Community health workers’ involvement in the prevention and control of non-communicable diseases in Wakiso District, Uganda

Abstract

Background Community health workers (CHWs) are an important cadre of the global health workforce as they are involved in providing health services at the community level. However, evidence on the role of CHWs in delivering interventions for non-communicable diseases (NCDs) in Uganda is limited. This study, therefore, assessed the involvement of CHWs in the prevention and control of NCDs in Wakiso District, Uganda with a focus on their knowledge, attitudes and practices, as well as community perceptions. Methods A cross-sectional study using mixed methods was conducted which involved a structured questionnaire among 485 CHWs, and 6 focus group discussions (FGDs) among community members. The study assessed knowledge, perceptions including the importance of the various risk factors, and the current involvement of CHWs in NCDs, including the challenges they faced. Quantitative data were analysed in STATA version 13.0 while thematic analysis was used for the qualitative data. Results The majority of CHWs (75.3%) correctly defined what NCDs are. Among CHWs who knew examples of NCDs (87.4%), the majority mentioned high blood pressure (77.1%), diabetes (73.4%) and cancer (63.0%). Many CHWs said that healthy diet (86.2%), physical activity (77.7%), avoiding smoking/tobacco use (70.9%), and limiting alcohol consumption (63.7%) were very important to prevent NCDs. Although more than half of the CHWs (63.1%) reported being involved in NCDs activities, only 20.9 and 20.6% had participated in community mobilisation and referral of patients respectively. The majority of CHWs (80.1%) who were involved in NCDs prevention and control reported challenges including inadequate knowledge (58.4%), lack of training (37.6%), and negative community perception towards NCDs (35.1%). From the FGDs, community members were concerned that CHWs did not have enough training on NCDs hence lacked enough information. Therefore, the community did not have much confidence in them regarding NCDs, hence rarely consulted them concerning these diseases. Conclusions Despite CHWs having some knowledge on NCDs and their risk factors, their involvement in the prevention and control of the diseases was low. Through enhanced training and community engagement, CHWs can contribute to the prevention and control of NCDs, including health education and community mobilisation.

Nigerian physiotherapists’ knowledge, current practice and perceptions of their role for promoting physical activity: A cross-sectional survey

“…Working with community organisations that are embedded locally and hence offer more insight into their population’s needs, could foster more effective ways to optimise physical activity promotional campaigns [ 58 ]. Previous research has also highlighted the potential of community health workers undertaking public health promotion in Africa [ 59 ]. Physiotherapists could also collaborate with health workers to endorse physical activity within their locality.…”

Health system capacity and readiness for delivery of integrated non-communicable disease services in primary health care: A qualitative analysis of the Ethiopian experience

“…Evidence from many LMICs, including Ethiopia, suggests that task-sharing from physician to non-physician health workers (mostly nurse and community health workers) can address critical workforce shortages and increase access to essential NCD health services [41,42]. In other settings, such workers have been crucial in delivering health education and conducting early detection, case management, and lifestyle interventions to manage NCDs in the community [43][44][45]. Despite this evidence from elsewhere and the expectation of Ethiopia's HEWs to deliver NCD services, we found that their role was limited [7].…”

Diagnosis and Treatment of Hypertension Among People Aged 45 Years and Over in India: A Sub-national Analysis of the Variation in Performance of Indian States

“…Given the issues around the affordability of private doctors and the lack of doctors in the public health sector, community health workers could be trained in screening those at risk and referring individuals for further management. Studies have shown that community health workers are effective in a number of public health programmes in various settings (44,45). In addition, mass screening camps for the early detection of HT cases can be considered in high risk areas with limited health facilities.…”