Health workers' knowledge, attitudes and practices of tuberculosis-directly observed treatment (TB-DOT) in the Grootfontein district of Otjozondjupa region in Namibia

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Date
2010
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Abstract
In the Grootfontein health district, directly observed treatment (DOT) services, a component of directly observed treatment short-course (DOTS) strategy (whereby tuberculosis (TB) patients take medicine under proper supervision and support) is available at all public health facilities. Yet the TB defaulter rate in Grootfontein is very high at 28, and treatment success rate remains at 56
Although many factors such as poverty, HIV/AIDS, late diagnosis, nonadherence and so forth are identified as contributing to the low success rate, little was known in Namibia about whether health workers' knowledge, attitudes and practices in using DOT could play a contributing role to the low treatment success rate. Therefore, this study aimed to explore and describe health workers' knowledge, attitudes and practices with regard to DOT. The specific objectives were to obtain socio-demographic information of health workers in the Grootfontein health district and to ascertain the knowledge, attitudes and practices of health workers in terms of TB-DOT services
A quantitative, descriptive approach to the study was used. Owing to the small size of the population, all 110 nurses dealing with TB patients and working in public health facilities in the Grootfontein health district were targeted. Data were collected using a selfadministered questionnaire and were analysed using descriptive statistics. The chisquare and p-values were used to test the significance of the relationship between the variables. The demographic data revealed that the majority (65) of the respondents were subprofessional nurses, against 35 who were professional nurses. More female health workers (78) than male participated in this study and their ages ranged between 20 to 59 years with those in the age group 50 to 59 years being in the majority (35)
The majority (70) of respondents were working in a hospital at the time of the study; of these 26 had working experience of more than twenty years, while only 9 had working experience of less than a year. However, no statistically significant difference was found regarding the demographic data of respondents
In terms of the research objective of ascertaining knowledge, attitudes and practices, 57 of respondents had not been trained in TB management. Despite a lack of training in TBDOT, 70 of all respondents demonstrated an stated that if TB patients did not want to take their medicine it was their own choice. On the other hand, 12understanding of the meaning of TB-DOT, while 76 indicated an understanding of the meaning of DOT supporter. However, no statistically significant difference was found between health workers' training and TB management.Some negative attitudes were also observed. Thirty-five percent of the respondents agreed that there was no time to practise DOT because of the shortage of health workers, while 17 argued that DOT is a waste of time, while 8 argued that DOT creates dependency. No statistically significant difference was found. In terms of the actual practice, the majority (81) of respondents indicated that they have the new national guidelines for TB management and this was verified by the researcher. Of all respondents who indicated having new guidelines, 98 of them indicated giving health education on TB DOT according to the guidelines to patients. It is recommended that in-service training in TB-DOT be strengthened and conducted not only for health workers who deal directly with TB patients, but also for the general population of health workers in the Grootfontein health district. This may enable the health workers to be effective while rotation services are being put into practice in thishealth district. Sufficient knowledge of TB-DOT may also challenge the negative attitudes held by some health workers regarding the management of TB patients. Moreover, community involvement and community participation should be encouraged. All health workers in TB control should take advantage of existing community own resources persons (CORPs) to enhance community knowledge of TB
Description
A thesis submitted in partial fulfilment of the requirement for the degree of Master of Public Health
Keywords
Public health, Tuberculosis, Tuberculosis Nursing
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