Eye care knowledge and practices among Malawian traditional healers and the development of collaborative blindness prevention programmes

Many African traditional healers provide treatment for eye diseases, yet there is little published information about eye care knowledge and practices among these healers; the information is necessary for the development of collaborative eye care activities with healers. Focus group discussions, in-depth interviews, and a representative sample survey of 107 randomly selected traditional healers in Chikwawa District, Malawi were conducted regarding eye care knowledge and practices. In the survey 68% of healers treated at least one of six common eye conditions. The most common eye condition treated by healers was cataract, followed by conjunctivitis/inflammatory trachoma. The size of the healer's practice, literacy, and great distance to a health facility were positively associated with the provision of eye care. Traditional healers have considerably more eye care interactions with the rural population than existing biomedical health personnel in Chikwawa District. Interviews revealed that most healers were aware of the availability of treatment for common eye conditions at biomedical health facilities and were interested in collaborating with existing biomedical eye care providers. We subsequently developed a collaborative eye care programme with healers in the district and report on early findings. Collaboration with healers in eye care programmes is advocated and recommendations are provided.