An illustrated booklet for reinforcing community health worker knowledge of tuberculosis and facilitating patient counselling

Background: Community health workers (CHWs) have facilitated the move to decentralise tuberculosis (TB) management, but lack access to information appropriate both for personal use and in patient interaction and education. Aim: To explore the impact of a pictorial-based TB booklet on reinforcing CHW knowledge and facilitating patient counselling.Setting: This study was conducted in local primary health care clinics and the Hospice in Grahamstown, Eastern Cape Province in South Africa. Methods: Quantitative and qualitative methods were used. A simple, 17-page, A5 booklet containing pictograms and simple text was designed in collaboration with CHWs who advised on preferred content. Its influence on knowledge was assessed in 31 CHWs using a 17-item questionnaire in a before-and-after study. The experiences of CHWs using the booklet were qualitatively explored using focus group discussions (FGD) and semi-structured interviews. Results: Overall knowledge increased significantly from 70.6% to 85.3% (p