Table 4 Feasibility Requirements and Existing Conditions in SJDM Health Facilities (N = 17)
Financial Requirements | Existing Conditions in SJDM | Rating |
1. Additional honorarium or incentives for BHWs | Χ Needs to be budgeted | 3.25 |
2. Budget for training (approx. US$ 300 to US$ 500/trainee) | Χ Needs to be budgeted | 2.5 |
Infrastructure and Operation Requirements | Existing Conditions in SJDM | Rating |
1. Doctors available 5× a week | o 17.6% of facilities have full-time doctors | 2.75 |
2. Rooms with visual and/or auditory privacy | o 35.3% of facilities have rooms with visual and auditory privacy | 2.75 |
3. Mechanism for infectious waste disposal | ✓ Existing | 3.75 |
4. Guidelines/responsibilities of BHWs as HCT providers | Χ Not yet existing | 2.75 |
5. Timely delivery of medical supplies | o Supply chain mechanisms take 1 to 2 months before delivering supplies | 3.25 |
6. Delineate deaths caused by TB alone and deaths caused by TB/HIV | ✓ Can be extrapolated from existing TB and HIV databases | 3.5 |
7. Agency to monitor the implementation of BHWs as HCT providers | ✓ TB/HIV collaboration group existing | 2.75 |
8. Establishing linkages with NGOs | ✓ SJDM has limited partnerships with NGOs | 3.75 |
Technical and training requirements | Existing Conditions in SJDM | Rating |
1. Training on basic TB/HIV knowledge | ✓ 88.2% of BHWs trained on basic HIV knowledge; 23.5% trained on TB/HIV in the last two years; | 3 |
2. Training on how to use the HIV rapid test kits | ✓ 5.9% of BHWs in facilities trained on HCT | 2 |
3. HIV awareness campaigns in the community | ✓ SJDM stakeholders conducted community awareness campaigns | 4 |
4. HCT refresher course for other primary health center personnel | ✓ Physicians and nurses trained on HCT in the last two years; less than 10% of midwives in facilities trained in HCT | 3.75 |
5. Knowledge transfer mechanisms from upper to lower levels of the health system | o Capacity building activities available but knowledge transfer mechanisms vague | 3.75 |
BHW Characteristics | Existing Conditions in SJDM | Rating |
1. Time spent for BHW responsibilities less than working time per week | ✓ Working minutes per week: 1920 mins; time spent for responsibilities: 1575 mins | 2.75 |
2. BHWs are high school graduates | ✓ 71% of BHWs are high school graduates | 3.25 |
3. Few stigmatization behaviors towards TB/HIV patients among BHWs | ✓ 20.3% of BHWs have hesitations in talking to a patient with TB/HIV | 2.75 |
4. Good knowledge in patient counselling principles among BHWs | o Only 16.5% have knowledge; 69.1% needs refresher course | 3 |