Assessing fidelity of community-tuberculosis programme in the central region of Burkina Faso

Abstract

Background: Tuberculosis (TB) remains a significant global public health concern, particularly in Africa. In Burkina Faso, a community-based TB program was established with funding from the Global Fund to Fight HIV/AIDS, TB, and Malaria. However, a mid-term evaluation of the program primarily focused on its effects, lacking an examination of the implementation process. To address this gap, an evaluation was conducted to assess the fidelity of the program’s implementation in Burkina Faso’s central region. Method: The study employed a qualitative case study approach, involving five districts in Ouagadougou. Data were gathered through individual interviews and document analysis between July and September 2019, involving various stakeholders, such as program managers, monitoring and evaluation managers, community health workers, traditional healers, community leaders, and health workers. Thematic analysis was conducted using NVivo software version 9. Results: The results indicate that all program components were indeed implemented, with a particularly high fidelity in the training of community health workers. Nevertheless, adaptations were made throughout the implementation process to address local challenges effectively. Conclusion: This study sheds light on the fidelity of a community-based TB program in Burkina Faso. While the program displayed a relatively faithful implementation overall, the identified challenges and adaptations underscore the importance of ongoing monitoring and resource availability. These insights are invaluable, contributing to the knowledge base and providing guidance for future program planning, implementation, and refinement to enhance the effectiveness and sustainability of community-based TB interventions in similar settings.

Keywords

• evaluation
• fidelity
• adaptation
• community-based programme
• tuberculosis
• burkina faso