A novel lung health programme addressing awareness and behaviour-change aiming to prevent chronic respiratory diseases in rural Uganda: a two-year train-the-trainer programme

Abstract

Chronic lung disease is a huge, growing, but under reported problem in Africa. Following a survey in rural Uganda, which found 16% of the adult population had COPD, we developed a lung health programme aiming to raise awareness in the community of the risk factors for developing chronic lung disease and how to reduce the risks. A two-year train-the-trainer programme was conducted by healthcare workers (HCWs) in Masindi District, Uganda. Strategy and preliminary education materials were co-developed in a series of meetings with stakeholders including clinicians and community members. An initial group of HCWs were trained and further refned the education programme; they then taught other HCWs. Educational materials covered: “What is lung health?”, “How lungs get damaged”, “Smoking cessation” and “Preventing harm by reducing exposure to biomass smoke”. These materials were approved by the Ministry of Health. Local radio messages were designed and broadcasted. We administered knowledge questionnaires before and after training for both HCWs and the community health workers (CHWs). We trained 12 HCWs who then trained 47 other HCWs, and over 100 community health workers (CHWs). After the programme, knowledge questionnaire scores improved: for HCWs, the percentage of correct answers were 74% before and 89% after training, and for CHWs from 74% to 91%. Over 15,000 people have been educated directly and thousands more through mass media messages. Knowledge questionnaires administered to 1261 people in the community confrmed awareness of lung health. This novel lung health programme illustrates how communities may be empowered to reduce their risks of developing chronic lung disease and is a model for addressing the rising tide of non-communicable diseases.