HospiVision: Integrating spirituality into health management practices

As the world pushes for the decolonisation of global public health approaches and encourages health plurality to deal with a complex polycrisis era, the centrality of spirituality and indigenous health knowledge systems and practices is becoming increasingly important. This is the belief of Dr Munya Saruchera, director of the Africa Centre for Inclusive Health Management. He adds that an increased focus on spirituality will require “… considering spiritual interventions in health outcomes, the impact of religious beliefs on illness experience and care and spirituality training for healthcare professionals”.

HospiVision, a non-profit, Christian faith-based organisation that provides compassionate spiritual care, counselling and training services across several public hospitals, is doing important work in this space. This includes presenting a CPD-accredited training course for healthcare practitioners on compassionate clinical practice that integrates ethics and different worldviews to healthcare staff at the hospitals where HospiVision provides a service, free of charge.

A 2025 Africa Centre webinar on the inclusion and centrality of spirituality in African indigenous health knowledge systems planted the seed for the relationship between the Africa Centre and HospiVision. The centre consequently participated in HospiVision’s Religion and Spirituality in Healthcare Conference in October last year and HospiVision attended the centre’s Roses on the River event in commemoration of World Aids Day in December. Going forward, the two organisations are planning to collaborate on a range of joint activities across the spheres of research, community engagement, policy and advocacy, events and resource mobilisation. The activities will focus on the themes of spirituality, community health and wellbeing, counselling and support services to build relevant capacity and skills and integrate spirituality into health management practices.

According to Dr Annemarie Oberholzer, CEO of HospiVision, the collaboration with the Africa Centre aims to bridge healthcare systems and communities’ spiritual and social realities. “Our work in public hospitals has shown us that patients do not arrive as clinical cases – they come as whole human beings shaped by family, culture, faith, fear, hope and lived experience.” She explains that spirituality profoundly shapes how people interpret illness, make healthcare decisions, cope with suffering and adhere to treatment. It influences healthcare-seeking behaviour, perceptions of healing and trust in medical systems. “Inclusive health management cannot be limited to structural access. It must also consider cultural and spiritual worldviews, community belief systems, the meaning people attach to illness and recovery and the moral and emotional resilience of healthcare staff.”

The challenge is that in many African contexts spirituality is sometimes regarded as incompatible with Western biomedical healthcare systems. According to Oberholzer, this perceived tension can create distance, mistrust or parallel care pathways in which patients move between systems without disclosure, which can affect continuity of care and treatment adherence. “In healthcare settings, there might also be concerns about regulation, professional standards and patient safety.” Without clear frameworks, the risk is that spirituality is either handled inconsistently or excluded altogether.

In this context, the Africa Centre-HospiVision collaboration aims to contribute to creating health management practices that acknowledge the full humanity of patients and healthcare workers alike by:

• advancing a more holistic understanding of patient care within healthcare management
• supporting research and training initiatives that recognise spirituality as part of person-centred healthcare
• encouraging dialogue between healthcare leaders, practitioners and communities about inclusive models of care

As part of the collaboration, the Africa Centre will co-host HospiVision’s Religion and Spirituality in Healthcare Conference in September.

Caregivers Empowerment Network – Africa (CENetA): Providing critical support to unpaid caregivers

Across Africa, caregivers (predominantly women) provide intensive, long-term support to family and community members, with minimal training, limited resources and little to no compensation. Most of those who receive care have non-communicable diseases (NCDs), age-related conditions, long-term illnesses or disabilities and some are fully dependent on the caregiver. Caregivers’ contributions are essential to health systems; yet they remain largely invisible in planning and budgeting.

Caregivers Empowerment Network – Africa (CENetA) exists to elevate their voices, strengthen support systems and advocate for policies that recognise and protect caregivers’ work. In 2025, the Africa Centre collaborated with CENetA to present two well-attended webinars on caregiving, which resulted in a joint research grant application on caregiving policy in Africa. Saruchera also serves as the chair of the CENetA board. The Africa Centre and CENetA have now entered into a four-year partnership to facilitate opportunities for further collaboration.

According to Renaldah Mboje, CENetA programme manager, more and more people are being cared for at home across Africa. Several factors contribute to the increase, including weak health systems, cultural abominations against sending aged family members to old-age facilities, a rise in Africa’s aged population (including older HIV-positive people) and an increase in NCDs and multi-morbidities. Yet there is no integrated policy or support for caregiving in Sub-Saharan Africa. As Saruchera points out, the focus is usually on those who receive care rather than on those who dedicate time and effort to providing it. The result is a lack of training and support for family members and communities taking care of their own, unfair gender implications (as women and girls mostly perform caregiving) and an adverse impact on the jobs and health of professionals who used to be employed in other sectors of the economy but find themselves doing caregiving instead.

Research by CENetA published in 2025 reveals the challenges faced by unpaid caregivers in Africa:

• Over half of family caregivers (56%) are primary caregivers, i.e. they live with their care receivers.
• About 80% are, to some extent, economically vulnerable as a result of their caregiving responsibilities, with 46% reporting either job loss, business disruptions or financial vulnerability due to caregiving demands.
• More than 50% of caregivers provide care for extended periods (5 to 10 years and more), which impacts the caregiver’s personal and socio-economic life and their mental health. Burnout, compassion fatigue and deterioration of their own health are common among caregivers.

“The continent needs to build awareness, skills and expertise and management capacity in caregiving and find culturally appropriate support beyond the Western old-age-home model to take care of the aged, who are needed in their families and communities as custodians of family and community knowledge,” Saruchera said.

One of CENetA’s key objectives is to strengthen evidence-based advocacy to inform national and regional policy frameworks, which speaks to the heart of this partnership. “Our partnership with the Africa Centre will assist us in realising this objective much more effectively,” Mboje said. “Whereas CENetA will make available the caregivers to share their experiences, the Africa Centre will gather the necessary data and package it for advocacy.”

Mboje further explains that suitable policies should support people who become caregivers in continuing to live their lives with minimal interference. “The support can include … cash transfers to cushion care-related costs, tax relief for employed caregivers, flexible human resource policies to shield caregivers from job losses and public respite care centres where caregivers can take a much-needed mental and physical break from caregiving.”

To accelerate progress with caregiving support, the collaboration between the Africa Centre and CENetA will involve, among other things:

• conducting joint research on the numerous facets of unpaid care work, including policies, economics, social relations, gender issues and linkages with poverty
• strengthening the capacity of caregiver professionals, tertiary students and young people through fellowships, training and mentorship
• co-developing advocacy strategies and policy briefs to influence sub-regional, continental and international decision-makers