Navigating care across cultures: A narrative literature review of the influence of cultural worldviews on the uptake, delivery, and acceptance of Palliative Care services in South African communities
Résumé
Palliative care in South Africa exists at the intersection of modern biomedical approaches and deeply rooted cultural beliefs surrounding death and dying. This narrative literature review explores how cultural worldviews influence the uptake, provision, and acceptance of palliative care services in South African communities. Using a thematic narrative synthesis approach, the review drew on literature from PubMed, Scopus, Google Scholar and African Journals Online, including peer-reviewed articles, policy documents and ethnographic studies. Key themes included traditional understandings of illness and death, spiritual and ancestral belief systems, taboos around discussing dying, and the central role of family and community in caregiving. These cultural frameworks shape how individuals and communities understand illness trajectories, define a “good death”, and respond to palliative care interventions. Traditional healers and spiritual leaders often support individuals and families through the dying process by offering guidance, rituals and culturally meaningful care that biomedical services may overlook. The findings highlight the need to integrate cultural sensitivity into palliative care planning and delivery. Culturally responsive care requires acknowledging indigenous knowledge systems, incorporating spiritual and psychosocial dimensions, and promoting collaboration between health professionals and traditional practitioners. Without such responsiveness, palliative care may be perceived as inaccessible or culturally inappropriate, particularly in rural and marginalised communities. The review concludes that inclusive care models that reflect South Africa’s cultural diversity are essential to ensure that end-of-life care is medically effective, spiritually meaningful and culturally resonant.
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