|Collaboration with Traditional Healers in HIV/AIDS Prevention and Care in Sub-Saharan Africa - A literature review (UNAIDS, 2000, 64 p.)|
More systematic evaluation of collaborative projects is urgently needed, especially to assess determinants of success and/or failure. Since many of these projects are still in an experimental phase, the information collected could be used to improve existing endeavours and help develop new ones. A multiplicity of variables needs to be assessed and it is only with systematic and repeated evaluations, using a variety of methods, that we can hope to answer some of the crucial questions we are faced with. There is a dearth of rigorous, long-term measures of effectiveness and sustainability. Of particular interest is the question of cost-effectiveness; not one of the projects reviewed here officially reported on the efficiency of training with respect to cost-effectiveness. Unfortunately, without cost-effectiveness data it is easier for funding agencies to deny the usefulness of such projects.
Research, not only into the methods that traditional healers use and the impact of training projects, but also into the relationship between the traditional and biomedical health care systems, is crucial if we hope to answer questions about collaboration between the two systems. Interesting questions, such as how each health system influences the other, and how the relationship could be mutually beneficial, deserve an in-depth analysis in order to build a sustainable link between the two sectors.
With greater emphasis on home care since the advent of AIDS, it is possible that traditional healers may act as a critical link in the continuum of care from hospital to home. Research into the healer approach to care is another neglected area of research that shows great potential. In particular, an in-depth analysis of the counselling provided by traditional healers, and how they integrate biomedical concepts into their traditional belief system and methods of practice, is still untouched by research. But it is crucial to our understanding of the impact traditional healers could have in both care and prevention of STDs and HIV/AIDS.
In the continuing struggle to provide comprehensive health care to a wider population, research into the role of traditional healers might result in the development of innovative new strategies. For example, since the mid-1990s, traditional healers have played an increasingly important role in the promotion of condoms in a few countries in Africa. It is thus possible for them to play a role in providing greater access to other health care options such as family planning. This area has been looked at in some countries for primary health care, but has not been expanded to other areas of health or assessed on a large scale. The goal of maximizing availability of drugs in poor countries makes research on herbal medicine especially important today.
The question of standardization and regulation of traditional medicine training and traditional healers' practice has been debated with respect to creating national policies. Consensus has not yet been reached, but the issues are complex as recognition often depends on organization of traditional healers. There is a danger that regulation and standardization of traditional healers' practices will cause a loss of diversity within these practices. However, many traditional healers are still interested in recognition by the biomedical structure and welcome official policy changes to this end.
Collaborative projects have much to learn from each other. An improved system of communication among traditional healers, as well as within and between countries, would be useful. Regular meetings and networking would benefit not only the projects concerned but their beneficiaries as well.