Building Referral Networks

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• Building Referral Networks
• between Traditional Health Practitioners and
  Biomedical health system.
• A strategy to reach underserved communities
• with comprehensive HIV services.

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African SolutionsFor African Challenges

• Presentation by
• Dr. D. Balaba (MD, MPH)
• Co-authors P. Kyeyune and I. Lutalo
• Kampala, Uganda
• August 2006

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(No Transcript)
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Introduction

• Urgent need to strengthen referral networks
  between THP and Biomedical health practitioners.

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THETA14 years promoting partnership with
traditional healing systems, biomedicine and the
larger community
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THETA definition of THPs

• Lives and is recognized by his/her community as
  a counselor/care provider
• Uses indigenous knowledge handed down through
  generations
• Indigenous knowledge is based on socio-cultural
  backgrounds as well as prevalent KABP
• Has clients
• Special case of Traditional Birth Attendants

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Why partner with THP
Distribution of health workers by level of
health expenditure and burden of disease, by WHO
region Data sources (3, 18, 19). 0 5 10 15 20 25
30 35 40 45 of global workforce
Doctor - patient ratio in Uganda is 120,000
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Why Partner with THP

• 12 of Ugandans live in urban areas
• Over 50 of the health facilities in the urban
  areas
• THP accessibility and availability (THP
  in-habitant ratio 1 140 )
• Flexible payment terms for THP
• Community recognition and respect of THP(80
  visit)
• THP limitation in evidence based knowledge

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THETA

• 276 Traditional Health Practitioners and
• 89 Biomedical Health Practitioners in
• 4 Districts of Uganda

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Building Collaboration
Identification of Stakeholders
Workshop with BHP (3 days)
TH Comprehensive Knowledge Training (6 months)
THP HIV/AIDS awareness selection meeting (3
days)
Joint Meetings (THPs BPHs)
Baseline Survey
THPs Skills Building Training (4 months)
Stakeholders Meetings (THPs,BPHs community)
End of Program Survey
Ongoing Support Supervision
Certification
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Biomedical Health Practitioner's Meeting
Traditional Health Practitioner Training
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Joint meeting between Traditional and Biomedical
Health Practitioners
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Outcome - Referral
End of training
Beginning of training
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Patient Referral
Traditional Health Practitioner refers a patient
to health centre
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Referrals as diagnosed in Health facilities
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Outcome Counseling for HIV
End of training
Beginning of training
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Outcome Improved Herbal Treatment
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Outcome Standardized Usage
Standardizing
Documenting
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Information
13,000 community members (33 men and 67 women)
and have received information on various diseases
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Traditional Health Practitioners, go to the People
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Challenges

• Lack of a policy on TM and collaboration and
  legislative Framework
• Limited resources to support the referral network
  
• High level of illiteracy among the THP
• Poverty levels in the community
• Limitations in the existing healthcare system

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Lessons Learned

• Empowering THP and linking them to adequate
  referral facilities creates a sustainable and
  expanded HIV care system.
• THP willing to collaborate with BHP in HIV/AIDS
  management and support .
• THP play a vital role reinforcing communities to
  adopt positive health seeking behavior
• Participation of BHP in joint meetings helps them
  change their attitudes towards Traditional
  Medicine

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Recommendations

• To build functional community referral networks
• Governments must develop supportive appropriate
  policies, and
• Development partners must provide resources
  needed.

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Acknowledgment

• THETA team
• Districts and Community Persons
• Rockefeller foundation
• HIV/AIDS Integrated District Model program
  AIM/USAID
• American Jewish World Service

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• African Solutions
• For African Challenges
• dorothy_at_thetauganda.org
• www.thetauganda.org