Abstract

The South African healthcare system faces critical challenges, including HIV-related cancers, neglected mental health and inadequate primary care, which hinder the effective delivery of palliative care. This study investigated the integration of indigenous South African knowledge systems with culturally attuned methodologies to improve palliative care. Guided by the ecological perspective, the research examined the ways in which interactions between individuals and their environment shape healthcare practices. Drawing on a comprehensive review of sources such as the National Institutes of Health and Google Scholar, the study identified systemic exclusions of African beliefs and rituals in end-of-life care. This exclusion perpetuates colonial legacies and complicates psychosocial interventions for those affected by historical injustices such as apartheid. The findings highlight the urgent need to decolonise healthcare training, incorporating African epistemologies alongside allopathic practices to foster inclusivity, respect patient preferences and enhance mental health outcomes. The study advocates culturally competent psychosocial approaches that integrate physical, psychological and spiritual care, and which align with African cosmology. This transformative framework seeks to redress systemic inequities, improve quality of life and rectify colonial injustices. By integrating African palliative care systems into healthcare policies, the study emphasises the creation of equitable and culturally reflective healthcare solutions for diverse South African communities.