Re-Contextualizing Medical Pluralism in South Africa: a Research Schema for Indigenous Decision Making

The purpose of this article is to explain the rationale and development of a research schema that focuses on reducing the unintended consequences of medical pluralism in the context of communicable and non-communicable diseases in eastern and southern Africa. The research schema represents a contribution to the field of action-oriented research relating to the unintended consequences associated with medical pluralism that will be piloted in South Africa. The principle consequences of the unintended consequences of medically pluralism are delays in testing and treatment interruption. The research schema is framed through a resilience lens because the unintended consequences of medical pluralism bear the hallmarks of a complex ‘wicked problem’. The resilience perspective will use grassroots agency as the initial referential axis of enquiry. From this start point, broader systemic influences will be contextualized from a realist perspective using the ‘AART’ model of enquiry as a guiding heuristic (‘abduction, abstraction, retroduction and testing’). The ‘abductive’ component of the ‘AART’ model will facilitate a re-interrogation of broader systemic influences that sustain contemporary forms of medical pluralism as a precursor to the action-oriented phases. The methodological approach will include the application of proprietary software called SenseMaker® which was designed to enable research into complex anthropogenic phenomena. Analytically the re-interrogation aims to ‘empower indigenous decision making alongside scientific data’ as a mechanism to develop novel social practices that can reduce the unintended consequences associated with medical pluralism. The forthcoming pilot will ultimately be the judge of this theoretical contribution.