Knowledge of primary healthcare workers regarding the prevention and control of non-communicable diseases in Osun State, Nigeria: A rural-urban comparison

Abstract

Background: There is a rising burden of non-communicable diseases (NCDs) in the sub-Saharan Africa, and calls for integration of management of selected NCDs with primary healthcare (PHC) have been unrelenting. Cost-effective interventions for the prevention and control of NCDs can be delivered at PHC facilities in low-resource settings by clinical healthcare workers (HCWs).Aim: This study compared the knowledge of HCWs in PHC facilities regarding the prevention and control of NCDs in rural and urban local government areas (LGAs) of Osun State.Setting: A comparative cross-sectional study was conducted amongst 400 eligible HCWs recruited using a multistage sampling technique in PHC facilities of six rural and six urban LGAs.Methods: A pretested self-administered case-scenarios questionnaire was used to assess the knowledge of HCWs regarding the prevention and control of three selected NCDs (diabetes, hypertension and chronic respiratory diseases). Both descriptive and inferential statistics were conducted.Results: The mean knowledge scores of HCWs regarding the prevention and control of the three NCDs were 17.76 ± 4.41 in rural and 17.62 ± 4.02 in urban LGAs out of 30 maximum scores. The proportion of HCWs with adequate knowledge in the rural LGAs (31.0%) was slightly higher than the urban LGAs (23.0%); however, it was not statistically significant (χ2 = 3.247; p = 0.072). The major determinants of adequate knowledge include cadre of HCWs, location, years in practice with professional certificate, NCD training course attendance and reported experience managing diabetic patients.Conclusion: The HCWs in PHC facilities in rural and urban LGAs of Osun State, Nigeria, had a poor knowledge regarding the prevention and control of NCDs. Training and re-training of less-skilled HCWs in the PHC facilities using relevant WHO NCD protocols and guidelines are imperatives to improve their knowledge about the prevention and control of NCDs.

An Evaluation of Community Health Workers’ Knowledge, Attitude and Personal Lifestyle Behaviour in Non-Communicable Disease Health Promotion and Their Association with Self-Efficacy and NCD-Risk Perception

“…Overall, 29.9% (95% CI: 23.6-36.2%) of HEWs had a low level of NCD knowledge, 32.6% (95% CI: 26.2-39.0%) of HEWs had a moderate level of NCD knowledge, and 37.5% (95% CI: 30.8-44.2%) of HEWs had a high level of NCD knowledge. In contrast, a Nigerian study found that 23.0% of primary healthcare workers had adequate NCD knowledge [40], significantly lower than our findings. This variation could be due to knowledge score dimensions and classification differences.…”

The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis

“…Due to the chronic nature of NCDs, people living with these diseases and their risk factors require sustained person-centred and community-based care [13]. This would ideally be achieved through the PHC health system.…”

“…Access to quality and essential NCD interventions is further compounded by inadequate and maldistribution of skilled health workers, particularly physicians and nurses [13]. Consequently, NCD care at the PHC level is mainly handled by community health workers (CHWs), whose training and skills are generally considered insufficient for NCD management and prevention [14].…”

“…Most studies on NCDs in Nigeria centre on disease burden [2,[16][17][18][19]] while some others have assessed health care workers' knowledge on these diseases [13,20]. Only few studies have examined enablers and barriers to NCD service delivery in PHC facilities.…”

Barriers and facilitators in the acquisition of diabetes knowledge among tertiary-care nurses in central and southern Malawi: An exploratory-descriptive qualitative study

“…They have a major effect when supporting patients with self-management of their condition particularly using the proactive care management model and decision making support approaches [18][19][20][21][22]. Numerous studies outside SSA [16, [23][24][25][26][27] and within Africa [28][29][30][31][32][33][34][35] report low knowledge levels of diabetes and diabetes care among nurses. However, the factors that hinder and promote the nurses' acquisition of diabetes knowledge are not well established.…”