Table 6 Major themes from FGDs

• Engaging with and training caregivers

• Counseling on advantage of medication

• Offered counseling around spiritual issues that conflict with medication adherence (ex. witchcraft as cause of disease)

• Frequent home visits

• Alerted other healthcare providers when adherence is in question

• Developed a network of supporters for medication adherence (CHV, Neighbor, Caregiver, Doctor)

Please describe to me what changes have occurred in your patient care practice since you have completed this training?

• Incorporated counseling of patients and caregivers; counteracting misinformation address patients who feel they are a burden or have feelings of hopelessness

• Counseling led to improved CHV-patient relationship with more open discussion of illness by patient

• Instructed patients on use of technology to improve self-care (clock and phone alarms for medication reminders)

• Improved social life: counsel patients on use of technology to decrease social isolation

• Improved personal hygiene habits along with education of patients and caregivers

• Counseling on benefits of insurance coverage

What part of the training was new to you?

• Interpreting symptoms

• Improved communication skills with patients and family

• Dressing changes, catheter care, bedsore prevention, massage

• Early cancer treatment (? cure) is possible

• The importance of spiritual care, engaging community spiritual leaders in patient care

• Making referrals to nearest healthcare facility

• COVID-19 transmission and prevention

How did the training change your practice?

• Improved attentive listening and patients

• Improved interpersonal relationships with patients

• Offering support in accessing healthcare

• Recommended cost-effective alternatives to current interventions

• Embraced support networks in the community

How did you cope while seeing the very sick patients?

• Training improved understanding of palliative care

• Apply the new skills helped CHV develop courage and hope

• CHV grew closer to the patient and family based on the new skills

• Encouraged patient interactions with local spiritual leaders

• Have the support of palliative care doctors and nurses helped CHV cope with ill patients

How do you think the community benefits from your training?

• Patient attitude change from viewing sickness as witchcraft

• Exhibiting new skills changed the view of CHVs, some community members began to refer to CHV as “doctor”

• Improved community trust and confidentiality

• training of caregivers allowed them to help a family member and others in the community

• Increased awareness that caring can be done in the community, not just the hospital

• Engaged the community in assisting patients and families