Examining the potential roles of traditional healers in expanding HAART programs in rural western Uganda

In Uganda, despite increasing access to HAART, treatment reaches only 40% of those who need it. This gap between HAART coverage and the number requiring treatment is especially apparent in rural areas, largely due to a shortage of available health human resources. In order to meet the goal of universal HAART coverage, it will be necessary to engage non-conventional human resources like traditional healers (THs). THs are present in most communities, have been shown to successfully aide in other aspects of HIV care, and have been utilized to provide treatment for other diseases. The purpose of this study is to assess the feasibility of including THs in HAART programs in western by identifying factors which predict willingness and capacity to participate and collaborate with the formal health sector.

Data was collected in 2 districts in 2008. THs were recruited using a list of THs registered in a healers association and were randomly chosen to either participate in one of 4 group discussions or complete questionnaires. Questionnaires were completed with 150 THs. Two group discussions with patients were also held, and participants were selected from pre-existing post-test counseling groups.

More than 50% of THs registered in the district were male. Almost all THs identified themselves as herbalists, with a fraction indicating they were solely faith healers or traditional birth attendants. Preliminary analysis indicates that many THs have correct knowledge of HIV/AIDS and HAART, are eager to provide expanded AIDS care to their patients, and are willing to collaborate with the formal health care sector to provide HAART. Many THs expressed a willingness to volunteer their time to improve HAART-related services. A significant barrier to successful collaboration was the perceived lack of willingness of doctors to work with THs.