scholarly journals The use of low-cost ruggedized Android tablets to augment in-service training of community health workers in Mukono, Uganda: perspectives and lessons learned from the field

2021 ◽  
Vol 21 (3) ◽  
pp. 1482-1490
Author(s):  
Christina E Stiles ◽  
Edward O’Neil Jr ◽  
Kenneth Kabali ◽  
James O’Donovan
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Low Cost ◽  
Local Level ◽  
Scale Up ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Refresher Training ◽  
Service Training

Background: Despite potential for community health workers (CHWs) to effectively reduce morbidity and mortality in sub-Saharan Africa, they still face multiple barriers including access to on-going and refresher training. Digital technology offers a potential solution to improve the provision of ongoing training for CHWs. Objectives: This report shares participant insights and experiences following the implementation of a mobile health (mHealth) assisted Integrated Community Case Management (iCCM) refresher training programme for CHWs in Mukono, Uganda. We seek to document benefits and challenges of such an approach. Methods: CHWs were trained to recognize, treat and prevent childhood pneumonia via locally made videos preloaded onto low cost, ruggedized Android tablets. Subsequent interviews were compiled with key stakeholders including CHWs, CHW leaders and programme supervisors to better understand the strengths, barriers and lessons learned following the interven- tion. Results: Success factors included the establishment of CHW leadership structures, the ability to use the tablets to learn on an “any pace, any place” basis and using the tablets to conduct community teaching and outreach. Barriers included appro- priate consideration of the implementation timeline and avoiding a “one size fits all” approach to digital literacy training. Conclusions: The strength of the program stemmed from a grassroots approach that prioritized stakeholder input at all stages. Leadership at a local level, a history of local engagement and trust built up over a period time were also integral. As organizations aim to scale up digitally enhanced training initiatives, it is paramount that attention is paid to these human factors which are key for program success. Keywords: Low-cost ruggedized Android tablets; in-service training; community health workers; Mukono.

Community Health Workers (CHWs) as Innovators

2018 ◽  
Vol 13 (1) ◽  
pp. 15-28
Author(s):  
Tyler Prentiss ◽  
John Zervos ◽  
Mohan Tanniru ◽  
Joseph Tan
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Underserved Populations ◽  
Low Cost ◽  
Cost Effective ◽  
Well Being ◽  
Grant Writing ◽  
Multiple Sources ◽  
Context Of Learning

Community health workers (CHWs) have a longstanding role in improving the health and well-being of underserved populations in resource-limited settings. CHWs are trusted in the communities they serve and are often able to see through solutions on community challenges that outside persons cannot. Notwithstanding, such solutions often must be low-cost, easily implementable, and permit knowledge gaps among CHWs to be filled via appropriate training. In this sense, use of cost-effective information technology (IT) solutions can be key to increasing access to knowledge for these community agents. This paper highlights insights gleaned from a pilot study performed in Detroit, Michigan with a group of CHWs in basic grant-writing training via an e-platform, the Community Health Innovator Program (CHIP). The results are discussed within the context of learning theory. It is concluded that e-platforms are necessary for CHWs to leverage knowledge from multiple sources in an adaptive environment towards addressing ever-evolving global health challenges.

Improving use of maternal care services among married adolescent girls: an intervention study in rural India

2020 ◽  
pp. 1-20
Author(s):  
Ashok Dyalchand ◽  
Rohini Prabha Pande ◽  
Gopal Kulkarni ◽  
Manisha Khale
Keyword(s):  
Antenatal Care ◽  
Community Health ◽  
Community Health Workers ◽  
Adolescent Girls ◽  
Maternal Care ◽  
Health Workers ◽  
Care Delivery ◽  
Scale Up ◽  
Care Services ◽  
Study Sites

Abstract This study examined the effect of the Safe Adolescent Transition and Health Initiative (SATHI) programme on the use of maternal care services among rural, pregnant adolescents in India. This was an intensive community-based, multi-site intervention project conducted in Maharashtra state between 2008 and 2011. Its aims were to improve the reproductive health of married adolescent girls and avert the adverse consequences of early motherhood. It had a quasi-experimental, case-control, pre-post design to enable rigorous evaluation. This study used cross-sectional data from 644 married girls aged under 19 years at baseline and 802 at endline to assess the maternal care outcomes of antenatal care, delivery and postnatal services and nutrition during pregnancy. Difference-in-differences analysis showed that all outcomes improved significantly in the study sites between baseline and endline, and the improvement in study sites was significantly larger than in the control sites. Multivariate analysis showed a statistically significant dose–response effect of intervention participation for antenatal care, pregnancy nutrition and postnatal care. Study participation was not statistically significantly associated with higher rates of safe or institutional delivery. The analysis suggests that training and supporting community health workers to work with married adolescent girls using interpersonal communication and interacting frequently with them and their families and communities can significantly improve the use of maternal care services among this population. With almost a million community health workers and 200,000 auxiliary nurse midwives at the community level providing primary level care in India, this intervention offers a proven strategy to replicate and scale-up to reach large numbers of married adolescent girls who do not currently use maternal care services.

scholarly journals Community health workers at the dawn of a new era: 9. CHWs’ relationships with the health system and communities

2021 ◽  
Vol 19 (S3) ◽  
Author(s):  
Karen LeBan ◽  
Maryse Kok ◽  
Henry B. Perry
Keyword(s):  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Large Scale ◽  
Health Workers ◽  
Local Level ◽  
Grey Literature ◽  
Community Context ◽  
New Era

Abstract Background This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major challenge in large-scale CHW programmes is the need for CHWs to establish and maintain beneficial relationships with both sets of actors, who may have different expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities. Methods The authors conducted a selective review of journal articles and the grey literature, including case study findings in the 2020 book Health for the People: National CHW Programs from Afghanistan to Zimbabwe. They also drew upon their experience working with CHW programmes. Results The space where CHWs form relationships with the health system and the community has various inherent strengths and tensions that can enable or constrain the quality of these relationships. Important elements are role clarity for all actors, working referral systems, and functioning supply chains. CHWs need good interpersonal communication skills, good community engagement skills, and the opportunity to participate in community-based organizations. Communities need to have a realistic understanding of the CHW programme, to be involved in a transparent process for selecting CHWs, and to have the opportunity to participate in the CHW programme. Support and interaction between CHWs and other health workers are essential, as is positive engagement with community members, groups, and leaders. Conclusion To be successful, large-scale CHW programmes need well-designed, effective support from the health system, productive interactions between CHWs and health system staff, and support and engagement of the community. This requires health sector leadership from national to local levels, support from local government, and partnerships with community organizations. Large-scale CHW programmes should be designed to enable local flexibility in adjusting to the local community context.

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