Undesirable Levels of Practice Behaviours and Associated Knowledge amongst Community Health Workers in Rural South India Responsible for Type 2 Diabetes Screening and Management

Anirudh G. Gudlavalleti (), Giridhara R. Babu, Varun Agiwal, G. V. S. Murthy, Nicolaas C. Schaper and Onno C. P. van Schayck
Additional contact information
Anirudh G. Gudlavalleti: Pragyaan Sustainable Health Outcomes Foundation, World Trade Centre, Nanakramguda, Hyderabad 500032, Telangana, India
Giridhara R. Babu: Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
Varun Agiwal: Indian Institute of Public Health Hyderabad, Rajendranagar, Hyderabad 500030, Telangana, India
G. V. S. Murthy: Pragyaan Sustainable Health Outcomes Foundation, World Trade Centre, Nanakramguda, Hyderabad 500032, Telangana, India
Nicolaas C. Schaper: Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
Onno C. P. van Schayck: Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands

IJERPH, 2024, vol. 21, issue 5, 1-17

Abstract: Background: Type 2 diabetes (T2DM) poses an enormous global health care challenge, especially among rural communities. Healthcare in these areas can be inadequate and inaccessible due to socio-demographic barriers. To overcome this situation, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. Objective: This cross-sectional study aimed to evaluate the proficiency of CHWs involved in diabetes screening and management in rural South India by identifying the existing practice behaviours and knowledge gaps. Methods: Employing a customised questionnaire, developed through inputs from experts and government officials, we assessed practice behaviours and the corresponding knowledge base of 275 CHWs. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. Results: The study showcased significant deficiencies in both practice behaviours (97%) and knowledge (95%) with current mean levels ranging from 48 to 50%, respectively, among the participants. The identified areas of insufficiency were broadly representative of the core competencies required for effective diabetes management, encompassing diabetes diagnosis and referral, HbA1c testing, diabetes diet, diabetes type and self-management, microvascular complications and their screening, peripheral neuropathy management, and diabetes risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management, and calculation of diabetes risk assessment. Conclusion: This study highlights widespread deficiencies (97% CHWs) in diabetes management practices and knowledge (95% CHWs). To overcome these deficiencies, a thorough needs assessments is vital for effective CHW training. Training of CHWs should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.

Keywords: community health workers; health worker diabetes knowledge; health worker diabetes practice; health worker diabetes behaviour; South-East Asia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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