Assessment of tuberculosis knowledge among Lesotho village health workers and utilisation of their tuberculosis services by the communities they serve

Abstract

Background The role of village health workers (VHWs), among other roles is to educate communities about tuberculosis (TB), TB screening and its treatment. The knowledge of TB among VHWs is crucial because they will carry out their role at the community well and this will impact the overall outcome of TB treatment. Aim The study is aimed at assessing the knowledge of TB among VHWs and households at the village level and the utilisation of VHWs’ TB services. Setting The study took place in 19 health centres from 10 districts of Lesotho. Methods The study used a cross-sectional descriptive design. Three study populations were interviewed, two at the household level (2040 households, 8295 individuals) and one at the clinic level (723 VHW). Results Overall, TB knowledge among VHWs for the majority of clinics except two was inadequate (below mean of 31.5). The utilisation of VHWs’ TB services among community members was also low. Conclusion Low utilisation of VHWs’ TB services by community members emanated from inadequate TB knowledge of VHWs. Regular refresher training among VHWs is recommended as the way forward in order to keep VHWs abreast with new TB developments.

Factors associated with Community Health Agents’ knowledge about tuberculosis

“…The inadequacy of training is evident in the CHAs’ knowledge and their performance in the NTCP, particularly when considering only their knowledge about tuberculosis (component 1), where 47.6% of CHAs demonstrated deficient knowledge. A similar finding was reported in a study conducted in Lesotho, Africa ( 27 ) .…”

“…The well-known consequences of limited knowledge about tuberculosis cannot be overlooked. Such limitations reinforce unsatisfactory practices in actions considered essential for successful infection control ( 28 - 29 ) , significantly interfere with the community education process for managing tuberculosis, weaken the DOT strategy, and result in low community adherence to tuberculosis control services ( 27 ) . Furthermore, the knowledge and training of CHAs in tuberculosis treatment are factors that influence patient satisfaction with the services these workers provide ( 30 ) .…”

Utilisation of village health workers’ services for tuberculosis screening in Lesotho

“…Detailed methodology of selecting clinics and villages that participated in the study is provided in the baseline report of the main study. 7 …”

“…It was established that 74.5% of community members in Lesotho were aware of their TB status. 7 Of the members aware of their TB status, less than half (43.8%) reported ever participating in TB screening. Only one in five respondents who were screened for TB did so on the advice of the VHW, showing underutilisation of these important team players in primary healthcare.…”

“…3 , 4 It is also acknowledged that VHWs play a significant part in improving health outcomes. 5 , 6 , 7 In Lesotho, VHWs are part of the primary healthcare team under the supervision and guidance of clinic professionals in charge of the health centres. 8 , 9 They connect the community with clinics in their respective villages.…”