Needs assessment for adapting TB directly observed treatment intervention programme in Limpopo Province, South Africa: A community-based participatory research approach

Abstract

BackgroundLimpopo Province is one of the hardest hit by tuberculosis and human immune virus infections in the country. The province has been implementing a directly observed treatment strategy since 1996. However, the cure rate was 64% in 2015 and remains far from the set target by the World Health Organization of 85%. Poor health-care seeking and adherence behaviours were identified as major risk behaviours.AimTo apply a Community-Based Participatory Research (CBPR) approach in identifying barriers and facilitators to health-care seeking and adherence to treatment, and to determine strategies and messages in order to inform the design of an adapted intervention programme.SettingThis study was conducted in three districts in the Limpopo Province, Capricorn, Mopani and Sekhukhune districts.MethodsThe community participatory research approach was applied. Purposive sampling was used to sample participants. Focus group discussions were used to collect data. Participatory analysis was used comparing findings within and across all the participants.ResultsA total of 161 participated in the study. Participants included coordinators, professional nurses, supporters and patients. Major modifiable behavioural-related barriers were lack of knowledge about tuberculosis, misinformation and misperceptions cultural beliefs, stigma and refusal of treatment support. Environment-related barriers were attitudes of health workers, lack of support by family and community, lack of food and use of alcohol and drugs. Strategies and messages included persuasive and motivational messages to promote healthy behaviour.ConclusionJoint programmatic collaboration between the community and academic researchers is really needed for interventions to address the needs of the community.

An evaluation of the innovative potentials of a HIV pilot exploring medical pluralism in rural South Africa

“…Without the culturally prescribed remedial cleansing ritual/s the offender risks the contamination developing into makgoma which can be transmitted to others, and/or result ‘in the patient fading (dying) away’ (parenthesis in original, Mönnig, 1978 , p. 67). The symptoms of makgoma are similar to symptoms associated with HIV co-infections, such as tuberculosis (Mabunda et al., 2016 ).…”

“…Makgoma is a disease that Sotho-Tswana speaking traditionalists associate with ‘ritual taboo violations’ (Makgahlela & Sodi, 2016 , p. 543). Ritual taboo violations represents a social practice that occurs when a person fails to conduct a specific ritual to overcome a particular cultural transgression such as ‘sleeping with a woman following an abortion’ (Mabunda, Khoza, Van den Borne, & Lebese, 2016 , p. 5). Failure to rectify the transgression can result in physical symptoms that represent ‘contamination’ of the body which is considered to be a ‘taboo’ among traditionalists (Shirindi & Makofane, 2015 , p. 942).…”

Atuação do enfermeiro acerca da tuberculose na Atenção Primária à Saúde: revisão de literatura

“…[36][37] For health education to be effective, professionals must be sensitive to the patients" culture. They must take into account their beliefs, which, associated with lack of knowledge about the disease and treatment, imply a delay in the demand for health services, reflecting in the late diagnosis 30,38,39 ; tracking for investigation of contacts; family participation; and adherence to treatment. 34,38 It is worth mentioning that the community approach in groups is a way to minimize misinformation, mistakes and reduction of stigma 39 .…”

“…They must take into account their beliefs, which, associated with lack of knowledge about the disease and treatment, imply a delay in the demand for health services, reflecting in the late diagnosis 30,38,39 ; tracking for investigation of contacts; family participation; and adherence to treatment. 34,38 It is worth mentioning that the community approach in groups is a way to minimize misinformation, mistakes and reduction of stigma 39 . At the same time, it requires the need for a clear form, outlining the responsibilities of each member 38,40 and a focus on health promotion for families and communities.…”

Determinants of Child Health Behaviors in a Disadvantaged Area from a Community Perspective: A Participatory Needs Assessment

“…Community members as well as professionals are included in the research process in a partnership with academic researchers to understand the health needs through the eyes of the community. In this process, ideas can also be proposed concerning how these health needs could be answered [ 27 , 28 ]. Therefore, such a participatory needs assessment provides essential input for the development of a childhood obesity prevention intervention targeting this community [ 24 ].…”