Biomedical and Traditional Healing Collaboration on HIV/AIDS Professor Nceba Gqaleni DST/NRF Research Chair: Indigenous Health Care Systems

Vision & Mission of the DST/NRF Research Chair To restore the dignity of African Traditional Medicine through excellence in research To become a centre of choice for traditional health practitioners, IK knowledge holders and scientists for research of African TM

Healers and doctors sign memorandum “The groundbreaking agreement was sealed after a meeting at the Nelson R Mandela Medical School, which was attended by King Goodwill Zwelithini, KZN Minister of Health Dr Zweli Mkhize and the national Minister of Health, Dr Manto Tshabalala-Msimang” Farook Khan and Wendy Nzama. The Mercury, 24 Oct 2003

PEPFAR Collaboration project Focus on the establishment of a strategic collaboration between public health clinics and Traditional Health Practitioners Prevention Palliative care VCT and referral OVC

THPs TRAINED The project began in 2005/2006 financial year in the eThekwini district. It is currently in its fourth year of operation. At the end of the second year the project had 174 trained THPs actively involved. An additional number of 309 THPs were trained during 2008 increased the number of THPs actively involved to 483 at the end of the third year. In the third year the project expanded to include two new districts i.e. Ilembe and Umgumgumdlovu. Currently the project has 736 trained THPs participating in the project. The eThekwini Skills Development Unit agreed as their outreach programme to develop and capacitate THP's on Adult Basic Education and Training (ABET). There are 120 THP's that attend 2 classes at KwaNgcolosi and KwaMakhutha. This service further enhances the work we are doing.

Monitoring and Evaluation Site Initiations After each training session site initiations are undertaken A site initiation is an additional meeting between Traditional Health Practitioners and the M&E team to initiate the project on the ground. It serves to once more review all materials and handing over of the necessary resources to THPs. Also explained is the process and frequency by which data collectors will engage with the THPs and the assurance that additional and ongoing support and assistance will be provided as and when required. The site initiation and site visit also serves to assess the site to ascertain whether it meets all the project requirements before can be declared as a functional site

Patient Record Keeping System All patient and THP details required by the project is entered by the THP into a Patient Record Form (PRF). Copies of these forms are collected from the THPs and then captured into a central database

Data Collection and Data Capturing All Standard Operating Procedures and other guidelines have been fully developed and implemented. The Data Monitors (DM) visit the THPs bi-weekly to collect the PRFs as well as provide support and assistance where required. Both the data collection and data capturing processes have improved significantly over the last year and is operating more efficiently. There has been an improvement in the quality of data that has been captured, PRFs have less errors, inconsistencies and missing data. There are currently 16 Data Monitors and 6 Data Capturers employed on the project

REFERRAL SYSTEM THPs are encouraged to refer patients when deemed necessary in their opinion to public health facilities. A nursing sister employed to assist in this process is located at the eThekwini Municipality and reports to the manager from the Council. Her function is to establish links with the referral clinics to capture the number of people who have been referred for VCT and care.

Numbers of patients reached through prevention messages and care Indicators   2006 2007 2008 2009 Total no. patients seen 2067 1804 12864 10113 Patients received advice on Condom use 1967 1290 11389 9191 Patients received advice on Abstinence and Being Faithful 1870 1308 11810 9532 Patients received advice on Abstinence only 54 N/A 250 92 Patients suspected of HIV 981 606 3345 1839 Patients received palliative care 2086 1615

Enhancing prevention communication A new strategic approach has been developed and implemented where THPs use the knowledge acquired during the training to promote prevention messages and behavior change in their community activities e.g. school visits, religious functions and other community gatherings like imbozos.

ACKNOLEDGEMENTS Supported by the US Program Mission to South Africa, CDC U62/CCU024561 The contribution of the THP colleagues who have so generously shared their wisdom and expertise is greatly appreciated Patients for consenting