Experiences of traditional health practitioners working with department of health in the rural sub-district of Ratlou

Legobye, Nomvula Hazel
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Background Traditional Health Practitioners (THPs), previously known as traditional healers, continue to be the first point of contact with health services for most African indigenous communities. This choice of health care provision is happening while the National Department of Health (NDoH) is making strides to work together with the THPs. While this process by the NDoH is ongoing, tensions still exist between THPs and Bio-medical Health Practitioners (BHPs). This study aimed to explore the experiences of THPs working with the North West Department of Health (NWDoH) in the rural sub-district of Ratlou, in the Ngaka Modiri Molema (NMM) District of the North West Province of South Africa. Methods A qualitative exploratory research design was used to conduct this study. In-depth interviews were conducted with 30 purposively selected THPs providing services in the district. A thematic analysis approach was used, which involved familiarising myself with the data, assigning preliminary codes to the data in order to describe the content, searching for similar patterns or themes from all the interviews, reviewing themes and then finally naming the extracted themes. Results Four themes emerged from this study: collaboration appreciation, collaboration challenges, collaboration gains and impact, and approaches to collaboration strengthening in the rural sub-district of Ratlou. Collaboration appreciation was due to acknowledging opportunities for knowledge enhancement, collaboration contentment, traditional versus western cultural harmony, patient referral harmony and reciprocal learning between THPs and BHPs. Collaboration challenges included health provider attitudes, non-acceptance by BHPs of traditional treatment methodologies, strained referral systems and communication breakdown. Collaboration gains and impact were experienced in terms of reduction of morbidity and mortality, the involvement of THPs in health-related programmes and activities and opportunities for inter-referral of patients. Recommendations for strengthening the collaboration in Ratlou sub-district included promoting a two-way referral system; effective communication platforms; recognition of THPs as equal partners in health care service provision coupled with mutual respect and reciprocal learning; and community garden project initiation. Conclusion This study has revealed that the majority of THPs have embraced working together with the NWDoH. It is important to strengthen communication between THPs and BHPs through a structured patient referral organogram, recognition of THPs as equal partners in health service delivery, reciprocal learning, mutual respect and initiation of community garden projects at Primary Health Care (PHC) level.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirement for the degree of Master of Public Health (Rural Health). October 2019