Sacred Texts and Public Health: Interpretive Traditions, Bodily Ethics and Health-Seeking Behaviour in African Contexts

Abstract

Across much of sub-Saharan Africa, the Bible is not a private devotional object but a working public-health document. It supplies the categories through which illness is named, the vocabulary in which symptoms are disclosed or concealed, and part of the reasoning by which people decide where to go first when a child convulses, or a cough will not stop. This review asks a narrower question than the religion-and-health literature usually poses: not whether faith helps or harms, but how particular ways of reading healing texts translate into particular patterns of care-seeking, and which of the resulting delays are tractable. Three arguments are developed. First, African Christian communities do not share one hermeneutic. Mission-church, African Instituted Church, Pentecostal-charismatic and African biblical-hermeneutic readings differ in what they take a healing narrative to be, and those differences predict behaviour more reliably than intensity of belief does. Second, biblical texts carry an implicit bodily ethics, a set of assumptions about contagion, visibility, ritual boundary, gender and personhood, that continues to shape stigma and disclosure in African clinics, most visibly around HIV, epilepsy and disability. Third, therapeutic itineraries are sequential and legible. Mozambican patients who consulted multiple healers before testing waited a median of nine months against two for those who consulted none; Ghanaian cancer patients typically reached hospital after spiritual and herbal care; yet cluster-randomised evidence from Nigeria, Ghana and Tanzania shows that collaboration with religious and traditional practitioners can improve outcomes without displacing them. The review argues that therapeutic pluralism is a rational response to health systems that are variously inaccessible, culturally unintelligible or impersonal, and that the useful public-health target is referral design rather than displacement. Comparative material from the United States, Latin America and Asia is used to locate the African case against settings of stronger biomedical dominance. Literature published through 2025 is synthesised.