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

Samuel Agbenyegah Addy,Farrukh Ishaque Saah,Evelyn Acquah,Elvis Enowbeyang Tarkang,Hubert Amu,Eric Osei,Prince Justin Anku,Joyce Komesuor

doi:10.1155/2019/5039197

Abstract

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.

Highlights

Tuberculosis remains a major global public health problem as it is the leading cause of death from infectious diseases worldwide [1]
Understanding the experiences of community contribution to TB care will contribute to enhancing the process but will inform policy direction for better implementation to achieve the programme’s targets and goals; this current study investigated community contribution to TB care in the Krachi West District of the Volta region, Ghana
If the patient is older than the treatment supporter, a lot of things are compromised because the father’s authority or parent’s authority is at play here, that is one thing we look out for, if the patient’s resident is close to a health facility, and there is no supporter as such, we assign a CHN or an enrolled nurse in that community to ensure that the patient takes the medicine for successful treatment

Summary

Introduction

Tuberculosis remains a major global public health problem as it is the leading cause of death from infectious diseases worldwide [1]. Despite the proven effectiveness of low-cost strategies to control TB, just one-quarter of all TB patients worldwide receive care in accordance with the international guidelines for diagnosis, treatment, and monitoring [2]. Many of these patients receive inadequate treatment under poorly organized and insufficiently monitored programmes in both public and private sectors while some, received no treatment at all. 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, recommended

Methods

Results

Discussion

Conclusion