Culturally-based health promotion programmes Ronán M Conroy a Corresponding AuthorEmail Address, Michael Elmore-Meegan a

Culturally-based health promotion programmes
Ronán M Conroy a Corresponding AuthorEmail Address, Michael Elmore-Meegan a
Authors' reply
Sir—Our research was not run as a prospective study. Mortality data for the control areas were extracted from records by the Kenyan Ministry of Health at our request in 1999, when we were collating and analysing the records of the ICROSS traditional birth attendant programme. The control areas were not left without a traditional birth attendant programme as part of a controlled experiment. Rather, they had no programme because the Ministry of Health had neither the resources nor the expertise to launch and maintain such programmes.
The ICROSS programme, which is run in partnership with the Kenyan Ministry of Health, is supported by the Irish and Danish Governments. ICROSS has made several attempts to secure funding to extend the traditional birth attendant programme to other areas in Kenya, but to date these have been unsuccessful. Many bilateral donors have shifted funds away from supporting primary healthcare, perhaps partly because of lack of evidence that such support really improves community health. We hope that our results will help to highlight the untapped potential that is represented by the traditional healers and birth attendants in communities in less-developed countries. Rather than simply attempting to provide such communities with health services along more-developed-world lines, we should, in parallel, be developing and supporting the communities' indigenous health services.
a Department of Biostatistics, Royal College of Surgeons, Dublin 2, Ireland; and ICROSS Kenya, PO Box 506, Ngong, Kenya
Corresponding Author Information Department of Biostatistics, Royal College of Surgeons, Dublin 2, Ireland
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