The Duty of Community Health Extension Workers in Tuberculosis Evolution in Andoni

Theresa Awortu Jeremiah PhD; Prof. Innime Righteous

doi:10.56201/ijhpr.vol.11.no8.2026.pg137.151

📄 Download Paper

The Duty of Community Health Extension Workers in Tuberculosis Evolution in Andoni

Theresa Awortu Jeremiah PhD, Prof. Innime Righteous

Abstract

Tuberculosis (TB) remains a major public health challenge, particularly in developing countries where limited access to healthcare services, inadequate awareness, delayed diagnosis, treatment interruption, and social stigma continue to affect disease control efforts. Community Health Extension Workers serve as essential links between healthcare facilities and communities by providing health education, promoting disease prevention, identifying suspected cases, and supporting treatment adherence. This study examined the duty of Community Health Extension Workers in tuberculosis control in Andoni Local Government Area of Rivers State, Nigeria. Specifically, the study assessed the duty of CHEWs in creating tuberculosis awareness, examined their contribution to early detection of tuberculosis cases, determined their duty in promoting treatment adherence among tuberculosis patients, and identified challenges affecting their performance in tuberculosis control. The study adopted a descriptive survey research design. The population of the study comprised Community Health Extension Workers, primary healthcare workers, tuberculosis patients, and community members in Andoni Local Government Area. A sample size of 120 respondents was selected, and 112 properly completed questionnaires were analysed. Data were collected using a structured questionnaire developed based on the research objectives and questions. The instrument was measured using a five-point Likert scale of Strongly Agree, Agree, Undecided, Disagree, and Strongly Disagree. Data collected were analysed using frequency distribution, percentages, mean scores, and Pearson Product Moment Correlation for hypothesis testing at a 0.05 level of significance. The findings revealed that Community Health Extension Workers play a significant duty in tuberculosis awareness creation through community education, sensitization programmes, and stigma reduction activities. The study also found that CHEWs contribute significantly to early detection of tuberculosis cases by identifying individuals with symptoms, referring suspected cases to healthcare facilities, and conducting household visits for contact tracing. Furthermore, the findings showed that CHEWs promote treatment adherence among tuberculosis patients through counselling, follow-up visits, medication reminders, and continuous patient support. However, the study identified major challenges affecting their performance, including inadequate training, limited logistics, transportation difficulties, shortage of working materials, tuberculosis stigma, and poor community cooperation. The hypothesis test showed a significant positive relationship between the duty of Community Health Extension Workers and tuberculosis control outcomes in Andoni Local Government Area (p < 0.05). Therefore, the study concluded that CHEWs have a significant duty in tuberculosis control and are important contributors to achieving effective community-based TB prevention and management. The study recommended continuous training and capacity building for CHEWs, provision of adequate logistics and resources, strengthening of community awareness programmes, improved supervision, and greater community participation in tuberculosis control activities.

References

Abimbola, S., Olanipekun, T., Schaaf, M., Negin, J., Jan, S., Martiniuk, A. L., & Scott, K. (2019). Where there is no doctor: The dutys of community health extension workers in primary health care in Nigeria. BMJ Global Health, 4(5), e001561. https://doi.org/10.1136/bmjgh-2019-001561 Abouyannis, M., Hossain, M. A., & Reilly, R. (2021). Community health workers and tuberculosis control: A systematic review of interventions and outcomes in low- and middle-income countries. BMC Public Health, 21, 1768. https://doi.org/10.1186/s12889-021-11774-8 Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall. Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143–164. https://doi.org/10.1177/1090198104263660 Courtwright, A., & Turner, A. N. (2010). Tuberculosis and stigmatization: Pathways and interventions. Public Health Reports, 125(Suppl. 4), 34–42. https://doi.org/10.1177/00333549101250S407 Creswell, J., Sahu, S., Blok, L., Bakker, M. I., Stevens, R., & Ditiu, L. (2014). A multi-site evaluation of innovative approaches to increase tuberculosis case notification: Summary results. PLoS ONE, 9(4), e94465. https://doi.org/10.1371/journal.pone.0094465 Creswell, J. W., & Creswell, J. D. (2023). Research design: Qualitative, quantitative, and mixed methods approaches (6th ed.). Thousand Oaks, CA: SAGE Publications. Datiko, D. G., Yassin, M. A., Theobald, S. J., Blok, L., Suvanand, S., Creswell, J., Cuevas, L. E., Ramsay, A., & Zachariah, R. (2017). Health extension workers improve tuberculosis case finding and treatment outcomes in Ethiopia: A large-scale implementation study. BMJ Global Health, 2(4), e000390. https://doi.org/10.1136/bmjgh-2017-000390 Frieden, T. R., Sbarbaro, J. A., & International Union Against Tuberculosis and Lung Disease. (2003). Promoting adherence to treatment for tuberculosis: The importance of direct observation. Bulletin of the World Health Organization, 81(5), 407–409. Janz, N. K., & Becker, M. H. (1984). The Health Belief Model: A decade later. Health Education Quarterly, 11(1), 1–47. https://doi.org/10.1177/109019818401100101 Lewin, S., Munabi-Babigumira, S., Glenton, C., Daniels, K., Bosch-Capblanch, X., van Wyk, B. E., Odgaard-Jensen, J., Johansen, M., Aja, G. N., Zwarenstein, M., & Scheel, I. B. (2010). Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database of Systematic Reviews, 2010(3), CD004015. https://doi.org/10.1002/14651858.CD004015.pub3 MacPherson, P., Houben, R. M. G. J., Glynn, J. R., Corbett, E. L., & Kranzer, K. (2014). Pretreatment loss to follow-up in tuberculosis patients in low- and lower-middle- income countries: A systematic review and meta-analysis. Bulletin of the World Health Organization, 92(2), 126–138. https://doi.org/10.2471/BLT.13.124800 Perry, H. B., Zulliger, R., & Rogers, M. M. (2020). Community health workers in low-, middle- , and high-income countries: An overview of their history, recent evolution, and current effectiveness. Annual Review of Public Health, 41, 399–421. https://doi.org/10.1146/annurev-publhealth-040119-094247 Rifkin, S. B. (2009). Lessons from community participation in health programmes: A review of the past years. International Health, 1(1), 31–36. https://doi.org/10.1016/j.inhe.2009.02.001 Rosenstock, I. M. (1966). Why people use health services. The Milbank Memorial Fund Quarterly, 44(3), 94–127. Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the Health Belief Model. Health Education Quarterly, 15(2), 175–183. https://doi.org/10.1177/109019818801500203 Scott, K., Beckham, S. W., Gross, M., Pariyo, G., Rao, K. D., Cometto, G., & Perry, H. B. (2018). What do we know about community-based health worker programmes? A systematic review of existing reviews on community health workers. Human Resources for Health, 16, 39. https://doi.org/10.1186/s12960-018-0304-x Shargie, E. B., & Lindtjørn, B. (2007). Determinants of treatment adherence among tuberculosis patients in Ethiopia: A community-based study. BMC Public Health, 7, 165. https://doi.org/10.1186/1471-2458-7-165 Taherdoost, H. (2021). Data collection methods and tools for research; A step-by-step guide to choose data collection technique for academic and business research projects. International Journal of Academic Research in Management, 10(1), 10–38. Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s Alpha. International Journal of Medical Education, 2, 53–55. https://doi.org/10.5116/ijme.4dfb.8dfd Uplekar, M., Weil, D., Lönnroth, K., Jaramillo, E., Lienhardt, C., Dias, H. M., Falzon, D., Floyd, K., Gargioni, G., Getahun, H., et al. (2015). WHO’s new End TB Strategy. The Lancet, 385(9979), 1799–1801. https://doi.org/10.1016/S0140-6736(15)60570-0 World Health Organization. (1978). Declaration of Alma-Ata: International Conference on Primary Health Care. Geneva: World Health Organization. World Health Organization. (2018). Declaration of Astana: Global Conference on Primary Health Care. Geneva: World Health Organization. World Health Organization. (2023). Consolidated guidelines on tuberculosis: Module 2— Screening: Systematic screening for tuberculosis disease. Geneva: World Health Organization. World Health Organization. (2024). Global tuberculosis report 2024. Geneva: World Health Organization. Yassin, M. A., Datiko, D. G., Tulloch, O., Markos, P., Aschalew, M., Shargie, E. B., Dangisso, M. H., Komatsu, R., & Cuevas, L. E. (2013). Innovative community-based approaches doubled tuberculosis case notification and improved treatment outcome in southern Ethiopia. PLoS ONE, 8(5), e63174. https://doi.org/10.1371/journal.pone.0063174

The Duty of Community Health Extension Workers in Tuberculosis Evolution in Andoni

Abstract

References

More Articles from INTERNATIONAL JOURNAL OF HEALTH AND PHARMACEUTICAL RESEARCH