Community Health Workers’ Knowledge, Attitudes, and Practices towards Epilepsy in Sofala, Central Mozambique

Vasco Francisco Japissane Cumbe (), Claire Greene, Afonso Mazine Tiago Fumo, Hélder Fumo, Dirceu Mabunda, Lídia Chaúque Gouveia, Maria A. Oquendo, Cristiane S. Duarte, Mohsin Sidat and Jair de Jesus Mari
Additional contact information
Vasco Francisco Japissane Cumbe: Mental Health Department, Ministry of Health, Provincial Health Directorate of Sofala, Beira 543, Mozambique
Claire Greene: Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA
Afonso Mazine Tiago Fumo: Medicine Department, Psychiatry and Mental Health Service, Beira Central Hospital, Sofala 1613, Mozambique
Hélder Fumo: Mental Health Department, Ministry of Health, Provincial Health Directorate of Sofala, Beira 543, Mozambique
Dirceu Mabunda: Mental Health and Psychiatry Department, Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo 257, Mozambique
Lídia Chaúque Gouveia: Mental Health and Psychiatry Department, Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo 257, Mozambique
Maria A. Oquendo: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
Cristiane S. Duarte: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
Mohsin Sidat: Department of Community Health, Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo 257, Mozambique
Jair de Jesus Mari: Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, UNIFESP, São Paulo 04017-030, Brazil

IJERPH, 2022, vol. 19, issue 22, 1-13

Abstract: Background: Epilepsy is the most common neurological disease in the world, affecting 50 million people, with the majority living in low- and middle-income countries (LMICs). A major focus of epilepsy treatment in LMICs has been task-sharing the identification and care for epilepsy by community health workers (CHWs). The present study aimed to assess the knowledge, attitudes, and practices (KAPs) of CHWs towards epilepsy in Mozambique. Methods: One hundred and thirty-five CHWs completed a questionnaire that included socio-demographic characteristics and 44-items divided into six subscales pertaining to KAPs towards epilepsy (QKAP-EPI) across nine districts of Sofala, Mozambique. The internal consistency was examined to evaluate the reliability of the instrument (QKAP-EPI). The association between sociodemographic variables and QKAP-EPI subscales was examined using linear regression models. Results: The internal consistency was moderate for two subscales (causes of epilepsy, α = 0.65; medical treatment, α = 0.694), acceptable for cultural treatment (α = 0.797) and excellent for 2 subscales (safety and risks, α = 0.926; negative attitudes, α = 0.904). Overall, CHWs demonstrated accurate epilepsy knowledge (medical treatment: mean = 1.63, SD = 0.28; safety/risks: mean = 1.62, SD = 0.59). However, CHWs reported inaccurate epilepsy knowledge of the causes, negative attitudes, as well as culturally specific treatments for epilepsy, such as: “if a person with epilepsy burns when set on fire they cannot be treated”. Knowledge about how to manage epileptic seizures varied across the different emergency care practices, from the accurate belief that it is not advisable to place objects in the individual’s mouth during an epileptic seizure, to the wrong perception of the need to hold the person in seizures to control seizures. Heterogeneity in the level of epilepsy knowledge was observed among CHWs, when considering epilepsy according to the local names as treatable (“Dzumba”) and other forms as untreatable (“Nzwiti”). Conclusion: CHWs knowledge of medical treatment and epilepsy safety/risks were adequate. However, information on the causes of epilepsy, stigmatizing attitudes, cultural treatment, and some knowledge of epileptic seizure management were low. These areas of poor knowledge should be the focus of educating CHWs in increasing their ability to provide quality care for patients with epilepsy in Mozambique.

Keywords: epilepsy; community health workers; knowledge; attitudes; practices; primary health care; Mozambique (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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