Ethiopian community health workers' beliefs and attitudes towards children with autism: Impact of a brief training intervention

Tilahun, Dejene; Fekadu, Abebaw; Tekola, Bethlehem; Araya, Mesfin; Roth, Ilona; Davey, Basiro; Hanlon, Charlotte and Hoekstra, Rosa A. (2019). Ethiopian community health workers' beliefs and attitudes towards children with autism: Impact of a brief training intervention. Autism, 23(1) pp. 39–49.

DOI: https://doi.org/10.1177/1362361317730298

Abstract

There is a severe shortage of services for children with autism in Ethiopia; access to services is further impeded by negative beliefs and stigmatising attitudes towards affected children and their families. To increase access to services, care provision is decentralised through task-shifted care by community health extension workers. This study aimed to examine the impact of a brief training (Health Education and Training; HEAT) for Ethiopian rural health extension workers and comprised three groups: (1) health extension workers who completed a basic mental health training module (HEAT group, N = 104); (2) health extension workers who received enhanced training, comprising basic HEAT as well as video-based training on developmental disorders and a mental health pocket guide (HEAT+ group, N = 97); and (3) health extension workers untrained in mental health (N = 108). All participants completed a questionnaire assessing beliefs and social distance towards children with autism. Both the HEAT and HEAT+ group showed fewer negative beliefs and decreased social distance towards children with autism compared to the untrained health extension worker group, with the HEAT+ group outperforming the HEAT group. However, HEAT+ trained health extension workers were less likely to have positive expectations about children with autism than untrained health extension workers. These findings have relevance for task-sharing and scale up of autism services in low-resource settings worldwide.

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