Exploring Strategies to Improve the Performance of Community Health Volunteers for Tuberculosis Care and Prevention: A Qualitative Study

BACKGROUND: Community health volunteers contributed to the total Tuberculosis (TB) case findings; however, the attrition rate of these volunteers was high which reduces their optimal performance. Hence, sustainability of efforts should be explored to retain the community health volunteers in the TB program. Improvement of community health volunteers to perform community-based health education and prevent TB has not been examined consistently around the globe, including Indonesia. This study aimed to explore the strategies to improve performance of community health volunteers for TB care and prevention to reduce the incidence and stop the spread of TB in the community. METHODS: A qualitative design was adopted and we used two focus group discussions in 2017 to collect the data. The participants included village health workers as volunteers in two regencies of Bandung City, West Java Indonesia. A thematic analysis was used to analyze the data. RESULTS: Four major themes should be considered in developing a community-based TB health education program: (1) informing community health volunteers about the benefits and difficulties of being a TB volunteer; (2) recognizing the activities and feelings of volunteers; (3) emphasizing the Willingness to Help Others; and (4) having access to TB training. CONCLUSION: To develop a community-based health education program for TB care and prevention, community nurses need to listen to the opinions of community health volunteers, and TB patients and their family members to ensure that the health education program is tailored to meet community needs.