Assessing The Roles Of Community Based Service Providers And Healthcare Workers In The Prevention Of Relapse Among Tb Infected Patients In Namibia

ABSTRACT

Background: Mycobacterium Tuberculosis commonly referred to as (TB) is still one of the major health concerns, with high prevalence globally as well as in Namibia. While significant progress has been achieved in the prevention and treatment services of TB in the country, including use of community-based service providers and community-based health workers, the number of relapse cases remained high. The study aimed at assessing the role of Community Based Service Providers in the prevention of relapse among TB infected patients in Namibia.

Methodology: A quantitative research approach was adopted using purposive sampling method. Data was collected from three regions (Ohangwena, Khomas and Erongo). All Community Based Health Workers and Community Based Service Providers in the three regions were included in the sample. The data were analysed using SPSS software version 22.

Results: The study showed that 43% of CBHWs were employed and 57% were unemployed. Majority of CBHW respondents were female at 68% with 32% males while for CBSP respondents, 81.1% were females with 18.9% males. The CBHW’s who access their clients by walking, through public transport and hospital vehicles were 72.2%, 26.2% and 1.6% respectively. All respondents (100%) agreed that the factors that militate against the effectiveness of their duties include shortage of funds for logistics, unavailability of transport, untrained CBHWs, shortage of IEC materials, lack of human resources and outdated policies used by the CBSP. The majority of respondents, 89.2%, alluded to the provision of a basic kit to CBHW and availing of transport and raising of acceptability to reduce stigma while 94.6%, indicate promotion of family & community awareness of disease prevention & care related to chronic illness will play a vital role in the improvement of health service delivery. Improvement measures showed some association with the health facility.

Discussion and Conclusion: In general, the study showed that factors such as shortage of human resources, insufficient funding, unavailability of transport, shortage of IEC materials and insufficient incentives to CBHWs are factors that hinder the effectiveness of CBO. Factors that militate against the effectiveness of the duties of CBHWs were shown to be associated with region and health facility of origin. Appropriate measures to be taken to reduce relapse among TB infected patients in these regions include introducing DOT points in different districts, establishment of elderly homes and provision of awareness on alcohol and drug abuse.