Journal of Epidemiology and Global Health

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Volume 7, Issue 4, December 2017, Pages 219 - 225

‘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

Authors
Akash Ranjan Singha, *, akashranjansingh02@gmail.com, Abhijit Pakharea, Arun M. Kokanea, Hemant Deepak Shewadeb, Ashish Chauhanc, Abhishek Singha, Arti Gangward, Prahlad Singh Thakurd
aAll India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
bInternational Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
cImmunization Technical Support Unit, Ministry of Health & Family Welfare, Govt. of India, New Delhi, India
dState TB Cell, Department of Health and Family Welfare, Bhopal, India
* Corresponding author at: Department of Community and Family Medicine, AIIMS Bhopal, Saket Nagar, Bhopal, Madhya Pradesh, India.
Corresponding Author
Received 10 May 2017, Revised 29 June 2017, Accepted 1 July 2017, Available Online 14 August 2017.
DOI
10.1016/j.jegh.2017.07.002How to use a DOI?
Keywords
Directly observed therapy; Community-health workers; Perceived barriers; Operational research; Mixed-method study
Abstract

Introduction: Community-based direct observed treatment (DOT) providers are an important bridge for the national tuberculosis programme in India to reach the unreached. The present study has explored the knowledge, attitude, practice and barriers perceived by the community-based DOT providers.

Methods: Mixed–methods study design was used among 41 community-based DOT providers (Accredited Social Health Activist (ASHAs)) working in 67 villages from a primary health center in Raisen district of Madhya Pradesh, India. The cross-sectional quantitative component assessed the knowledge and practices and three focus-group discussions explored the attitude and perceived barriers related to DOT provision.

Result: ‘Adequate knowledge’ and ‘satisfactory practice’ related to DOT provision was seen in 14 (34%) and 13 (32%) ASHAs respectively. Only two (5%) received any amount of honorarium for completion of DOT in last 3 years. The focus-group discussions revealed unfavourable attitude; inadequate training and supervision, non-payment of honorarium, issues related to assured services after referral and patient related factors as the barriers to satisfactory practice of DOT.

Conclusion: 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.

Copyright
© 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.
Open Access
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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<Previous Article In Issue
Next Article In Issue>
Journal
Journal of Epidemiology and Global Health
Volume-Issue
7 - 4
Pages
219 - 225
Publication Date
2017/08/14
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
10.1016/j.jegh.2017.07.002How to use a DOI?
Copyright
© 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.
Open Access
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Cite this article

risenwbib
TY  - JOUR
AU  - Akash Ranjan Singh
AU  - Abhijit Pakhare
AU  - Arun M. Kokane
AU  - Hemant Deepak Shewade
AU  - Ashish Chauhan
AU  - Abhishek Singh
AU  - Arti Gangwar
AU  - Prahlad Singh Thakur
PY  - 2017
DA  - 2017/08/14
TI  - ‘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
JO  - Journal of Epidemiology and Global Health
SP  - 219
EP  - 225
VL  - 7
IS  - 4
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2017.07.002
DO  - 10.1016/j.jegh.2017.07.002
ID  - Singh2017
ER  -