In the Central African Republic, biomedical healthcare coexists with deeply rooted traditional medicinal systems. These systems form a significant component of maternal and reproductive healthcare, yet their sustainability and potential for integration remain poorly understood within formal medicine. This ethnographic study aimed to document and analyse the sustainable characteristics of traditional medicinal practices in southern Central African Republic, focusing on obstetrics and gynaecology. It sought to identify the principles, knowledge transmission, and resource management underpinning their enduring use. A longitudinal ethnographic approach was employed, involving extended fieldwork. Data were collected through participant observation, in-depth interviews with traditional healers, midwives, and community members, and focus group discussions. Thematic analysis was used to interpret the qualitative data. The findings reveal a complex, adaptive system. Sustainability is achieved through strict harvesting protocols, intergenerational knowledge transfer, and syncretic practices that selectively incorporate biomedical elements. A prominent theme was the ritualised conservation of key botanical species, with most interviewed practitioners describing specific rules to prevent over-harvesting. Traditional medicinal practices in the region demonstrate inherent sustainable mechanisms that have ensured their continuity. These practices are dynamic, engaging with changing environmental and social circumstances, including limited access to biomedical facilities. Formal health policy should recognise and engage with these sustainable systems. Training programmes for community health workers could facilitate respectful dialogue. Conservation efforts should collaborate with traditional practitioners to protect medicinal flora. ethnography, traditional medicine, sustainability, obstetrics, gynaecology, Central African Republic, maternal health This study provides a detailed ethnographic account of sustainable medicinal practices, offering evidence for healthcare policymakers and practitioners seeking to develop culturally coherent and ecologically informed maternal health strategies.
Gbawengué et al. (Fri,) studied this question.