Integrating Indigenous Trauma Care: A Protocol for Engaging African Traditional Healers as First Responders in Northern Mozambique's Emergency Medical System

This protocol outlines a mixed-methods study to co-design a framework for integrating African traditional healers as first responders within the formal emergency medical system (EMS) in post-conflict Northern Mozambique. It addresses critical gaps in pre-hospital trauma care in resource-limited settings, where traditional healers are often the primary, yet formally unrecognised, point of contact for injuries. The objective is to develop, with healers and biomedical personnel, a contextually appropriate model for collaboration that leverages indigenous knowledge and practices. The methodology employs a sequential exploratory design, conducted from 2024 to 2026. Phase one involves qualitative interviews and focus group discussions with traditional healers, community health workers, and hospital staff across three districts to map existing practices and perceptions. Phase two utilises a modified Delphi survey with a multi-stakeholder panel to build consensus on integration protocols, training priorities, and referral pathways. The study’s rigour is enhanced by its participatory design and iterative consensus-building process. The anticipated outcome is an evidence-based argument that formal recognition and structured collaboration can enhance community trust, improve first-response coverage, and reduce mortality from time-sensitive injuries, while respecting cultural paradigms of healing. The significance lies in offering a replicable, African-centred model for health system strengthening that bridges biomedical and indigenous systems, with implications for policy on task-shifting and equitable emergency care access in similar post-conflict regions.