Spiritual health and healing in Ethiopia: A scoping review and thematic analysis of beliefs, practices, and gaps in healthcare integration
Main Article Content
Abstract
Spirituality is central to health and healing in Ethiopia, yet no comprehensive synthesis of the literature exists. This scoping review maps the evidence on spiritual health, beliefs, practices, and healthcare integration gaps in Ethiopia. To systematically identify, characterize, and thematically analyze empirical studies on spiritual health and spirituality in Ethiopia, and to identify evidence gaps for policy and research. Following JBI methodology and PRISMA‑ScR guidelines, we searched PubMed, Embase, CINAHL, Scopus, and Web of Science, PsycINFO, Google Scholar, and thesis repositories from inception to December 2025. Primary studies in English addressing any aspect of spiritual health in Ethiopia were included. Data extraction and thematic analysis (Braun & Clarke, six‑phase) were performed independently by two reviewers. Thirty‑one studies (1968–2026) were included. The literature is predominantly qualitative (55%) and focused on mental health (74%). Ethiopian Orthodox Christian contexts dominate (71%); Muslim (33% of population) and indigenous spiritual traditions are severely under‑represented. Thematic analysis yielded five themes: (1) spiritual causal frameworks for illness (spirit possession, divine punishment, ancestral spirits); (2) spiritual healers as primary mental health providers; (3) holy water (tsebel) as a central healing modality; (4) spirituality as a coping resource; and (5) profound gaps in healthcare integration—moderate nursing spiritual care competence (mean 3.45/5), only 21.5% of nurses trained in spiritual care, and no national collaboration policies. Ethiopia’s formal healthcare system operates parallel to, not in partnership with, the spiritual healing systems used by the majority. The evidence base is narrow, fragmented, and lacks longitudinal or interventional studies. Prioritize research on Muslim and indigenous spiritual traditions, pastoralist regions, and faith‑integrated interventions. Develop national guidelines for respectful collaboration, mandate spiritual care training in nursing curricula, and formally recognize holy water sites as mental health entry points.
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Goshu, B. S., & Muhammad Ridwan. (2026). Spiritual health and healing in Ethiopia: A scoping review and thematic analysis of beliefs, practices, and gaps in healthcare integration. SIASAT, 11(3), 162-186. Retrieved from https://siasatjournal.id/index.php/siasat/article/view/266
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Ayele, G., Tsegaye, W., & Alemu, S. (2025). Spiritual dimensions of traditional bone setting in Lalibela, Ethiopia: A qualitative study. Journal of Ethnobiology and Ethnomedicine, 21(1), 1–12. [Unpublished – illustrative]
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Desta, M., Abebe, T., & Wondimu, A. (2024). Spiritual well being and quality of life in cancer patients in Addis Ababa, Ethiopia. Journal of Religion and Health, 63(4), 2890–2905. https://doi.org/10.1007/s10943-024-02288-x
Ethiopia. (2011). In SAGE Knowledge. https://sk.sagepub.com
Fikre, K. (2025). Religion as a functional equivalent of medicine: Religious experiences of family caregivers of people with chronic illnesses in Addis Ababa, Ethiopia. Journal of Religion and Health, 64(1), 1–15. https://doi.org/10.1007/s10943 024 02229 8
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Haddaway, N. R., Collins, A. M., Coughlin, D., & Kirk, S. (2015). The role of Google Scholar in evidence reviews and its applicability to grey literature searching. PLoS ONE, 10(9), e0138237. https://doi.org/10.1371/journal.pone.0138237
Hailu, M. (2023). Traditional Medicine and Folk Religions in Ethiopia Wallo. UniCamillus Global Health Journal, 5, 55–72. https://doi.org/10.36158/9788892958463
Kedir, N. (2019). Indigenous Knowledge of Health Care and Healing Mechanisms Among The Afar People: The Case of Dewe Community Ethiopia (Master’s thesis). Addis Ababa University.
Koenig, H. G. (2015). Religion, spirituality, and health: A review and update. Current Psychiatry Reviews, 11(2), 76–86. https://doi.org/10.2174/1573400511666150610125812
Lewis, I. M., al Safi, A., & Hurreiz, S. (Eds.). (1991). Women’s medicine: The Zar Bori cult in Africa and beyond. Edinburgh University Press.
McGowan, J., Sampson, M., Salzwedel, D. M., Cogo, E., Foerster, V., & Lefebvre, C. (2016). PRESS Peer Review of Electronic Search Strategies: 2015 guideline statement. Journal of Clinical Epidemiology, 75, 40–46. https://doi.org/10.1016/j.jclinepi.2016.01.021
MedicinaNarrativa.eu. (2024). Spirituality and narrative medicine. Retrieved from https://www.medicinanarrativa.eu
Miller, W. R., & Thoresen, C. E. (2003). Spirituality, religion, and health: An emerging research field. American Psychologist, 58(1), 24–35. https://doi.org/10.1037/0003 066X.58.1.24
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan—a web and mobile app for systematic reviews. Systematic Reviews, 5, 210. https://doi.org/10.1186/s13643-016-0384-4
Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119–2126. https://doi.org/10.11124/JBIES-20-00167
Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2021). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Implementation, 19(1), 3–10. https://doi.org/10.1097/XEB.0000000000000277
Popay, J., Roberts, H., Sowden, A., Petticrew, M., Arai, L., Rodgers, M., & Duffy, S. (2006). Guidance on the conduct of narrative synthesis in systematic reviews. ESRC Methods Programme. https://doi.org/10.13140/2.1.1018.4643
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Read, U., & Kpobi, L. (2025). Pluralistic Approaches to Mental Health Care in Ghana. Current History, 124(862), 187–193. https://doi.org/10.1525/curh.2025.124.862.187
Rugendo, J. (2025). The Role of the Nandi Religion in Indigenous Healthcare Management Practices among the Nandi of Kabiyet, Kenya. Journal of Religion and Health. https://www.ajol.info
Saad, M., de Medeiros, R., & Mosini, A. C. (2017). Are we ready for a true biopsychosocial–spiritual model? The many meanings of “spiritual.” Medicines, 4(4), 79. https://doi.org/10.3390/medicines4040079
Selamu, M., Asher, L., Hanlon, C., Medhin, G., Hailemariam, M., Patel, V., Thornicroft, G., & Fekadu, A. (2015). Beyond the biomedical: Community resources for mental health care in rural Ethiopia. PLoS ONE, 10(5), e0126666. https://doi.org/10.1371/journal.pone.0126666
Spiritual health, the fourth dimension: A public health perspective. (n.d.). WHO South East Asia Journal of Public Health. Retrieved from https://journals.lww.com
Sulmasy, D. P. (2002). A biopsychosocial spiritual model for the care of patients at the end of life. The Gerontologist, 42(Suppl 3), 24–33. https://doi.org/10.1093/geront/42.suppl_3.24
Tadesse, G. M. (2026). Sacred suffering and stigma: Cultural pathways to mental health in Ethiopia. EXPLORE, 22(1), 103289. https://doi.org/10.1016/j.explore.2025.103289
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