Traditional healers and the potential for collaboration with the national tuberculosis programme in Vanuatu: results from a mixed methods study.
BACKGROUND
This study was conducted in the Pacific island nation of Vanuatu. Our objective was to assess knowledge, attitudes and practice of traditional healers who treat lung diseases and tuberculosis (TB), including their willingness to collaborate with the national TB programme.


METHODS
This was a descriptive study using both qualitative and quantitative methods. Quantitative analysis was based on the responses provided to closed-ended questions, and we used descriptive analysis (frequencies) to describe the knowledge, attitudes and practice of the traditional healers towards TB. Qualitative analysis was based on open-ended questions permitting fuller explanations. We used thematic analysis and developed a posteriori inductive categories to draw original and unbiased conclusions.


RESULTS
Nineteen traditional healers were interviewed; 18 were male. Fifteen of the healers reported treating short wind (a local term to describe lung, chest or breathing illnesses) which they attributed to food, alcohol, smoking or pollution from contact with menstrual blood, and a range of other physical and spiritual causes. Ten said that they would treat TB with leaf medicine. Four traditional healers said that they would not treat TB. Twelve of the healers had referred someone to a hospital for a strong wet-cough and just over half of the healers (9) reported a previous collaboration with the Government health care system. Eighteen of the traditional healers would be willing to collaborate with the national TB programme, with or without compensation.


CONCLUSIONS
Traditional healers in Vanuatu treat lung diseases including TB. Many have previously collaborated with the Government funded health care system, and almost all of them indicated a willingness to collaborate with the national TB programme. The engagement of traditional healers in TB management should be considered, using an evidence based and culturally sensitive approach.
Secretariat of the Pacific Community, Public Health Division, BP D5, Noumea Cedex 98848, New Caledonia. kerri.viney@hotmail.com.
Kerri
K
Viney
Penelope
P
Johnson
Markleen
M
Tagaro
Saen
S
Fanai
Nguyen N
NN
Linh
Paul
P
Kelly
David
D
Harley
Adrian
A
Sleigh
D000293:Adolescent; D000328:Adult; D003299:Cooperative Behavior; D003695:Delivery of Health Care; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000628:therapy*; D009514:Vanuatu; D055815:Young Adult