Knowledge and documentation of patient health information among traditional health practitioners in urban and peri-urban areas of eThekwini Municipality, KwaZulu-Natal Province, South Africa

Health Inf Manag. 2021 Sep;50(3):118-127. doi: 10.1177/1833358319890475. Epub 2019 Dec 31.

Abstract

Background: Documentation of patient health information (PHI) is a regulatory requirement and hence a standard procedure in allopathic healthcare practice. The opposite is true for African traditional medicine (ATM) in most African countries, including South Africa, despite legal and policy frameworks that recognise and mandate the institutionalisation of ATM. Developing good practice standards for PHI documentation is an essential step in the institutionalisation of ATM.

Objective: This study examined the knowledge and practices of documentation of PHI by traditional health practitioners (THPs) in Durban, eThekwini Municipality, KwaZulu-Natal Province, South Africa.

Methods: In this quantitative cross-sectional study, snowball sampling was used to identify and recruit THPs. An interviewer-administered questionnaire was used to gather data. Chi-square tests and logistic regression were used to assess associations of knowledge and practice of documentation of PHI with potential predictors; age, gender, education, type of practitioner, experience, number of patients seen per day and location of the practice.

Results: Of the 248 THPs who participated, 71.8% were female. Mean (SD) age was 47.4 (14.2), ranging 18-81 years. The majority (65.7%) were Izangoma (diviners). Overall, 42.9% of the THPs reported knowledge of patient medical records (PMRs). In logistic regression, only number of patients seen per day remained a significant predictor of knowledge about PMR. THPs who reported seeing 6-10 patients were five times more likely (Odds Ratio (OR): 5.164, 95% Confidence Interval (CI): 1.270-20.996; p = 0.022) to report knowledge of PMR than those seeing <6 patients per day. Overall, 25.0% of THPs reported that they were documenting some PHI. Documentation was associated with having knowledge of PMR (OR: 29.323, 95% CI: 10.455-82.241; p < 0.0001) and being an Isangoma (OR: 3.251, 95% CI: 1.092-9.679; p = 0.02). Not knowing what (56.5%) and how (50.5%) to record were the most commonly cited reasons for not documenting.

Conclusion: Knowledge of PMR is low, and the practice of documenting PHI is even lower among THPs in eThekwini. That knowledge of PMR was a strong predictor of documentation practice, and the most common reason for not documenting was lack of knowledge about what and how to document suggests that training could improve PHI documentation in traditional medicine practice.

Keywords: Africa; African traditional medicine; health information management; health information systems; patient medical records; traditional health practitioners; traditional medicine.