convinced that revitalising Traditional Health Practice education is one of the most important—and most neglected—tasks in post-apartheid South Africa’s project of transformation. It is about more than professional recognition. It is about healing the fractures of colonial epistemicide, restoring parity between knowledge systems, and ensuring that future generations of THPs can walk confidently with both ancestral authority and national legitimacy.

As I write this on Afrospiritual-Ink, I think of the many young initiates entering apprenticeship today. They are stepping into traditions that are centuries old, but they are also stepping into a policy environment that still struggles to make room for them. My hope is that the work of scholars, practitioners, and policymakers can converge so that these initiates inherit not only rituals and medicines, but also recognition, dignity, and pathways into the future.

Comments

Post a Comment

Popular posts from this blog

At the Fireside of Knowledge: Reflections from the Traditional Medicines Indaba

Image
On 6 September 2025, I joined colleagues, elders, and allies at the Traditional Medicines Indaba—a gathering convened under the banner of C20 South Africa’s Equitable Health for All (EHA) process. Within EHA, our specific stream focuses on traditional medicine as a community health response—not as a parallel or alternative, but as a living health system with legitimacy, depth, and global relevance. This Indaba was therefore more than a meeting. It was a moment of positioning: how do we, as healers, scholars, and policy advocates, articulate the role of Indigenous Health Knowledge Systems (IHKS) in the fight for equitable health for all? A Day of Collective Visioning The agenda was as alive as the conversations themselves. From morning welcomes and fireside chats—where themes of regional perspective, gender and health, and current research took centre stage—to afternoon commissions, the day oscillated between intimacy and institution-building. It was in the commissions that the heartbea...
Read more

When Knowledge Lives in Silence: The Crisis Facing African Indigenous Medicine

Image
I was recently asked on LinkedIn: “Where can I read more about African Indigenous Medicinal Systems in detail?” The truth is, you can’t. Not easily, anyway. Not because the knowledge doesn’t exist, but because it was never written down. Why Our Knowledge Is Missing from the Page Traditional Health Practice and Indigenous Knowledge Systems are underdeveloped, under-documented, and under-researched. This isn’t an accident; it is history. The practitioners who carried this wisdom before us often could not write. And when writing was possible, they avoided it. Why? Because to record was to risk theft. Knowledge was guarded jealously, kept oral, transmitted in ceremony, in practice, in apprenticeship. They were right to be cautious. Too often, our people have had their medicines studied, renamed, patented, and sold back to us. What remained sacred became commodity. But this caution had consequences: today we stand on the edge of losing practices not because they failed, but because they wer...
Read more