Background In sub-Saharan Africa, shortages of trained healthcare workers and limited resources necessitate innovative and cost-effective approaches for training, supervising, and mentoring. This qualitative case study describes participants’ and trainers’ perspectives and experiences with a text messaging component of a blended training course in HIV counseling and testing in Zimbabwe, using minimal resources in terms of staff time and equipment requirements. This component included a whole-group discussion forum as well as two-person partner discussions designed to promote reflection and analysis, teamwork, and active learning. Case presentation The Ministry of Health and Child Care (MoHCC) of Zimbabwe collaborated with the International Training and Education Center for Health (I-TECH) on adaptation of a 5-day in-service training in HIV Testing Services for Children and Adolescents. The new 7-week blended format included in-person sessions, tablet-based self-study, and discussions using the text messaging application, WhatsApp. Between August 2016 and January 2017, 11 cohorts (293 participants in total) were trained with this new curriculum, incorporating text messaging to support peer-to-peer and work-based education. Data collected included training participants’ feedback, key informant interviews with the training team, and thematic analysis of WhatsApp messages from full-cohort discussions and a sampling of one-to-one partner discussions. A total of 293 healthcare workers from 233 health facilities across all provinces in Zimbabwe completed the blended learning course. Participants strongly endorsed using WhatsApp groups as part of the training. In the whole-group discussions, the combined cohorts generated over 6300 text messages. Several categories of communication emerged in analysis of group discussions: (1) participants’ case experiences and questions; (2) feedback and recommendations for work issues raised; (3) inquiries, comments, and responses about course assignments and specific course content; (4) encouragement; and (5) technical challenges encountered using the blended learning methodology. Case discussions were complex, including patient history, symptoms, medications, and psychosocial issues—child abuse, adherence, and disclosure. Conclusions Using text messaging in a communication platform that is an ongoing part of healthcare workers’ daily lives can be an effective adjunct to in-service training, minimizing isolation and providing interactivity, supporting students’ ability to fully integrate content into new skill attainment.
continuous improvements to the MSGH coursework and program design, and to describe the desired student characteristics for admission into graduate degree programs in global health.Methods: This study examines survey responses from students matriculated in the MSGH program between 2014 and 2015. All active students were invited to complete an online self-assessment with questions related to their global health experience, skills and career goals. Free-text responses were hand-coded using 10 categorical variables. These categories were developed through an inductive process.Findings: Previous data revealed that students admitted to the MSGH program during this first year were 78% female, with an average age of 36. 57% were working in health science and 11% in government or public administration. Survey text responses from active students during the same time period provide additional information on their backgrounds and goals. Students' previous global health experiences fell overwhelmingly in the medicine and mission/volunteer categories, 45% and 50% respectively. Responses indicating the desired area of future work were spread more evenly across the categories. All professional categories, excluding volunteer and mission work, were represented in at least 2 text responses. The highest response rates were in the categories of medicine and government and policy, 30% and 25% respectively.Interpretation: The diversity of industries represented by students admitted to the program underscores the interprofessional nature of the field and the workforce. This diversity is encouraging and necessitates pedagogical techniques that can appeal to a wide array of students, including a majority female population. Findings also suggest that career advising will need to adapt to market demands, prioritizing program management in the non-profit/governmental sectors.
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