Human Resources for Health in Maternal, Neonatal and - HRH ...

Building relationships with cultural practitioners provides in roads to communities
strengthening links in order to provide care that is more responsive to the needs of the
community. Traditional practitioners are often consulted independently of CHWs (De
Francisco 1994) but efforts are being made to work with traditional practitioners in a team
where care can be shared and referrals made (Nakyanzi 1999; de Vaate, Coleman et al. 2002).
Traditional and Western approaches to care should be viewed as complementary (WHO
1989) which necessitates partnership between practitioners (Replogle 2007).
In Uganda, THETA (Traditional and modern health practitioners together against AIDS and
other diseases), is promoting collaboration between traditional and biomedical health workers
in the prevention and care of STIs including HIV. THETA is working with CHWs to
establish women's information needs and cultural practices that affect their health
(HealthLink 1999). A study by Kaboru et als in Zambia indicates that both traditional and
biomedical practitioners are interested in collaborative practice but there is a low level of
experience in overt collaboration (Kaboru 2006). Most partnerships concerned issues of safe
delivery but intersectoral contacts addressing STIs and HIV/AIDS care issues were less
common. A similar project in South Africa was designed to question PHC clinic nurses and
traditional healers including TBAs about their attitudes toward collaboration and working
together within PHC services. Various recommendations emerged confirming that successful
collaboration is based on respect and a positive attitude toward traditional healers and to
explain the aims of the project (Troskie 1997). A Cambodia study also affirmed that TBAs are
willing to collaborate with the public health care providers and are keen to be a part of a TBA
Association (Parco 2000).
Involving TBAs in the government health care delivery system enables them to give their
best possible performance (Peng 1979). This enables them to work closely with community
health nurses who are responsible for their supervision and skills update. Effective
partnerships with TBAs are not only dependant on stable relationships with other workers at
community level but on further trained and be more successful integration into the health
system (Perez, Aung et al. 2008). Kapoor outlines ways in which TBAs have been integrated
into family planning programmes in Bangladesh, Pakistan and India through the development
of relationships and training (1994).
In Eritrea a partnership to improve the health of mothers and babies was developed between
nurses, midwives and traditional birth attendants. The traditional birth attendants, who are
seen as community opinion leaders, are encouraged to promote health-seeking behaviour in
the community and refer pregnant women to health facilities for delivery. The ministry of
health has established programmes to recruit and train people from local communities on a
range of issues, including the need to end harmful traditional practices such as female genital
mutilation. The programme has identified the need to improve the relationship between
P a g e | 104