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Traditional herbal medicine remains a vital component of healthcare across Africa, deeply rooted in indigenous cultural beliefs and practices. This systematic review employs the PRISMA framework to analyse regulatory frameworks, cultural significance, and practical challenges related to herbal medicine use in multiple African countries. Findings reveal that nations such as Ghana, Kenya, and Uganda have made notable progress in establishing regulatory agencies and legislative oversight, while others, including Ethiopia, exhibit weaker governance structures. The study highlights the critical role of cultural embeddedness, with traditional medicine addressing holistic health dimensions often absent in biomedical approaches. Despite the accessibility and affordability of herbal remedies, concerns about dosage inconsistencies, contamination, and lack of standardisation persist. Furthermore, uneven institutionalisation and generational knowledge loss threaten sustainability. The review underscores the need for harmonised regulatory standards, preservation of indigenous knowledge, increased research investment, and strengthened collaboration between traditional healers and biomedical practitioners. These measures are essential to safely integrate traditional medicine into formal healthcare systems and support universal health coverage across Africa.

This study investigates the role of traditional medicine in addressing reproductive health needs in Allandale Village, Mpumalanga Province, through the lens of social justice. The research explores how indigenous healing practices intersect with principles of equity, cultural relevance, and access to reproductive healthcare in a context marked by structural inequality and limited biomedical services. In many rural South African communities, traditional medicine remains the primary source of reproductive health support due to its accessibility, affordability, and alignment with cultural values. Therefore, by investigating how indigenous healing practices interact with the concepts of equity, cultural relevance, and access to reproductive healthcare in a setting that is socially and economically marginalized, this study fills a crucial need. Guided by an ethnomedical framework, the study adopts a qualitative approach to assess whether traditional medicine enhances or constrains women's reproductive autonomy and health outcomes. Participants included local women aged 18 to 50 who actively use or engage with traditional reproductive health practices. The findings reveal that traditional healers play a crucial role in preventive care, fertility regulation, and postpartum support, with many women expressing confidence in the efficacy and cultural resonance of indigenous treatments. However, the study also highlights tensions between traditional and biomedical systems, including gaps in regulation, safety assurance, and gender dynamics. From a social justice perspective, the research argues for a pluralistic health policy that recognises and supports indigenous knowledge systems, promotes collaboration between biomedical professionals and traditional healers, and ensures that all women, especially those in marginalised rural areas, have access to safe, effective, and culturally appropriate reproductive healthcare. The study findings underscore traditional medicine’s role and further contribute to broader discussions on health equity globally by underscoring the importance of integrating culturally grounded, community driven healthcare approaches into national and international health systems to address persistent disparities and promote inclusive, context sensitive reproductive health solutions to women reproductive health. The study concludes with a call for the strengthened implementation of the Traditional Health Practitioners Act 22 of 2007 and the development of community-led, rights-based models of health integration.