scholarly journals Community Contribution to Tuberculosis Care in the Krachi West District of Ghana: A Qualitative Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Samuel Agbenyegah Addy ◽  
Eric Osei ◽  
Joyce Komesuor ◽  
Evelyn Acquah ◽  
Prince Justin Anku ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Involvement ◽  
Health Workers ◽  
World Health ◽  
Community Members ◽  
Community Health Volunteers ◽  
Directly Observed Treatment ◽  
Community Contribution ◽  
Tuberculosis Care ◽  
Selection Of

Background. Eradicating tuberculosis (TB) is one of the targets of the recently constituted Sustainable Development Goal (SDG) Three. In the light of limitations inherent in prevailing tuberculosis care and the global urgency to improve TB care, decentralising TB care beyond health facilities by harnessing the contribution of communities is essential in ensuring effective tuberculosis care. In this paper, we explored community contribution to TB care in the Krachi West District of Ghana. Methods. In this qualitative study, 24 TB stakeholders made up of 7 health workers, 9 tuberculosis patients, 4 community health volunteers, 2 treatment supporters, and 2 opinion leaders were interviewed. Data collected were analysed manually, but thematically. Statements of the participants were presented as quotes to substantiate issues discussed. Results. Community contribution to TB care was low. Most of the community members were not aware of any community level activity towards tuberculosis care. Though patients were mainly the ones responsible for the selection of their treatment supporters, there were instances where health workers selected supporters for them without their consent. Some treatment supporters were also not given any education concerning their roles in supporting their patients, resulting in some patients defaulting treatment and others taking their medications wrongfully. Conclusion. Our study revealed low community involvement in tuberculosis care in the Krachi West District of Ghana. Community sensitisation on the World Health Organisation’s Directly Observed Treatment Strategy (which Ghana adopted in 1994) to increase community involvement in tuberculosis activities is, therefore, recommended.

scholarly journals Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eunice Mallari ◽  
Gideon Lasco ◽  
Don Jervis Sayman ◽  
Arianna Maever L. Amit ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Lived Experiences ◽  
Health Workers ◽  
The Philippines ◽  
Community Members ◽  
Cross Sectional ◽  
The Impact

Abstract Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

scholarly journals Exploring Community Tuberculosis Program in the Pastoralist Setting of Ethiopia: a Qualitative Study of Community Health Workers' Perspectives in Borena Zone, Oromia Region

2021 ◽  
Author(s):  
Abebe Megerso ◽  
Negusie Deyessa ◽  
Godana Jarso ◽  
Robel Tezera ◽  
Alemayehu Worku
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Community Involvement ◽  
Health Workers ◽  
Community Setting ◽  
Community Factors ◽  
Geographically Dispersed ◽  
Pastoralist Community ◽  
Data Saturation ◽  
Pastoral Setting

Abstract Background: Tuberculosis (TB) is one of the top ten causes of death and thee first cause of death due to single infectious disease in the world. Nevertheless, access to TB prevention and control is not uniform even within a country, The community TB program is designed to improve the access in Ethiopia. Exploring the program performance from the perspectives of its implemters in a pastoral setting remains important.Method: We conducted a qualitative study using an interpretive description method in the pastoralist community setting of Ethiopia. Study participants were recruited from geographically dispersed areas. Data were collected through in-depth interview using semi-structured guides and audio recordings during February 01-30, 2020. The interview guide was developed based on consultation with TB program experts and clinicians treating TB patients in the study area. Notes were taken at the interview to enrich the transcription of the data. The interview was conducted by the principal investigator. The subsequent data collection was informed by emerging ideas from forgoing interview transcriptions. The interview continued until data saturation was achieved.Results: One hundred and fisty six codes, nine categories and three themes emanated. The first theme was an inadequate community TB performance and some of its codes include inadequate presumptive TB case identification and compromised DOTs service delivery. The second theme was factors contributing to the performance. Community factors, lack of physical access to health facilities and indirect non-medical cost are some of categories under this theme. The final theme was related to solutions and its categories include a need for active community involvement and modification of service delivery approaches.Conclusion:Community TB performance is inadequate in the pastoralist community and many factors contribute to the inadequate performance. Aligning the program to the context of the pastoralist community setting is required to improve the performance.

scholarly journals The levels of Community Involvement in Health (CIH): a case of rural and urban communities in KwaZulu-Natal

Curationis ◽  
2009 ◽  
Vol 32 (1) ◽  
Author(s):  
G.G. Mchunu
Keyword(s):  
Community Health ◽  
Urban Communities ◽  
Citizen Participation ◽  
Community Involvement ◽  
Community Health Centers ◽  
Health Workers ◽  
Community Members ◽  
Rural And Urban ◽  
Kwazulu Natal ◽  
Group Interviews

The study aimed to describe the practice of community involvement in health programmes.The study therefore explored the nature and practice of community involvementin health programmes in the two communities in KwaZulu Natal. Thestudy was guided by the conceptual framework adapted from Amstein’s,( 1969) Ladderof Citizen Participation. This framework shows different levels and steps in communityparticipation. A case study method was used to conduct the study. The twocases were one urban based and one rural based community health centers in theIlembe health district, in Kwa Zulu Natal. A sample of 31 persons participated in thestudy. The sample comprised 8 registered nurses, 2 enrolled nurses 13 communitymembers and 8 community health workers. Data was collected using structured individualinterviews and focus group interviews, and was guided by the case protocol.Community involvement in health largely depended on the type of community, withrural community members being in charge of their health projects and urban communitymembers helping each other as neighbours in times of need.

scholarly journals Heat Emergencies: Perceptions and Practices of Community Members and Emergency Department Healthcare Providers in Karachi, Pakistan: A Qualitative Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4736
Author(s):  
Uzma Rahim Khan ◽  
Naveed Ahmed ◽  
Rubaba Naeem ◽  
Umerdad Khudadad ◽  
Sarwat Masud ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Professionals ◽  
Health Workers ◽  
Heat Waves ◽  
Healthcare Providers ◽  
Community Members ◽  
Home Based ◽  
Facility Level ◽  
Training Community ◽  
Access And Quality

Heat waves are the second leading cause of weather-related morbidity and mortality affecting millions of individuals globally, every year. The aim of this study was to understand the perceptions and practices of community residents and healthcare professionals with respect to identification and treatment of heat emergencies. A qualitative study was conducted using focus group discussions and in-depth interviews, with the residents of an urban squatter settlement, community health workers, and physicians and nurses working in the emergency departments of three local hospitals in Karachi. Data was analyzed using content analysis. The themes that emerged were (1) perceptions of the community on heat emergencies; (2) recognition and early treatment at home; (3) access and quality of care in the hospital; (4) recognition and treatment at the health facility; (5) facility level plan; (6) training. Community members were able to recognize dehydration as a heat emergency. Males, elderly, and school-going children were considered at high risk for heat emergencies. The timely treatment of heat emergencies was widely linked with availability of financial resources. Limited availability of water, electricity, and open public spaces were identified as risk factors for heat emergencies. Home based remedies were reported as the preferred practice for treatment by community members. Both community members and healthcare professionals were cognizant of recognizing heat related emergencies.

scholarly journals “Our culture prohibits some things”: Qualitative inquiry into how sociocultural context influences the scale up of community-based injectable contraceptives in Nigeria

2019 ◽  
Author(s):  
Oluwaseun Akinyemi ◽  
Bronwyn Harris ◽  
Mary Kawonga
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Health Workers ◽  
Scale Up ◽  
Community Members ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Injectable Contraceptives ◽  
Depth Interviews

AbstractObjectivesTo explore how sociocultural factors may support or impede the adoption of community-based distribution of injectable contraceptives in Nigeria.DesignA qualitative study based on a grounded theory approach was conducted through in-depth interviews and focus group discussions.SettingMost participants lived in Gombe State, North East Nigeria. Other participants were from Ibadan (South West) and Abuja (Federal capital territory).ParticipantsThrough seven key informant interviews, 15 in-depth interviews and 10 focus group discussions, 102 participants were involved in the study.MethodsThis study, conducted in 2016 was part of a larger study on scale up of community-based distribution of injectable contraceptives. Qualitative data were collected from traditional and religious leaders, health workers and community members. The data were audio recorded, transcribed and analysed using a thematic framework method.ResultsSociocultural challenges to scale up included patriarchy and men’s fear of losing control over their spouses, traditional and religious beliefs about fertility, and myths about contraceptives and family planning. As a result of deep-rooted beliefs that children are ‘divine blessings’ and that procreation should not be regulated, participants described a subtle resistance to uptake of injectable contraceptives. Since Gombe is largely a patriarchal society, male involvement emerged as important to the success of meaningful innovation uptake. Community leaders largely described their participation in the scale up process as active, although they also identified scope for further involvement and recognition.ConclusionScale up is more than setting up health sector implementing structures, training health workers and getting innovation supplies, but also requires preparedness which includes paying attention to complex contextual issues. This requires the health system and those who work in it, to move beyond a narrow health ‘comfort zone’ by actively engaging with, and learning from, those who are leading, caring for and living in, the community.Strengths and limitations of this studyThe study participants represented a range of stakeholders - users of injectable contraceptives, community members, providers and health system managers.Our results highlighted that scale up is influenced by several socio-cultural factors; thus, showing the importance of paying attention to complex contextual issues during innovation uptake.The findings of our study emphasized how health systems and communities should interact in order to ensure successful scale up of health innovations.As with any qualitative study, the findings of this study are not statistically generalizable.FundingThis research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No--B 8606.R02), Sida (Grant No:54100113), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z) and Deutscher Akademischer Austauschdienst (DAAD). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the authors.Declarations of interestNone.

scholarly journals “We have to learn to cooperate with each other”: a qualitative study to explore integration of traditional healers into the provision of HIV self-testing and tuberculosis screening in Eswatini

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bernadette Schausberger ◽  
Nqobile Mmema ◽  
Velibanti Dlamini ◽  
Lenhle Dube ◽  
Aung Aung ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Workers ◽  
Traditional Healers ◽  
Health Facilities ◽  
Cultural Literacy ◽  
Health Seeking ◽  
Community Members ◽  
Group Discussions ◽  
Self Testing ◽  
Self Test

Abstract Background Traditional healing plays an important role in healthcare in Eswatini, and innovative collaborations with traditional healers may enable hard-to-reach men to access HIV and tuberculosis diagnostic services. This study explored attitudes towards integration of traditional healers into the provision of HIV self-testing kits and sputum collection containers. Methods A qualitative study was conducted in 2019–2020 in Shiselweni region, Eswatini. Eight male traditional healers were trained on HIV and tuberculosis care including distribution of HIV self-testing kits and sputum collection containers. Attitudes towards the intervention were elicited through in-depth interviews with the eight traditional healers, ten clients, five healthcare workers and seven focus group discussions with community members. Interviews and group discussions were conducted in SiSwati, audio-recorded, translated and transcribed into English. Data were coded inductively and analysed thematically. Results 81 HIV self-testing kits and 24 sputum collection containers were distributed by the healers to 99 clients, with 14% of participants reporting a reactive HIV self-test result. The distribution of sputum containers did not result in any tuberculosis diagnoses, as samples were refused at health centres. Traditional healers perceived themselves as important healthcare providers, and after training, were willing and able to distribute HIV self-test kits and sputum containers to clients. Many saw themselves as peers who could address barriers to health-seeking among Swazi men that reflected hegemonic masculinities and patriarchal attitudes. Traditional healers were considered to provide services that were private, flexible, efficient and non-judgemental, although some clients and community members expressed concerns over confidentiality breaches. Attitudes among health workers were mixed, with some calling for greater collaboration with traditional healers and others expressing doubts about their potential role in promoting HIV and tuberculosis services. Specifically, many health workers did not accept sputum samples collected outside health facilities. Conclusions Offering HIV self-testing kits and sputum containers through traditional healers led to high HIV yields, but no TB diagnoses. The intervention was appreciated by healers’ clients, due to the cultural literacy of traditional healers and practical considerations. Scaling-up this approach could bridge testing gaps if traditional healers are supported, but procedures for receiving sputum samples at health facilities need further strengthening.

scholarly journals A Qualitative Study on The Role of Community Health Workers In Influencing Social Connectedness Using The Household Model: A Case Study of Neno District, Malawi

2020 ◽  
Author(s):  
Myness Stella Kasanda Ndambo ◽  
Fabien Munyaneza ◽  
Moses Aron ◽  
Henry Makungwa ◽  
Annie Michaelis ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Community Health ◽  
Community Health Workers ◽  
Social Connectedness ◽  
Health Workers ◽  
Community Members ◽  
Individual Agency ◽  
Stigma And Discrimination ◽  
Household Model

Abstract Background: There is growing global recognition that community health workers (CHWs) play a key role in facilitating social connectedness. Through direct interactions and relationship building, CHWs link people to key services such as healthcare and social support. Several models aim to understand how CHWs facilitate these interactions, but the theory of change is not yet fully understood. In Neno District, Malawi, CHWs recently transitioned from a disease-focused model to what we call the “household model.” Under the household model, each CHW is assigned to several households to provide screening and linkage to care, as well as psychosocial and chronic disease support. We theorise that this public health approach facilitates social connectedness in the households and rural communities served by CHWs. We aim to understand drivers of influence on social connections from the CHW-, healthcare worker-, and patient perspectives. Methods: This was a cross-sectional qualitative study utilising focus group discussions (FGDs) and in-depth semi-structured interviews with purposively sampled community stakeholders, CHWs, health service providers, and patients (total N=180) from October 2018 through March 2020. Results: Participants reported improved social interactions and connectedness and increased access to health care in their communities following the transition to the household model. This was driven by factors including reduced stigma and discrimination, empowerment of households and community members, and fostering both social cohesiveness and individual agency in accessing health services. The main themes that emanated from this study are; expansion of care by CHWs, trust in CHW’s provision of care, and equal treatment of community members by CHWs. Conclusion: Our study demonstrates that through the polyvalent household model, CHWs foster high levels of social connectedness in the communities, evidenced by a reported reduction in stigma and discrimination and an increase in individual agency in accessing health services.

scholarly journals Cultural Perceptions of Child Abuse in Terms of Parents Perspective a Qualitative Study in Indonesia

2020 ◽  
Author(s):  
Reizkiana Feva Kosmah Dewi ◽  
Meita Dhamayanti ◽  
Sri Endah Rahayuningsih ◽  
Kuswandewi Mutyara ◽  
Nita Arisanti ◽  
...  
Keyword(s):  
High School ◽  
Child Abuse ◽  
Focus Group ◽  
Qualitative Study ◽  
Health Workers ◽  
Qualitative Content Analysis ◽  
World Health ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cultural Perceptions

Abstract Background Child abuse (CA) is a serious problem and difficult to detect. According to World Health Organization (WHO), CA is responsible on 950,000 deaths in children aged below 18 every year. As many cultures as various of CA among parents inside. This research aims to determine the cultural perceptions of child abuse in terms of parents in Indonesia. Method A qualitative study using focus group discussions was conducted to thirty one parents that selected purposively. The discussion centered about CA definition, classification, and frequency, level of CA (mild, moderate, and severe), the difference between violence and discipline. The focus group discussions divided in to 3 groups level education, Elementary/Junior high school, senior high school, and bachelor’s degree. The process offocus group discussion were recorded, transcribed, and analyzed using manifest qualitative content analysis. Results Every cultures in Indonesia perceived that CA is a form of parents’ emotion which lead to injure children physically and mentally. Indonesian cultures were not familiar with neglect and exploitation. Participants’ opinion regarding level of violence can be categorized as severe if leaving wounds, need to be hospitalized, and visumed. The parents assumed as CA if occurred more than twice and/or leaving marks. The discipline’s ussualy purpose is not to mistreat, but for goods, character building, and educating the children. Conclusions Cultural perceptions of parents about CA is a form of parents’ emotion which lead to injure children physically and mentally. The community and health workers should be aware to decrease morbidity and mortality of CA

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