Preparedness of the health care workforce for management of asthma at the primary health care facilties in Western Kenya

Background: Due to limited workforce at the referral or higher-level health facilities, there is a recommendation to shift task of prevention and control of some NCDs to lower level heath facilities. However, the preparedness of the workforce at primary health care facilities is poorly understood. Objectives: The aim of this study was to access the knowledge, practices and barriers on the treatment and management of asthma among health workers at the primary facilities (Level 2) in Bomet County. Methods: This study employed a cross-sectional study design. Census method was used to select 90 health workers while 5 sub county public health officers were selected using purposive sampling. Data was collected using semi-structured questionnaires and key informant interview guide. Results: We assessed whether the respondents had a guideline for the treatment and management of asthma at the health facility and majority 63.6% (n=56) said no and a key informant’sinterviewer reiterated that “Asthma patients were not treated according to the approved guideline because of its unavailability at health facilities and challenges of implementing it in a resource limited settings”. In addition, the majority (61.6%, n=54) agreed that they have the capacity to treat and manage asthmaand only30.8% (n=28) agreed that people come with severe conditions that they cannot treat. The major concern (100%, n=88) was lackequipment to treat and manage asthma conditionsand lack or limited refresher training 64.4% (n=65). Majority says that other barriersrelated to the patients are distance to the health facility 67.9% (n=59) and cultural belief 64.6 (n=57). All the respondents say that inter-facility transfer and harsh weather conditions are barriers. Conclusion: This study shows that task shifting can be explored with current capacity of health care workforce but there are gaps that relate to the facilities and patients. The study therefore provides an insight for developing a model or a framework for task shifting of NCDs related health services at primary health care facilities in resource limited environments.