The African Journal of Primary Health & Family Medicine welcomes submissions that encourage scholarly exchange between family medicine and primary health care researchers and practitioners across Africa and the developing world, whilst providing a contextual and holistic view of family medicine as practiced across the continent.

Background: The role of village health workers (VHWs), among other roles is to educate communities about tuberculosis (TB), TB screening and its treatment. The knowledge of TB among VHWs is crucial because they will carry out their role at the community well and this will impact the overall outcome of TB treatment.Aim: The study is aimed at assessing the knowledge of TB among VHWs and households at the village level and the utilisation of VHWs’ TB services.Setting: The study took place in 19 health centres from 10 districts of Lesotho.Methods: The study used a cross-sectional descriptive design. Three study populations were interviewed, two at the household level (2040 households, 8295 individuals) and one at the clinic level (723 VHW).Results: Overall, TB knowledge among VHWs for the majority of clinics except two was inadequate (below mean of 31.5). The utilisation of VHWs’ TB services among community members was also low.Conclusion: Low utilisation of VHWs’ TB services by community members emanated from inadequate TB knowledge of VHWs. Regular refresher training among VHWs is recommended as the way forward in order to keep VHWs abreast with new TB developments.

Hospitalisation of chronic diseases can be costly and time-consuming to patients with chronic diseases, and success of management of chronic diseases is in the primary care. This chapter gives a detailed description of primary health and its role in the management of chronic diseases. Hypertension as a chronic disease of interest and its management in the primary healthcare (PHC) context are also to be discussed in detail. However, to give this chapter clarity, a brief description of the country Lesotho will be given. The summary of the country will highlight major barriers to health care which mainly include poverty, difficult topography with no or poor infrastructure which hinder access to primary health care. Situational analysis is made with regard to current practice. The potential role of a pharmacist in the care and treatment of hypertension is explored. Best practices, need for policy change, guidelines and implementation plans will be highlighted. The aim of the chapter is to evaluate how chronic diseases are managed at the primary health care. The objectives include: a) to explore primary health care concept, b) to critically evaluate PHC concept in an African country and c) to describe human resource needs to meet the demands of PHC chronic diseases management.

Background: Village health workers (VHWs) play an essential role because they extend the capacity of primary healthcare, particularly for developing countries. In Lesotho, VHWs are part of the primary healthcare connecting the community with clinics in their respective villages. They contribute to the prevention of the spread of tuberculosis (TB) within their catchment areas by encouraging communities to partake in TB screening. This study aimed at identifying factors associated with the utilisation of VHWs’ service to undertake TB screenings in Lesotho.Methods: This study emanates from the main study that used a cross-sectional descriptive design. A total of 19 health service areas (HSAs) comprised 17 catchment areas and two clinics, each randomly selected from the District Health Management Team (DHMT) and the Lesotho Flying Doctors Service (LFDS), respectively. A total of 2928 individual household members aged 15 and above were included in the study. Data analysis included descriptive and inferential statistics.Results: There were more female than male respondents, with a majority (77%) below 65 years of age. Tuberculosis knowledge of respondents was mostly on the TB symptoms and curability of TB, but they were less knowledgeable about the causes of TB. The use of VHWs’ services for TB screening was very low (23.3%).Conclusion: The study revealed that while respondents were to some extent knowledgeable about TB, their utilisation of VHWs’ services for TB screening varied with education level, having worked in South Africa and the household size at α = 0.01.

Background: Cancer is a global health burden with an increasing incidence, particularly in low- and middle-income countries. Cancer treatment is associated with a financial burden worsened by insurance status, treatment type and geographic location. Aim: This study evaluates the cost of cancer treatment for patients treated outside Lesotho from the perspective of the healthcare service provider. Setting: The study was carried out at the Ministry of Health (MOH) headquarters using payment bills and at the Senkatana Oncology Clinic using the patients’ clinical files. Methods: A quantitative cross-sectional retrospective study analysed medical bills incurred between 2019 and 2022 and patients’ clinical files from the same period. The average costs of various treatment modalities were compared based on age, gender and cancer type. Results: Of the 200 patients enrolled, 76% (n = 152) were females, and the majority were aged above 30 years (n = 183, 91.5%). Younger patients (below 30) faced the highest chemotherapy average costs, and radiotherapy average costs were highest for the 31–60 age group. The average cost of accommodation coefficient (1.216) showed a positive association, but it was not statistically significant (p = 0.625). A statistically significant difference was observed in the combination of radiotherapy and chemotherapy with accommodation (p = 0.001). Conclusion: Cancer patients who seek cancer treatment outside the country undergo chemotherapy, radiotherapy and surgery, with the majority being on both chemotherapy and radiotherapy. A statistically significant difference was observed in the combination of radiotherapy and chemotherapy and accommodation. Contribution: This study provides an understanding of cancer treatment costs outside Lesotho by enhancing budget insights and recommending a strategic approach.

The South African Journal of Oncology is a peer-reviewed on-line journal which publishes high quality articles on all aspects of oncology. The Editorial Board strongly supports a multidisciplinary approach to cancer care research as well as translational research in oncology.