ABSTRACT
Background: The current malaria control strategy of WHO centres on early diagnosis and prompt treatment using effective drugs. Children with severe malaria are often brought late to health facilities and traditional health practitioners are said to be the main cause of treatment delay. In the context of the Rectal Artesunate Project in Tanzania; the role of traditional healers in the management of severe malaria in children was studied. Methodology A community cross-sectional study was conducted in Kilosa and Handeni Districts; involving four villages selected on the basis of existing statistics on the number of traditional health practitioners involved in the management of severe malaria. A total of 41 traditional health practitioners were selected using the snowballing technique; whereby in-depth interviews were used to collect information. Eight Focus Group Discussions (FGDs) involving traditional health practitioners; caregivers and community leaders were carried out in each district. Results: Home management of fever involving sponging or washing with warm water at the household level; was widely practiced by caregivers. One important finding was that traditional health practitioners and mothers were not linking the local illness termed degedege; a prominent feature in severe malaria; to biomedically-defined malaria. The majority of mothers (75