title: Gender and performance of community treatment assistants in Tanzania.
abstract: OBJECTIVE
  To examine the effects of gender and demographics of community treatment assistants (CTAs) on their performance of assigned tasks and quantity of speech during mass drug administration of azithromycin for trachoma in rural Tanzania.
  
  
  METHODS
  Surveys of CTAs and audio recordings of interactions between CTAs and villagers during drug distribution.
  
  
  METHODS
  Mass drug administration program in rural Kongwa district.
  
  
  METHODS
  Fifty-seven randomly selected CTAs, and 3122 residents of villages receiving azithromycin as part of the Kongwa Trachoma Project.
  
  
  METHODS
  None.
  
  
  METHODS
  Speech quantity graded by Roter interaction analysis system, presence of culturally appropriate greeting and education on facial hygiene for trachoma prevention from coded analysis of audio-recorded interactions.
  
  
  RESULTS
  At sites with all female CTAs, each CTA spent more time and spoke more in each interaction in comparison with CTAs at sites with only male CTAs and CTAs at 'mixed gender' sites (sites with both male and female CTAs). At 'mixed gender' sites, males spoke significantly more than females. Female CTAs mentioned trachoma prevention with facial cleanliness more than twice as often as male CTAs; however, both genders mentioned hygiene in <10% of interactions. Both genders had culturally appropriate greetings in <25% of interactions.
  
  
  CONCLUSIONS
  Gender dynamics affect the amount of time that CTAs spend with villagers during drug distribution, and the relative amount of speech when both genders work together. Both genders are not meeting expectations for trachoma prevention education and greeting villagers, and novel training methods are necessary.
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Jenson
authors.affiliation: Treatment Team, Kongwa Trachoma Project, Kongwa, Tanzania.
authors.forename: Catherine
authors.initials: C
authors.lastname: Gracewello
authors.affiliation: Treatment Team, Kongwa Trachoma Project, Kongwa, Tanzania.
authors.forename: Harran
authors.initials: H
authors.lastname: Mkocha
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Roter
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Munoz
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Sheila
authors.initials: S
authors.lastname: West
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D017963:Azithromycin / Q000008:administration & dosage; D003142:Communication; D003150:Community Health Workers / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors; D013636:Tanzania; D013647:Task Performance and Analysis; D014141:Trachoma / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin
keywords: Tanzania; community health worker; gender; mass drug administration; trachoma