Traditional Healers as Client Advocates in the HIV-endemic Region of Maputo, Mozambique: Results from a qualitative study

Traditional healers are commonly utilized throughout sub-Saharan Africa instead of, and in concert with, biomedical facilities. Traditional healers are trusted providers and prominent community members, and could be important partners in improving engagement with HIV services in endemic contexts. Our study sought to understand the roles of healers in the urban setting of Maputo, Mozambique, where HIV prevalence is high and testing rates are low. Qualitative data were gathered through minimally-structured interviews with 36 healers. Analysis followed an inductive, grounded theory approach. Data reveal three themes relevant to improving engagement with HIV services in this endemic region: 1) healers have positive attitudes towards biomedicine; 2) healers advocate for their sick clients; and 3) clients are reticent to present to biomedical facilities. Healers describe their roles as "cooperative" with biomedical providers to provide healthcare for their clients. Results suggest that healers could be considered critical enablers to effective HIV programs in communities. They have social and symbolic capital that positions them to beneficially influence clients, and are natural partners for interventions to improve uptake of HIV services.