African Traditional Health Practitioners (ATHPs) provide primary healthcare to up to 80% of Africans, yet their communicative agency during health crises remains largely underexplored. In South Africa, 65–80% of the population reportedly consults ATHPs also known as Traditional Healers for initial medical advice, underscoring their vital role as primary healthcare providers given patient health-seeking behaviour within the country’s healthcare landscape. Despite this significance, ATHPs are typically engaged reactively at the peak of crises rather than proactively from the message development phase. This article explores ATHPs’ potential communicative agency in health crisis communication, focusing on the conceptualisation phase of messaging. Using the Unified Co-creation Model, this qualitative instrumental case study draws on 11 stakeholder interviews to examine the systemic exclusion of ATHPs from health crisis communication planning. Findings reveal that ATHPs are typically tasked with information provision and dissemination as well as persuading communities to adopt biomedical solutions during health crises, while formal structures for their inclusion remain minimal. The study argues that ATHPs, as cultural intermediaries with generational Indigenous health knowledge, have the potential to contribute to the transformation of health crisis communication if integrated early through co-creation frameworks. Their inclusion as equal stakeholders alongside biomedical practitioners and policymakers is critical for developing culturally resonant and effective health crisis communication strategies.

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