A Systematic Review of Empirical Research on Key Issues in African Medicine in South Africa,

African medicine, often termed traditional, complementary, or indigenous medicine, is a significant component of South Africa's healthcare landscape. Its practice and potential integration with the biomedical system involve complex cultural, regulatory, and clinical dimensions. A systematic synthesis of empirical evidence on its contemporary key issues is required to inform discourse. This systematic review aimed to identify, appraise, and synthesise empirical research on the key issues characterising African medicine in South Africa. Its objectives were to map the extant evidence, clarify central themes and challenges, and identify gaps to direct future scholarly inquiry. A systematic literature review was conducted according to established guidelines. Multiple academic databases were searched for relevant peer-reviewed, empirical studies. Studies were screened against predefined inclusion criteria, data were extracted using a standardised form, and findings were synthesised thematically. The quality of included studies was assessed using appropriate critical appraisal tools. The review identified several predominant themes. A central finding was the widespread concurrent use of African medicine and biomedical healthcare, frequently without disclosure to biomedical practitioners. Key issues encompassed persistent regulatory challenges, safety concerns related to certain practices and pharmacovigilance, and markedly variable perspectives on integration models amongst different stakeholders. Empirical research confirms African medicine as an entrenched, dual-use system in South Africa. It is characterised by enduring cultural relevance alongside unresolved practical and systemic challenges, resulting in a complex interface with the formal health sector. Future research should employ more robust, mixed-methods designs focused on under-studied populations and clinical outcomes. Policy development must prioritise regulatory harmonisation and structured collaboration between healthcare systems. Training programmes for all health practitioners should incorporate intercultural competence and pharmacovigilance related to African medicine. traditional medicine, complementary medicine, healthcare integration, health policy, traditional health practitioners, South Africa, systematic review This review provides a consolidated evidence base on critical issues in African medicine in South Africa, offering a foundation for informed policy dialogue, ethical integration efforts, and targeted future research.