Pr

1
Survey on Knowledge, Attitudes and perceptions
about Traditional Healers and healing conducted
on Health Professionals working at Mtubatuba
Clinics and Hlabisa Hospital, KwaZulu-Natal,
South Africa.
FN Mbatha1 T. Ngwenya2 D Ngcobo3 SE Mthembu4
JF Aguilera5,6 1Partnership for the Delivery of
Primary Health Care including HIV and AIDS
Programme (PDPHCP), KwaZulu-Natal Provincial
Management Unit, Department of Health (DOH),
South Africa 2AMREF SA, KwaZulu Natal,
Umkhanyakude District, South Africa 3PDPHCP,
KwaZulu Natal, District Programme Management
Unit, DOH, South Africa 4PDPHCP, KwaZulu Natal,
Provincial Programme Management Unit, DOH, South
Africa 5National Programme Management Unit, DOH,
Pretoria, South Africa 6AEDES, Brussels,
Belgium PDPHCP is funded by the European
Commission. The views and opinions expressed are
not necessarily those of the European Commission
Abstract
Objectives
Table 2 Responses towards THP treatments/healing
practices

• The primary aim of the study was assess the
  knowledge, attitudes and perceptions (KAP) of the
  health professionals working in the Mtubatuba
  clinics and Hlabisa hospital regarding the
  traditional healers practitioners (THP) and their
  practices.
• Within this aim, key research questions include
  KAP on
• What THP do and can offer to health and
  well-being of the target community?
• Role that THP do and may play in treating
  HIV/AIDS?
• Collaboration with THP through a system of
  patient referral in responding to HIV/AIDS, STIs
  and TB treatment and prevention?
• Work and collaboration with THP (if at all) in
  general health and well-being of the target
  community?
• Strengths and challenges related to strengthening
  their collaboration and work with THP in the
  area?

Objectives. In 2004, it was estimated that 70 of
South Africans consulted traditional healers when
they were ill. We aim to assess the knowledge,
attitudes and perceptions (KAP) of the health
professionals working in Mtubatuba clinics and
Hlabisa hospital with regards to traditional
healers and their practice, and look at
opportunities for collaboration between DOH and
THs. Methods. The AMREF Traditional Healers
Project (THP) in Umkhanyakude District in
Northern KwaZulu-Natal was funded by DOH to
provide quality PHC services to their clients.
Based on a literature review, the KAP study used
in-depth interviews and a survey questionnaire
including demographic details and a short 22-item
KAP measure scored on a Lickert scale. Informed
consents were obtained from participants. Data
were analysed using Excel. A total of 16
interviewees participated with one focus group
held at Hlabisa hospital. Results. A total of
98 questionnaires were completed to staff at
Hlabisa hospital (49) and at 8 clinics visited
(51). Positive attitudes towards THs included
(1) 63 would be happy to work hand in hand with
TH in dealing with HIV and AIDS, (2) 42 would
personally visit a TH if they were ill, (3) 75
felt that TH could be trained to provide DOT for
TB. Negative attitudes included (1) 78 stated
that some TH practices could increase the risks
of HIV infection, (2) 65 stated that TH do not
have adequate knowledge on HIV and AIDS.
Conclusions. KAP study highlighted that
collaboration between THs and DOH was not optimal
and could be improved. 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. .
Item n Agree Disagree
Some traditional healing practices could increase risk of HIV infection 92 78 15
THP have all the knowledge needed to treat people living with HIV/AIDS 83 19 65
Traditional medicines can have a role in the treatment of PLWHA 78 48 31
THP cannot be trusted to treat people with HIV/AIDS 76 31 47
Traditional healers can cure AIDS 73 12 62
Table 3 Responses towards support for and
potential collaborative models
Item n Agree Disagree
I would be happy to work in a team with a traditional healer to provide treatment for TB 97 60 39
I would be happy to work hand in hand with traditional healers in dealing with HIV/AIDS in a hospital situation 91 63 30
I would prefer that a doctor or nurse provides counseling during VCT than a THP 90 75 18
Traditional healers can be trained to effectively treat people living with HIV/AIDS 89 77 18
I would be happy to work with traditional healers in the treatment and prevention of STIs 88 59 31
Traditional medicine and western medicine cannot work together in helping people living with HIV/AIDS 76 34 44
Methods

• Quantitative Approach Survey Questionnaire
• Target population A random sample of all health
  professionals working in the Mtubatuba clinics
  and Hlabisa hospital
• A copy of the questionnaire in preferred language
  (English or Zulu) was provided to participants
• Collection of demographic details and a short
  22-item KAP measure (Lickert scale)
• Data was captured in Excel and analyzed using
  SPSS
• 2. Qualitative Approach In-depth Interviews
• Convenient sample of survey questionnaire
  participants were selected
• Individual interviews and focus groups at Hlabisa
  Hospital and in one of the clinics visited
• Semi-structured interviews were used
• Qualitative thematic analysis was conducted on
  the transcripts of the interviews and focus
  groups.
• 3. All social science ethical conventions were
  maintained

Conclusions

• The results indicate a strong support for
  collaboration between health professionals and
  THs.
• However, challenges have also been identified
  which could make this collaboration difficult.
• Moreover, results suggest that more work has to
  be done with respect to shifting the knowledge,
  attitudes and perceptions of staff at the clinic
  and hospitals.
• Way Forward
• More training of THs on health related topics
• Development of a THs data collection tool and
  referral letter adapted to their literacy levels
  with pictures and graphics (see Figure 1)
• Opening of a VCT center in a community where
  traditional healers can refer their clients to a
  professional nurse for VCT.
• Strengthen the communication link between
  department of health and traditional healers.

Introduction
Results

• The EU in partnership with the KwaZulu-Natal
  Department of Health funded AMREF to develop the
  capacity of traditional healers in the Mtubatuba
  area at Umkhanyakude District in Northern KZN
• A total of 80 Traditional healers were trained on
  topics related to HIV and AIDS such as TB, VCT
• A needs assessment and KAP survey were conducted
  to support the implementation of the traditional
  healers project.
• The AMREF Traditional Healers project was
  developed taking into account that
• Traditional healers play a unique role in the
  lives of many of those who are infected or at
  risk of HIV and AIDS (AMREF,2005)
• 2.An estimated that about 80 of rural
  communities in South Africa still seek help from
  traditional healers as they live within their
  communities and are easily accessible. WHO(2003)
• 3.There is an assumption that traditional healers
  are well placed to refer complex cases to medical
  health, especially since people often consult
  them before they seek western medicine. (AMREF,
  2005)

• One Hospital and a total of 8 out of the 9
  clinics in the Hlabisa sub district were visited.
  
• A total of 98 questionnaires were completed.
• 48 at the Hlabisa hospital
• 50 at the 8 clinics visited
• Staff interviewed were mainly nurses (44) and
  HIV counselors (11)
• A total of 4 persons participated in
  in-depth-interviews
• Two focus groups of 6 participants each were
  conducted in Hlabisa hospital and at eMonzi
  clinic.

Figure 1. Traditional Healers Referral Letter
Table 1 General responses towards THP and their
services
Item n Agree Disagree
I do not feel that THP have anything to offer those who have an STI 85 27 60
Traditional healers are fakes who pretend to cure AIDS 80 41 41
THP are ideally placed in their communities to provide effective support for people living with HIV/Aids 79 47 37