Antiretroviral Treatment Literacy Training for Traditional Medical Practitioners in Africa

Issues:

Traditional Medical Practitioners (TMPs) provide primary health care to many of the underserved rural poor in African communities. Their clients are often those meeting the medical criteria to begin anti-retroviral (ARV) treatment. TMPs lack critical ARV treatment information and as a result may prescribe traditional procedures that exacerbate the symptoms of opportunistic infections or herbal remedies that interact with drugs used in anti-retroviral therapy.

Description:

Samaritan’s House, a community –based organization  has worked with TMPs for over ten years and has recently implemented a training programme with the goal of increasing their knowledge of anti-retroviral treatment. Thirty-five TMPs representing four Togolese Regions  attended one of three five-day ARV Treatment Literacy Workshops, which covered material including ARV resistance, adherence and interaction with traditional herbal remedies. A preliminary evaluation of the programme has been completed using pre- and post-training assessment questionnaires and facilitator observations.

Lessons learned:

Pre-training results revealed good general knowledge of HIV modes of transmission, diagnosis and of how ARV resistance develops. Few respondents reported commonly held myths. The average total group score increased on post-training evaluation; however a minority of participants’ scores decreased. TMP scores were high on questions related to ARV treatment, but many were unwilling to accept the harmful effects of interactions between herbal remedies and ARVs. Facilitators observed distrust of western medical institutions and that prior training on HIV/AIDS issues or biological science were important factors impacting overall learning.

Recommendations:

Although this is the first known programme with the goal of training TMPs on ARV treatment, it could easily be replicated in other contexts. Samaritan’s House plans to continue working with TMPs in this area and expects to see greater improvement in assessment scores as a result. Workshop attendance has generated interest among TMPs to research their own traditional medicines.