Knowledge, attitude, and practice and service barriers in a tuberculosis programme in Lakes State, South Sudan: a qualitative study

Background: The World Health Organisation (WHO) estimates the incidence of tuberculosis (TB) in South Sudan to be 79 per 100,000 for new sputum smear positive TB and 140 per 100,000 for all forms of TB cases. The case detection rate of 53% for all forms of TB in South Sudan is below the WHO target of 70%.Objective: To explore knowledge, attitude, and practice barriers as well as service barriers to implementing TB programme in Lakes State, South Sudan.Method: This was a qualitative study conducted in May 2015.Results: Despite some understanding of the symptoms, causes, and consequences of TB, the stigma for TB and lack of disclosure of the disease, is very high among the local community. The limited network of TB facilities for case detection, lack of community distribution of TB drugs and lack of food at hospitals when patients were admitted for treatment, are key barriers to TB service delivery.Conclusion: To overcome barriers it is recommended that the local community worldview should be incorporated into TB awareness, testing, and treatment, and attention should be paid to areas where traditional practices, such as elimination of maize, clash with modern treatments

Working together for health: the world health report 2006

This report was produced under the overall direction of Tim Evans (Assistant Director-General; Evidence and Information for Policy). The principal authors were Lincoln Chen; David Evans; Tim Evans; Ritu Sadana; Barbara Stilwell; Phyllida Travis; Wim Van Lerberghe and Pascal Zurn; assisted by Christie Aschwanden and Joanne McManus. Organizational supervision of the report was provided by Manuel M. Dayrit and Carmen Dolea. The Managing Editor of the report was Thomson Prentice. Valuable inputs in the form of contributions; peer-review; suggestions and criticisms were received from the Director-General's Office; and from Maia Ambegaokar; Dina Balabanova; James Buchan; Gilles Dussault; Martin McKee and Barbara McPake. Significant contributions to the analytical work were received from Mario Dal Poz; Sigrid Draeger; Norbert Dreesch; Patricia Hernandez; Yohannes Kinfu; Teena Kunjumen; Hugo Mercer; Amit Prasad; Angelica Souza and Niko Speybroek. Additional help and advice were kindly provided by Regional Directors and members of their staff. Other contributors were Sabine Ablefoni; Taghreed Adam; Alayne Adams; Chris Afford; Alan Leather; Fariba Aldarazi; Ghanim Al'Sheick; Ala Alwan; Sarah Barber; Kisalaya Basu; Jacques Baudouy; Robert Beaglehole; Habib Benzian; Karin Bergstrom; Isa Bogaert; Paul Bossyns; Jean-Marc Braichet; Hilary Brown; Paul Bunnell; Francisco Campos; Eleonora Cavagnero; Xuanhao Chan; Amelina Chaouachi; Ottorino Cosivi; Nadia Danon-Hersch; Khassoum Diallo; Alimata Diarra; Marjolein Dieleman; Dela Dovlo; Nathalie Drew; Sambe Duale; Steeve Ebener; Dominique Egger; JoAnne Epping-Jordan; Marthe-Sylvie Essengue; Edwige Faydi; Paulo Ferrinho; Noela Fitzgerald; Martin Fletcher; Helga Fogstad; Gilles Forte; Kathy Fritsch; Michelle Funk; Charles Godue; Sandy Gove; Alexandre Griekspoor; Steffen Groth; Anil Gupta; Piya Hanvoravongchai; Hande Harmanci; Lisa Hinton; Sue Ineson; Anwar Islam; Anna Iversen; PT Jayawickramarajah; Patrick Kadama; Hans Karle; Julia Karnaukhova; Guy Kegels; Meleckidzedeck Khayesi; Mireille Kingma; Stephen Kinoti; Etienne Krug; Yunkap Kwankam; Chandrakant Laharyia; Gaert Laleman; Jean Pierre Lokonga; Ana Lopes Temporao; Alessandro Loretti; Pat McCarty; Judith Mandelbaum- Schmid; Annick Manuel; Bruno Marchal; Tim Martineau; Liz Mason; Zoe Matthews; Sandra McGinnis; Abdelhay Mechbal; Remo Meloni; Nata Menabde; Phillipa Mladovski; Dominic Montagu; Jean Moore; Krishnan Natarajan; Mwansa Nkwane; John Norcini; Ezekiel Nukoro; Isabelle Nuttal; Jennifer Nyoni; Cornelius Oepen; Judith Oulton; Francis Omaswa; Mary O'Neill; Ariel Pablos-Mendez; Fred Peccaud; Margie Peden; Galina Perfilieva; Bob Pond; Raymond Pong; Amit Prasad; Usha Raman; Tom Ricketts; Robert Ridley; Arjanne Rietsema; Felix Rigoli; Barbara Rijks; Salif Samake; Benedetto Saraceno; Shekhar Saxena; Robert Scherpbier; Lee-Martin Shook-Pui; Kit Sinclair; Alaka Singh; Ronald Skeldon; Susan Skillman; Ajay Tandon; Tessa Tan-Torres Edejer; Linda Tawfik; Michel Thieren; Anke Tijstma; Nicole Valentine; Wim Van Damme; Dirk Van der Roost; Mark van Ommeren; Paul Verboom; Marko Vujicic; Lis Wagner; Eva Wallstam; Diane Whitney; Marijke Wijnroks; Paul Wing; Christiane Wiskow; Tana Wuliji; Jean Yan; Sandy Yule; Manfred Zahorka; Diana Zandi; and Lingling Zhang. Contributors to statistical tables not already mentioned were Endre Bakka; Dorjsuren Bayarsaikhan; Ties Boerma; Eduard Bos; Thomas Buettner; Veneta Cherilova; Trevor Croft; Driss Zine Eddine Elidrissi; Anton Fric; Charu Garg; Peter Ghys; Amparo Gordillo; Eleanor Gouws; Attila Hancioglu; Kenneth Hill; Chandika Indikadahena; Mie Inoue; Gareth Jones; Joses Kirigia; Jan Klavus; Joseph Kutzin; Eduardo Levcovitz; Edilberto Loaiza; Doris Ma Fat; Francois Pelletier; Ravi Rannan-Elyia; Hossein Salehi; Cheryl Sawyer; Kenji Shibuya; Karen Stanecki; Ruben Suarez; Emi Suzuki; Nathalie Van de Maele; Jakob Victorin; Neff Walker; Tessa Wardlaw; Charles Waza; Jens Wilkens; John Wilmoth; and many staff in WHO country offices; governmental departments and agencies; and international institutions. The report was edited by Leo Vita-Finzi; assisted by Barbara Campanini. Editorial; administrative and production support was provided by Shelagh Probst and Gary Walker; who also coordinated the photographs. Figures and tables were provided by Gael Kernen who also was responsible for the web site version; and other electronic media. Proofreading was by Marie Fitzsimmons. The index was prepared by June Morrison