A descriptive quantitative study was undertaken in the Leribe and Butha-buthe northern districts of Lesotho. Thirty-six trained, twenty-four untrained TBAs and nine nurses involved in training TBAs were recruited. In line with research by Clarke and Lephoto (1989:3) the TBAs were elderly females who had children of their own. In contrast with the MOH (1993: 10) where TBAs were found to be illiterate, most (93%) of the TBAs in this study had at least a primary education. The art of primary midwifery was learned through assisting with a delivery and being taught by mothers or mothers-in-law. The public health nurses conduct formal training ofTBAs in Lesotho over a period of two weeks, where subjects like ante-natal care, delivery of the baby and post- natal care are addressed. The majority (78.8%) provide antenatal care at their homes or the home of the mother. This includes palpation, history taking, and abdominal massage and health education. An important role is identifying women at risk. During labour the progress of labour is monitored and care is given to the mother and baby post-natally. Trained TBAs could identify women at risk more readily than untrained TBAs. Cases referred most frequently were prolonged labour and retained placenta. Trained TBAs practiced hygiene more often and gave less herbs than untrained TBAs. The health care system is providing support to the TBAs through training and supervision, but was found to be inadequate. Community leaders are involved in the selection of TBAs for training. Regular meetings are held with the TB As to discuss problems. Communication is one of the problems the TB As have to face, because of the long distances from health care centres. A lack of infrastructure and supplies is also of concern. It can be concluded that TBAs play an important role in maternal health care in Lesotho and are supported to a lesser degree by the health care system, which causes problems for the TBAs in their practices. It is recommended that the ministry of health becomes more aware of the need for training TBAs and that a programme for training should be more appropriate, taking cultural practices into account. / Advanced Nursing Science / D.Lit. et Phil.

A descriptive quantitative study was undertaken in the Leribe and Butha-buthe northern districts of Lesotho. Thirty-six trained, twenty-four untrained TBAs and nine nurses involved in training TBAs were recruited. In line with research by Clarke and Lephoto (1989:3) the TBAs were elderly females who had children of their own. In contrast with the MOH (1993: 10) where TBAs were found to be illiterate, most (93%) of the TBAs in this study had at least a primary education. The art of primary midwifery was learned through assisting with a delivery and being taught by mothers or mothers-in-law. The public health nurses conduct formal training ofTBAs in Lesotho over a period of two weeks, where subjects like ante-natal care, delivery of the baby and post- natal care are addressed. The majority (78.8%) provide antenatal care at their homes or the home of the mother. This includes palpation, history taking, and abdominal massage and health education. An important role is identifying women at risk. During labour the progress of labour is monitored and care is given to the mother and baby post-natally. Trained TBAs could identify women at risk more readily than untrained TBAs. Cases referred most frequently were prolonged labour and retained placenta. Trained TBAs practiced hygiene more often and gave less herbs than untrained TBAs. The health care system is providing support to the TBAs through training and supervision, but was found to be inadequate. Community leaders are involved in the selection of TBAs for training. Regular meetings are held with the TB As to discuss problems. Communication is one of the problems the TB As have to face, because of the long distances from health care centres. A lack of infrastructure and supplies is also of concern. It can be concluded that TBAs play an important role in maternal health care in Lesotho and are supported to a lesser degree by the health care system, which causes problems for the TBAs in their practices. It is recommended that the ministry of health becomes more aware of the need for training TBAs and that a programme for training should be more appropriate, taking cultural practices into account. / Advanced Nursing Science / D.Lit. et Phil.

The purpose of the study was to explore and describe the existing relationship between traditional healers and nurse practitioners in Maseru Health Service Area in Lesotho and also to determine why people consult traditional healers. Qualitative and quantitative methods were used to investigate the relationship between traditional healers and nurse practitioners and also to determine why people utilize the services of traditional healers. The study was limited to Maseru Health Service Area in Lesotho. Data was collected from twenty-seven (27) nurses from nineteen (19) clinics and from thirty (30) traditional healers from the same health service area. Data from traditional healers was collected using semi-structured interviews while nurse practitioners were given a questionnaire to complete. The study revealed that there was no formal relationship between traditional healers and nurse practitioners. Support for traditional healers was revealed to be limited, for example, only four (14.8%) nurses had a programme for traditional healers while twenty ( 66.7%) traditional healers did not have any contact with nurse practitioners. Involvement of traditional healers in primary health care at grassroots level has therefore been very minimal. The reasons why people utilize traditional healers were found to be as follows: • When people think they have been bewitched. • Traditional healers can tell the actual cause of disease • Failure of modern practice • For social problems According to the study, both traditional healers and nurse practitioners felt that collaboration between traditional healers and nurse practitioners was essential because it would enable planned referral of patients from one group to another where necessary; it would also facilitate exchange of ideas and knowledge for the benefit of the people served. Recommendations on collaboration and on support systems are given in Chapter Six. / Health Studies / D. Litt. et Phil. (Nursing Science)

The purpose of the study was to explore and describe the existing relationship between traditional healers and nurse practitioners in Maseru Health Service Area in Lesotho and also to determine why people consult traditional healers. Qualitative and quantitative methods were used to investigate the relationship between traditional healers and nurse practitioners and also to determine why people utilize the services of traditional healers. The study was limited to Maseru Health Service Area in Lesotho. Data was collected from twenty-seven (27) nurses from nineteen (19) clinics and from thirty (30) traditional healers from the same health service area. Data from traditional healers was collected using semi-structured interviews while nurse practitioners were given a questionnaire to complete. The study revealed that there was no formal relationship between traditional healers and nurse practitioners. Support for traditional healers was revealed to be limited, for example, only four (14.8%) nurses had a programme for traditional healers while twenty ( 66.7%) traditional healers did not have any contact with nurse practitioners. Involvement of traditional healers in primary health care at grassroots level has therefore been very minimal. The reasons why people utilize traditional healers were found to be as follows: • When people think they have been bewitched. • Traditional healers can tell the actual cause of disease • Failure of modern practice • For social problems According to the study, both traditional healers and nurse practitioners felt that collaboration between traditional healers and nurse practitioners was essential because it would enable planned referral of patients from one group to another where necessary; it would also facilitate exchange of ideas and knowledge for the benefit of the people served. Recommendations on collaboration and on support systems are given in Chapter Six. / Health Studies / D. Litt. et Phil. (Nursing Science)