TABLE 1 Provider Classifications and Abbreviations

Provider Category Type Abbreviation
Community/Lay Worker Peer/service user PR
Community health care worker/health extension worker CHW
Non-specialized, Non-prescribing Pharmacist PH
Social Worker SW
Occupational Therapist OT
Non-specialized, Prescribing Clinical/health officer CO
Nurse RN
Medical doctor/general practitioner MD
Specialized Psychiatric Nurse PRN
Psychologist PY
Neurologist NE
Psychiatrist PS

Several participants emphasized that these providers play an important health care role throughout SSA but that no formal relationship between the health system and traditional health practitioners currently exists. The need to engage traditional health practitioners, and the need for functional referral pathways in all directions between the peer/service users, community health workers, and traditional practitioners was stressed by many participants. A large number of participants, including Lydia Matoka, a traditional health practitioner from Kenya, noted that in SSA, most rural area patients turn to traditional health practitioners first.

It was noted by several participants that traditional health practitioners can play an important role in encouraging treatment-seeking behaviors by providing community members with examples of how treatment has been helpful. For epilepsy, these providers might be able to offer counseling to help patients deal with perceived supernatural elements they may believe have a role in their disease (e.g., through mediation with ancestors).

Elliot Makhatini, a participant from South Africa, said one of the tertiary institutions in his area holds an annual forum for doctors, specialists, and traditional health practitioners to interact and give presentations



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