While these mechanisms are important, complementary activities also influenced TBA referral and integration success: “careful selection of TBAs; community participation; health system development; and affordability changes.” TBA’s must be provided with appropriate knowledge, easy access to health personnel, and quality and regular supervision; all three components enable training to become a tool for TBA integration into the healthcare system. The referral training for TBAs allows them to act as “intermediaries between the community and the formal health care system.” Training that advocates collaboration and regular involvement in clinic duties, increases the number of referrals and improves communication.