trained traditional health practitioners can collaborate with biomedical health professionals to...
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Trained Traditional Health Practitioners can collaborate with
Biomedical Health Professionals to improve TB & HIV case finding and
treatment success/ adherence: The case of UMkhanyakude District in KwaZulu
Natal, SA
By:
Boniface Hlabano; Connie Osborne, Nonhlanhla Mthimkhulu, Vusi Ntuli
Amref Health Africa International Health Conference
25 November, 2014, Nairobi
OUTLINE OF PRESENTATION
Background & Introduction Project Strategy &Tools Results Discussion-Conclusion Challenges Acknowledgements
Background: Framework for THP practice in South Africa
• Traditional Health Practitioners Act, Act 22 of 2007.
• THP DIRECTORATE for African Traditional Medicine at The National DOH.
• National THP COUNCIL (Interim) –established by the Minister of Health to regulate THP practice and representation
• In South Africa, research shows that:41% of TB patients would consult a THP prior to
biomedical diagnosis84% of diagnosed TB patients would consider
choosing a THP as a treatment supervisor (DOTs supporter)
88% of THPs trained in basic TB epidemiology would genuinely refer patients for screening in health facilities
92% of trained THPs are usually willing to act as treatment supervisors for TB patients
(Wlikinson, D; Gcabashe, L & Lurie, M. International Journal of TB & Lung Diseases Vol. 3(9) 835-842)
Background
The Amref Health Africa UMkhanyakude THP Project: 2011-
2014 THPs Trained
Municipality-Sub-District Males Females Total
Jozini 70 70 140
UMhlabuyalingana 71 82 153
Hlabisa 39 60 99
Mtubatuba 17 18 35
Big 5 False Bay 10 23 33
Total 207 253 460
45 Day Course-Structure Basic HIV and AIDS information:10 days
VCT and general counselling skills: 5 days
TB and DOTs: 3 days
Introduction to orphans and vulnerable children Care (OVC):2 days
Home-based care: 10 days
ARV literacy: 3 days
Integrated management for child infection (IMCI): 3 days
Prevention of mother to child transmission (PMTCT),STIs: 3 days
Project management: 2 days
Financial management: 2 days
Leadership skills: 2 days
PROJECT TOOLS-Extract from the Manual
PROJECT TOOLS- Referral Form
PROJECT TOOLS- Patient Register
RESULTS (Year 3) n=130
RESULTS (Year 3) n=130
RESULTSNo. of Patients Referred for TB screening: year 3
RESULTSNo of Referred TB suspects confirmed as TB
cases
RESULTS% Referred TB suspects confirmed as TB
cases (n=434)(vs 430)
RESULTS No. Of Patients Referred for HIV Testing: year 3
RESULTS No. Of referred HIV suspects tested
HIV+
RESULTS% HIV+ patients receiving treatment
adherence support from THPs (n=328)
THP SERVICE QUALITY IMPROVEMENT Protective clothing during patient consultation/examination
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THP SERVICE QUALITY IMPROVEMENT Improvement in storage of medicines: Before & After
THP SERVICE QUALITY IMPROVEMENT THP Consultation rooms: Before & After
UNINTENDED RESULTSEmpilweni Muti Forest-Environmental Conservation
DISCUSSION-CONCLUSIONWhen THPs are given up-to-date and accurate health-
related information, they can make appropriate changes in their working environment and abandon potentially harmful practices and treatments.
The results from this model confirm that collaboration between National TB Programs and community based initiatives has a huge potential to improve early TB case finding and treatment success. (The WHO, 2013: Engage-TB strategy)
This collaboration strengthens better management and integration of HIV/AIDS & STI and TB services
Such projects positively contribute to infection control practices within the THP practice including improved waste disposal and environmental conservation
CHALLENGESLarge variation amongst THPs associations Weak central organization and coordinationVarying and conflicting theories of disease
causation between biomedical and THPs THPs generally skeptical of DOH authority Some health professionals have negative attitudes
towards traditional treatments (lack scientific rigor) Poor access/supply of resources to improve
infection control (protective clothing)Lack of a policy which for back referrals to THPs
by health professionals
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Collaboration in Practice: 2013TB Day Commemorations-Jozini Sub District
ACKNOWLEDGEMENTS
CIDA-DFATD (Department of Foreign Affairs and Trade Development)
AMREF Health Africa Canada UMkhanyakude District Health ManagementUMkhanyakude Traditional Authorities (Tribal
Councils)Other Government Agencies and NGOsThe Traditional Health Practitioners AssociationKwa-Zulu Natal Office of The Premier
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