Implementing a community-based tuberculosis programme in the Omaheke region of Namibia: nurses' perceived challenges

Abstract

Tuberculosis (TB) is a resurgent disease in many regions of the world, including Namibia, fuelled by poor TB control programmes, human immunodeficiency virus (HIV) and poverty. The purpose of this survey was to identify nurses’ perceived challenges in implementing a community-based TB programme in the Omaheke region of Namibia. Structured interviews were conducted with 40 nurses involved in providing TB treatment and care in the Omaheke region. Patient-related challenges which hampered TB treatment included alcohol and drug abuse, poverty and stigma. Lack of transport for nurses to do community-based TB work, centralised TB services and patients’ lack of transport were access-related challenges. Knowledge-related challenges involved a lack of TB knowledge by both nurses and community members. The HIV pandemic has increased the number of TB patients and increased nurses’ workloads, aggravating the burden of TB as a resurgent disease in this region. Decentralisation of TB care to community and family levels would be necessary to reduce the number of people with active TB in the community, and to enhance the TB cure rates, in the Omaheke region of Namibia. In order to implement a successful communitybased TB programme, the patient-related, access-related and knowledge-related challenges, perceived by the nurses, need to be addressed effectively.