Indigenous and Folk Communication Traditions for Culturally-Resonant Health Promotion in Southern Africa. A Scoping Review

Indigenous and folk communication methods such as storytelling, drama, poetry, music, rituals, and visual art are deeply embedded within cultural traditions and play an important role in shaping health beliefs and behaviours. Their participatory and context-sensitive nature makes them particularly valuable for health promotion, especially in reaching populations facing linguistic or cultural barriers to Westernised formal interventions. This scoping review examined the use of indigenous communication for health promotion in Southern Africa, focusing on: (1) types of communication employed, (2) health issues addressed, (3) levels of engagement, (4) actors involved, and (5) reported impacts. A comprehensive search of Web of Science, Scopus, and EBSCO databases, supplemented by institutional repositories, identified relevant English-language studies published between 2000 and 2025. Sixty-nine studies met inclusion criteria across 13 Southern African countries. Storytelling, drama, music, proverbs, rituals, and visual arts emerged as dominant forms. Most interventions targeted HIV (n=50), followed by sexual and reproductive health, maternal health, and mental health. Engagement occurred primarily at the community level, with traditional leaders, community groups, non-governmental organisations, and health workers playing central roles. Prominent reported outcomes included increased awareness (n=45), and behaviour change (n=21). However, evidence of sustained behavioural or systemic change was limited. Building on these findings, we developed an integrated framework linking indigenous communication with health promotion theories through an “Integration Zone” that emphasis cultural resonance, trust, and community participation. This framework highlights indigenous communication as a powerful yet underused pathway toward more culturally resonant, equitable, and sustainable health promotion in Southern Africa.