Rolling Back from the Past: Approaches of engaging traditional health practitioners in disease surveillance and response: lessons for epidemic preparedness and control in Tanzania

Abstract

Gaps remain in effectively integration of traditional health practitioners (THPs) into the Tanzania’s Integrated Disease Surveillance and Response (IDSR) framework for comprehensive disease monitoring and response. This short communication reports findings from a study evaluated approaches to integrate conventional and traditional practitioners’ systems, identify challenges, and opportunities, and design interventions to facilitate this. Implemented in Mpwapwa District in early 2000s, the study comprised of three phases: 1) the formative assessment: involving the health officials, traditional practitioners, and community leaders in focus group discussions (FGDs); 2) the intervention phase: conduct exchange learning sessions, interactive workshops, standardizing referral pathway and reporting forms, training, develop and distribute educational materials; and, 3) the evaluation phase: six-month monitoring to capture existing linkages. Baseline findings showed limited referral pathways, variable record-keeping, mutual mistrust between systems, and literacy-related challenges affecting form completion. Within three months following the interventions, 59 formal transfers from THPs to conventional facilities were documented, an improved collaboration between the systems was demonstrated, including THPs accompanying patients to facilities. TPHs expressed willingness to have traditional medicines included in trials. These findings indicated that structured engagement of THPs is feasible and can expand surveillance reach and when paired with simple reporting tools, targeted training, monitoring, and regular feedback. This IDSR effectiveness is critical in era of emerging and re-emerging diseases.