Traditional medicinal knowledge and healing practices of indigenous health care spiritualists play an important role in health care, and contribute towards achieving Universal Health Care. The traditional healthcare spiritualists (THSs) were grouped into three categories. One category of Baganda THSs, Balubaale, engage ancestral spirits during health management. Balubaale are socially significant but are not legally accepted. Their initiation and training practices has not been documented in Uganda. The study purpose was to understand and establish the training of traditional healthcare spiritualists (THSs). Twelve (10M, 2F); practicing THSs in Central Uganda were purposively selected and recruited between 15th July 2019 and 29th April 2020, and were prospectively interacted with for 24 months. Transcribed data was coded and thematically analyzed using ATLAS ti. 22 computer software and presented based on an inductive approach. Findings show that many spiritualists are. Their key areas of training include connecting with ancestral spirits and the spiritual powers of non-materials and materials such as living and non-living things through rituals. They train in diagnosis and health management based on ancestral spirits and finally pass out in a communal ceremony witnessed by family and community members. We conclude that THSs undergo training and are supervised and supported by experienced spiritualists, family and the community. We recommend similar studies among other ethnic groups to contextualize the process of becoming a THS, compare and harmonize findings to facilitate inter-medical systems communication and policy considerations.

The authors have declared no competing interest.

"The World Bank and the Government of Uganda through Pharm-Biotechnology and Traditional Medicine (PHARMBIOTRAC) (P151847), an Africa Higher Education Center of Excellence (ACEII) at the Mbarara University of Science and Technology (MUST), Uganda supported this work." The funders did not play any role in this research nor the manuscript submitted

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