Marseille 2007
| Abstract #424 - Collaboration between Department of Health and Traditional Healers to Fight HIV/AIDS in KwaZulu-Natal, South Africa. | ||||
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Session: 8.3: Traditional and alternative approaches (Parallel) on Monday @ 11.00-12.30 in 5 Chaired by Jonathan Eflord, Marc Egrot Authors: Presenting Author: Mrs Fikile Naomi Mbatha - KZN DOH, South Africa |
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| Additional Authors: Mrs Tryphinah Ngwenya, Mr Douglas Ngcobo, Mr Sifiso Mthembu, Dr Jean-Francois Xavier Aguilera, | ||||
| Aim: Five and a half million people were estimated to live with HIV/AIDS (PLWA) in South Africa in 2005, which represented 19% of the adults aged 15 to 49 years of age. In KwaZulu-Natal (KZN) province, 39% [37-41%] of antenatal clinic attendees were HIV+ in 2005, the highest percentage in South Africa. In 2004, it was estimated that 70% of South Africans consulted traditional healers (TH) when they were ill. The KZN Department of Health (DOH), in collaboration with the organization AMREF, developed a pilot programme to develop the collaboration with selected THs to fight HIV/AIDS. | ||||
| Method / Issue: The programme involved (1) training of THs on topics including HIV/AIDS and tuberculosis, (2) opening of a VCT centre in a rural area where THs can refer their clients to a professional nurse, and (3) Knowledge, Attitudes and perceptions (KAP) study on THs and their practice; in-depth interviews, focus group and a questionnaire were used in a random sample of health professionals at eight municipality clinics and one hospital. Informed consents were obtained from participants. Quantitative data were scored on a Lickert scale and analysed using SPSS 14.0. | ||||
| Results / Comments: Eighty THs were fully trained. A total of 486 people had voluntary counseling since June 2006, 207 (43%) were tested, 62 (30%) HIV+ and 55 referred for CD4 count. We developed a specific referral form for THs using graphics pictures. We administered 98 questionnaires to staff at hospital (49%) and clinics (51%). Most respondents were willing to work with THs in (1) the treatment and prevention of STIs (59%, p=0.01), (2) dealing with HIV/AIDS in a hospital situation (63%, p=0.005), (3) a team of medical practitioners involved in prevention and treatment of TB (66%, p<0.001), and (3) clinic/hospital with PLWA or coming for VCT (60%, p=0.006). Most respondents also stated that THs could be trained to effectively treat PLWA (77%, p<0.001) or to provide DOT for TB (75%, p<0.001). Negative attitudes and perceptions included statement that some traditional healing practices could increase risk of HIV infection (78%, p<0.001), and that THs do not have all the knowledge needed to treat PLWA (65%, p<0.001). A total of 16 people were interviewed and participated in one focus group. Participants stated that THs are strongly supported by communities, and that they play a positive role, with at times more effective treatments than western medicine, including for HIV/AIDS, STIs and TB. Concerns were raised about secondary effects and efficiency of treatment delivered by THs. Strong support towards increased collaboration with THs was stressed, with primary barrier identified being the lack of trust between the two parties. | ||||
| Discussion: The KAP study highlighted that collaboration between THs and DOH was not optimal and could be improved, although positive attitudes and perceptions were highlighted. Strategies to address resistance of both parties on collaboration and concerns relating to TH healthcare provision were recommended. Since this is a pilot project, in an area where a majority of patients seek support from THs, the findings suggested that this programme deserves to be further monitored and evaluated. | ||||
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