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 Mbatha 1 ; T. Ngwenya 2 ; D Ngcobo 3 ; SE Mthembu 4 ; JF Aguilera 5,6 1 Partnership for the Delivery of Primary Health Care including HIV and AIDS Programme (PDPHCP), KwaZulu-Natal Provincial Management Unit, Department of Health (DOH), South Africa 2 AMREF SA, KwaZulu Natal, Umkhanyakude District, South Africa 3 PDPHCP, KwaZulu Natal, District Programme Management Unit, DOH, South Africa 4 PDPHCP, KwaZulu Natal, Provincial Programme Management Unit, DOH, South Africa 5 National Programme Management Unit, DOH, Pretoria, South Africa 6 AEDES, Brussels, Belgium PDPHCP is funded by the European Commission. The views and opinions expressed are not necessarily those of the European Commission Abstract Introduction Objectives Conclusions Results Methods 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..  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: 1.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) Table 1: General responses towards THP and their services Table 2: Responses towards THP treatments/healing practices Table 3: Responses towards support for and potential collaborative models  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. ItemnAgree % Disagree % I do not feel that THP have anything to offer those who have an STI 8527%60% Traditional healers are fakes who pretend to cure AIDS 8041% THP are ideally placed in their communities to provide effective support for people living with HIV/Aids 7947%37% ItemnAgree % Disagree % Some traditional healing practices could increase risk of HIV infection 9278%15% THP have all the knowledge needed to treat people living with HIV/AIDS 8319%65% Traditional medicines can have a role in the treatment of PLWHA 7848%31% THP cannot be trusted to treat people with HIV/AIDS 7631%47% Traditional healers can cure AIDS7312%62% ItemnAgree % Disagree % I would be happy to work in a team with a traditional healer to provide treatment for TB 9760%39% I would be happy to work hand in hand with traditional healers in dealing with HIV/AIDS in a hospital situation 9163%30% I would prefer that a doctor or nurse provides counseling during VCT than a THP 9075%18% Traditional healers can be trained to effectively treat people living with HIV/AIDS 8977%18% I would be happy to work with traditional healers in the treatment and prevention of STIs 8859%31% Traditional medicine and western medicine cannot work together in helping people living with HIV/AIDS 7634%44% 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? 1.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  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