Participatory action research to implement a model of collaboration between allopathic and traditional healthcare practitioners in the management of HIV/AIDS and TB

Abstract

Introduction: A collaborative healthcare system is needed to meet the cultural health needs of population groups. South Africa is overwhelmed with people from diverse cultural backgrounds leading an increased demand to consult both allopathic and traditional health practitioners as consumers of healthcare use both services. Studies indicated that about 80% of Africans first attempt to self-diagnose and treat or seek help from traditional health practitioners before formal consultation with allopathic health practitioners. The researcher has realised that there is a lack of collaboration between allopathic and traditional health practitioners in the management of patients living with HIV/AIDS and TB in the Gert Sibande District, Mpumalanga, South Africa. The lack of collaboration occurs despite the recommendation outlined in the African National Congress Health Plan, which indicated that traditional healing would be an integral and recognised part of healthcare in South Africa.

Aims: The study aimed to validate, adjust, and implement Nemutandani’s adjusted model for collaboration and evaluate the extent to which the model was useful to Gert Sibande District.

Methodology: A Participatory Action Research (PAR) design was used. The study was conducted in four phases, and the four steps of participatory action research acted as a lens: identification of needs, planning, implementation, and evaluation. The activities of each step were guided by the phases of the Replicating Effective Program (REP) framework: preconditions, pre-implementation, implementation, and evaluation.

The population of interest for phase one, two and four were stakeholders who were experience in managing patients living with HIV/AIDS and TB, and had the power to facilitate change in the community. For phase three population were patients living with HIV/AIDS and TB, and healthcare providers who were directly working with patients suffering from HIV/AIDS and TB. Maximum variations purposive sampling was used to select stakeholders. Thirteen stakeholders signed informed consent to participate in the study for phase one, two, and four. For phase three ten patients and three program champions from each of the two selected clinics signed consent to participate and participated in the study. Two Nominal Group Technique (NGT) workshops were conducted to collect data for phases one and two. In phase one, the need for implementing Nemutandani’s collaborative model was identified and the content of Nemutandani’s collaborative model that could effectively meet the health needs of Gert Sibande District, Mpumalanga Province, South Africa, was identified, and in phase two, Nemutandani’s collaborative model was adjusted to meet the health needs of Gert Sibande District, Mpumalanga Province, South Africa. Inductive content analysis was used to analyse data for phases one and two. The outcome of phase one was the identified the need for implementing Nemutandani’s adjusted collaborative model and the content of the model that could effectively meet the health needs of the Gert Sibande District, Mpumalanga Province, South Africa.

The outcome of phase two was Nemutandani’s adjusted collaborative model. In phase three, the adjusted model was implemented in two clinics in the Gert Sibande District, Mpumalanga Province, South Africa. The implementation of Nemutandani’s adjusted collaborative model lasted for two months, and the third month was used for the evaluation of the extent to which the model was useful to Gert Sibande District, Mpumalanga Province, South Africa. A Likert scale was formulated to collect data from the stakeholders regarding the extent to which Nemutandani’s adjusted collaborative model was useful to Gert Sibande District, Mpumalanga Province, South Africa.

Study findings: The findings revealed that in the Gert Sibande District, Mpumalanga Province, South Africa, implementation of Nemutandani’s adjusted collaborative was needed. Both traditional and allopathic health practitioners were willing to work together and learn from each other. Since the beginning of Nemutandani’s adjusted collaborative model implementation, people living with HIV/AIDS and TB honoured their appointments and were happy about the initiative. A need for further training was identified.

Conclusion: The study concludes that collaboration between allopathic and traditional health practitioners in the management of HIV/AIDS and TB is an effective way that can improve treatment adherence. Collaboration creates clear lines of communication between traditional and allopathic healthcare practitioners, and minimised the misunderstanding between the two healthcare providers treating the same patient.

Keywords: Allopathic, allopathic health practitioner, collaboration, implementation, model, participatory action research, traditional, and traditional health practitioner.