Healer-led vs. clinician-led training to improve personal protective equipment use among traditional healers in South Africa: a randomized controlled trial protocol
Date
2021-03-01
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
There are estimated two million traditional healers in sub-Saharan Africa (SSA), with more
than 10% (200,000) working in South Africa. Traditional healers in SSA are frequently exposed
to bloodborne pathogens through the widespread practice of traditional ‘injections’, in which
the healers perform dozens of subcutaneous incisions to rub herbs directly into the bloodied
tissue with their hands. Healers who report exposure to patient blood have a 2.2-fold higher
risk of being HIV-positive than those who do not report exposure. We propose a randomized
controlled trial (61 healers in the intervention group and 61 healers in the control group) in
Mpumalanga Province. Healers will receive personal protective equipment (PPE) education
and training, general HIV prevention education, and three educational outreach visits at the
healer’s place of practice to provide advice and support for PPE use and disposal. Healers in
the control arm will be trained by health care providers, while participants in the intervention
arm will receive training and outreach from a team of healers who were early adopters of PPE.
We will evaluate intervention implementation using data from surveys, observation, and
educational assessments. Implementation outcomes of interest include acceptability and
feasibility of PPE use during clinical encounters and fidelity of PPE use during treatments
that involve blood exposure. We will test our two intervention strategies to identify an
optimal strategy for PPE education in a region with high HIV prevalence.
Description
Keywords
Personal protective equipment; traditional healers; HIV prevention; randomized controlled trial; blood exposure