Abstract
This article aims to evaluate the contribution of Community DOTS, Directly Observed Treatment Short-Course, for the prevention and control of Tuberculosis actions in primary care in Brazil and Ethiopia, based on the perceptions and practice of the community health care workers. We employed the Symbolic Sites conceptual-methodological framework, accounting for its three types: Black box, Conceptual box, and Toolbox. The contrasting case study involved triangulating and complementing data collection and analysis from semi-structured interviews with community health workers and health professionals, site observation, and document analysis. The results highlight a sense of commitment as an essential value regarding the activities developed by community health workers in both contexts. The main challenges are the insufficient capacity building and supervision (Conceptual box), and the difficulties related to access (Toolbox), expressed in long geographic distances in the Ethiopian case and barriers related to territory violence, mostly drug trafficking, although not explicit, in the Brazilian context. This implies in a continuous effort for the community health workers to adapt their practices, respecting the cultural values (Black box), in order to direct their actions to overcome these challenges.
Highlights
Resumo O objetivo do artigo é avaliar a contribuição do DOTS comunitário, do inglês “Directly Observed Treatment Short-Course”, nas ações de prevenção e controle da tuberculose na atenção primária no Brasil e na Etiópia, a partir das percepções e práticas dos agentes comunitários de saúde (ACS)
This article aims to evaluate the contribution of Community DOTS, Directly Observed Treatment Short-Course, for the prevention and control of Tuberculosis actions in primary care in Brazil and Ethiopia, based on the perceptions and practice of the community health care workers
The results highlight a sense of commitment as an essential value regarding the activities developed by community health workers in both contexts
Summary
Sítios simbólicos de pertencimento e prevenção e controle da tuberculose: percepções e práticas dos Agentes Comunitários de Saúde no Brasil e na Etiópia. Symbolic sites of belonging and prevention and control of tuberculosis: perceptions and practices of community health workers in Brazil and Ethiopia. Gisela Cordeiro Pereira Cardoso (https://orcid.org/0000-0002-4014-0951) 1 Elizabeth Moreira dos Santos (https://orcid.org/0000-0002-2137-7048) 1 Yibeltal Kiflie Alemayehu (https://orcid.org/0000-0002-1781-0777) 2 Kifle Woldemichael (https://orcid.org/0000-0002-0265-218X) 3 Berhane Megerssa Ereso (https://orcid.org/0000-0001-9260-0123) 4 Wuleta Lemma (https://orcid.org/0000-0002-2672-5355) 5
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