‘Before reaching the last mile’- Knowledge, attitude, practice and perceived barriers related to tuberculosis directly observed therapy among ASHA workers in Central India: A mixed method study

Singh, Akash Ranjan; Pakhare, Abhijit; Kokane, Arun; Shewade, Hemant Deepak; Chauhan, Ashish; Singh, Abhishek; Gangwar, Arti; Thakur, Prahlad Singh

doi:10.1016/j.jegh.2017.07.002

Cited by 12 publications

(38 citation statements)

References 22 publications

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“…Empirical evidence linking knowledge to service delivery and performance is emerging, but limited [11]. In India, assessments of ASHA knowledge have been small in scale and often constrained to a single topical area, including oral health [12], tuberculosis [13], and diarrhea [14]. Broader assessments of ASHA's RMNCH&N knowledge and practices have pointed to significant gaps in knowledge about pre-eclampsia etiology [15], promotion of institutional delivery contraceptive-use [16], obstetric danger sign assessment [17], and neonatal care [18].…”

Section: Introductionmentioning

confidence: 99%

Novel approaches to measuring knowledge among frontline health workers in India: Are phone surveys a reliable option?

et al. 2020

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Background In 2017, India was home to nearly 20% of maternal and child deaths occurring globally. Accredited social health activists (ASHAs) act as the frontline for health services delivery in India, providing a range of reproductive, maternal, newborn, child health, and nutrition (RMNCH&N) services. Empirical evidence on ASHAs' knowledge is limited, yet is a critical determinant of the quality of health services provided. We assessed the determinants of RMNCH&N knowledge among ASHAs and examined the reliability of alternative modalities of survey delivery, including face-to-face and caller attended telephone interviews (phone surveys) in 4 districts of Madhya Pradesh, India. Methods We carried out face-to-face surveys among a random cross-sectional sample of ASHAs (n = 1,552), and administered a follow-up test-retest survey within 2 weeks of the initial survey to a subsample of ASHAs (n = 173). We interviewed a separate sub-sample of ASHAs 2 weeks of the face-to-face interview over the phone (n = 155). Analyses included bivariate analyses, multivariable linear regression, and prevalence and bias adjusted kappa analyses. Findings The average ASHA knowledge score was 64% and ranged across sub-domains from 71% for essential newborn care, 71% for WASH/ diarrhea, 64% for infant feeding, 61% for family planning, and 60% for maternal health. Leading determinants of knowledge included geographic location, age <30 years of age, education, experience as an ASHA, completion of seven or more client visits weekly, phone ownership and use as a communication tool for

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Section: Introductionmentioning

confidence: 99%

Novel approaches to measuring knowledge among frontline health workers in India: Are phone surveys a reliable option?

et al. 2020

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“…[ 7 11 ] In our study, most of the ASHAs were in the age range of 31–40 years, with the mean age being 35.82 ± 8.62 years, while other studies reported variable age groups like 29.55, 41 etc. [ 12 13 ]…”

Section: Discussionmentioning

confidence: 99%

Assessment of knowledge, attitude, practice (KAP) regarding directly observed therapy (DOT) in tuberculosis among ASHA workers from tribal subpopulation zone of Rajasthan

Singh

Dwivedi²,

Goswami³

et al. 2022

Journal of Family Medicine and Primary Care

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A BSTRACT Introduction: A high level of community awareness and positive perception towards tuberculosis and its management is crucial for the successful outcome of any control measure. In India the Accredited Social Health Activist (ASHA) plays a key role in providing awareness and counselling on healthcare issues and management, particularly in remote areas. The tribal population is vulnerable to such infectious diseases due to resource limitations and remote locations. We assessed the knowledge, attitude, and practice (KAP) regarding directly observed therapy (DOT) among ASHA workers in the tribal belt of the Sirohi district of Rajasthan state. Material and Methods: This cross-sectional study was conducted among ASHA workers of Sirohi district from January 2021 to June 2021. A predesigned and structured questionnaire was used to gather information on knowledge, attitude, and practices regarding the management of tuberculosis and DOT. Results: A total of 95 ASHAs participated in the study with a mean age of 35.82 years. Good knowledge (Mean score = 6.2947 ± 1.08052) was observed regarding tuberculosis and DOT. 81% ( n = 74) have good knowledge regarding DOT whereas most have a poor attitude and only 47% have adequate practice. A 55% of ASHAs did not adhere even a single TB patient in the last three years. Conclusion: In our study, knowledge gaps were identified which may result in substandard patient care. The structured refresher training towards DOT and also training to work in tribal areas will further improve the KAP of ASHAs. It might be needed to provide a module or curriculum regarding awareness among ASHAs for strengthening follow-up system for tuberculosis patients among the tribal population.

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“…Studies from other countries that verified the knowledge of health workers point to gaps in practice and knowledge related to DOT, indicating urgency in adopting innovations that address perceived barriers and improve the knowledge of professionals involved in the practice [18][19][20] . One of the main focus of discussion in the study by Choowong et al 20 addresses the need for professionals who are able to 24) 9 ( 7) 10 ( 7) 5 ( 4)…”

Section: Discussionmentioning

confidence: 99%

Challenges faced by health workers in the use of the directly observed treatment (DOT) for tuberculosis

Dalazoana¹,

Gabardo

Cardoso

2021

Rev. Inst. Med. trop. S. Paulo

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Tuberculosis is a worldwide public health problem, which, even with available treatment, continues to cause deaths worldwide. One of the obstacles to control the disease is the multifactorial difficulty of patients to adhere to treatment, in addition to the difficulty of health workers in circumventing barriers to implement strategies such as the directly observed treatment (DOT). The aim of this study is to analyze the performance and challenges faced by health workers in the use of DOT in tuberculosis. This is a descriptive, quali-quantitative study using data from interviews with primary-care professionals working in nine municipalities of Parana State, Brazil. The professionals answered a questionnaire containing four closed questions about DOT and an open question related to their professional opinion about the strategy. Quantitative data were entered into a spreadsheet and statistically propagated. Qualitative data were treated from the transcription of statements, subsequently submitted to content analysis. Of the 387 professionals interviewed, at least 58.9% had some knowledge about DOT. Among the main challenges faced by the professionals are: lack of user commitment to treatment (48.3%), users' difficulty in attending the basic health clinics (BHC) (31.4%), professionals' difficulty to reach the place where patients are treated (8.8 %), insufficient staff / lack of human resources (4.1%) and use of illicit drugs by patients (3.9%). Blaming the user and the lack of resources are the main highlights, in addition to issues such as the professionals' lack of access and knowledge that are highlighted by the difficulty of patients to adhere to the treatment of tuberculosis according to the participants' statements. The issues were raised by health workers manifestations involving adherence to treatment according to the DOT in the studied health region. It is possible, in this context, to observe the need for improvement in the knowledge of professionals with regard to the DOT, the importance of their bond with patients and families and the recognition of the part of responsibility that belongs to the health team on guaranteeing treatment.

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‘Before reaching the last mile’- Knowledge, attitude, practice and perceived barriers related to tuberculosis directly observed therapy among ASHA workers in Central India: A mixed method study

Abstract: Study revealed inadequate knowledge and unsatisfactory practice related to DOT provision among ASHAs. Innovations addressing the perceived barriers to improve practice of DOT provision by ASHAs are urgently required.

Cited by 12 publications

References 22 publications

Novel approaches to measuring knowledge among frontline health workers in India: Are phone surveys a reliable option?

Novel approaches to measuring knowledge among frontline health workers in India: Are phone surveys a reliable option?

Assessment of knowledge, attitude, practice (KAP) regarding directly observed therapy (DOT) in tuberculosis among ASHA workers from tribal subpopulation zone of Rajasthan

Challenges faced by health workers in the use of the directly observed treatment (DOT) for tuberculosis

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