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

RESUMO

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. Structu- red 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