A Global Review of Training of Community Health Workers

Vc, Li; Pr, Goethals; Dorfman, Sharon L.

doi:10.2190/iq.27.3.b

Cited by 6 publications

(7 citation statements)

References 7 publications

(3 reference statements)

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“…The CHW training is mainly evaluated by an assessment of their satisfaction, and competency in delivering the tasks that are allocated to them [3]. Behvarz knowledge and skills are assessed through theory and practical exams during and at the conclusion of the pre-service training as pre-requisites to their certification.…”

Section: Resultsmentioning

confidence: 99%

“…Residential pre-service training at district level was perceived influential in building the relationship between behvarz students and trainers as well as providing the opportunity for closer supervision and student assessment. However, this may not applicable in all settings as the ideal location for CHW training varies in different countries depending on funding, support system, facilities and the broader socio-cultural context [3,20,21]. …”

Section: Discussionmentioning

confidence: 99%

“…CHW training, in turn, generally seeks to develop new knowledge and skills related to specific tasks and to increase CHWs’ capacity to communicate with and serve local people [3]. Improving access to basic training has also been found to be an important element of improving CHW retention [4].…”

Section: Introductionmentioning

confidence: 99%

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The experience of community health workers training in Iran: a qualitative study

Javanparast

Baum

Labonté

et al. 2012

BMC Health Serv Res

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BackgroundThe role of Community Health Workers (CHWs) in improving access to basic healthcare services, and mobilising community actions on health is broadly recognised. The Primary Health Care (PHC) approach, identified in the Alma Ata conference in 1978, stressed the role of CHWs in addressing community health needs. Training of CHWs is one of the key aspects that generally seeks to develop new knowledge and skills related to specific tasks and to increase CHWs’ capacity to communicate with and serve local people. This study aimed to analyse the CHW training process in Iran and how different components of training have impacted on CHW performance and satisfaction.MethodsData were collected from both primary and secondary sources. Training policies were reviewed using available policy documents, training materials and other relevant documents at national and provincial levels. Documentary analysis was supplemented by individual interviews with ninety-one Iranian CHWs from 18 provinces representing a broad range of age, work experience and educational levels, both male and female.ResultsRecognition of the CHW program and their training in the national health planning and financing facilitates the implementation and sustainability of the program. The existence of specialised training centres managed by district health network provides an appropriate training environment that delivers comprehensive training and increases CHWs’ knowledge, skills and motivation to serve local communities. Changes in training content over time reflect an increasing number of programs integrated into PHC, complicating the work expected of CHWs. In-service training courses need to address better local needs.ConclusionAlthough CHW programs vary by country and context, the CHW training program in Iran offers transferable lessons for countries intending to improve training as one of the key elements in their CHW program.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The experience of community health workers training in Iran: a qualitative study

Javanparast

Baum

Labonté

et al. 2012

BMC Health Serv Res

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“…The World Health Organization recommends the need for ongoing training activities with regular supervision and refresher training for CHWs [22].The lack of consistent supervision of PPFP activities among FCHVs identi ed in this study is also likely to affect sustainability of the intervention in years to come. The ongoing training activities have also been regarded as a neglected aspect of most training programs for CHWs in LMICs [23]. The United States Agency for International Development Health Care Improvement Project has recommended that CHWs should be updated every six months from their initial training to sustain the practice of their skills [24].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the long-term impact of Female Community Health Volunteer involvement in a postpartum family planning intervention in Nepal: a mixed-method study at 1 year post-intervention

Dhital¹,

Siwal²,

Pokhrel

et al. 2020

Preprint

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Background This is a 1-year post-intervention study following an initiative to provide orientation to female community health volunteers (FCHVs) on postpartum family planning (PPFP) in Nepal implemented in December 2018. Despite positive results in the earlier post-intervention study, this study was designed to provide a more long-term perspective on sustainability by assessing the effect at 1-year post-intervention. Methods This mixed-methods study was conducted in January 2020 in Morang district, Nepal. We collected quantitative data from a knowledge assessment of FCHVs who had participated in the intervention on PPFP; data on their community-based counseling coverage and through interviews with postpartum mothers in two selected hospitals. Qualitative data was collected through six key informant interviews with health providers working on PPFP and four focus group discussions with FCHVs involved in the intervention. We performed descriptive and multivariable analyses for quantitative data and thematic analysis for qualitative data. Results of 1-year post-intervention were compared with pre-intervention and earlier evaluation study results. Results In total, 206 FCHVs participated in the 1-year post-intervention knowledge assessment with a 15-fold [adjusted odds ratio (AOR) = 14.9, p < 0.001] increase in knowledge when compared with the pre-intervention phase. A 20-fold increase in knowledge (AOR = 20.4, P < 0.001) had been reported in the post-test conducted immediately after the orientation. The FCHVs counseled 71% of the pregnant women within their communities at 1-year post-intervention. The postpartum mothers in hospitals had 2 times higher odds than in pre-intervention phase of being counseled by FCHVs during their pregnancy at 1-year post-intervention (AOR = 1.9, P = 0.036) as compared to a 3-fold higher odds of being counseled at 2-months post-intervention (AOR = 2.9, P < 0.001). The qualitative findings suggested a positive impression regarding the FCHV's involvement in PPFP counseling in the communities, however, supervision and monitoring over the longer term was identified as a key challenge and may influence sustainability of community-based and hospital-based PPFP services. Conclusion The FCHVs’ knowledge and community-based activities on PPFP remained higher than in the pre-intervention phase. They had however declined when compared to the 2-months post-intervention period. We propose regular supervision and monitoring of the work of the FCHVs in order to sustain progress.

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“…CHWs, lay helpers, and fieldworkers often share the same ethnic, cultural, and social backgrounds as the communities they serve and usually come from the same communities [29–31]. A study by Li et al reviewed CHW training manuals in several countries and provided a guide to 22 manuals [33]. Literature on CHWs is extensive, though there are fewer studies that evaluate the effectiveness and experience of CHW-type training programs [34–37].…”

Section: Introductionmentioning

confidence: 99%

Unintended Benefits: Leadership Skills and Behavioral Change among Guatemalan Fieldworkers Employed in a Longitudinal Household Air Pollution Study

Kuo

Thompson

Lee³

et al. 2011

Int Q Community Health Educ

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The RESPIRE and CRECER studies measured the effects of reduced household air pollution (HAP) from wood-fired cookstoves on respiratory health in rural highland Guatemala. This article examines behavior change and leadership skill development in local community members who were hired as fieldworkers to assist with research. Fieldworkers administered household questionnaires, shared functions similar to community health workers, and bridged health resources to communities. A mixed-methods design for data collection (in-depth interviews, focus groups, impact drawings, knowledge questionnaire, and retrospective pre-test) was used. Purposive sampling included 10 fieldworkers and 13 local service providers. Fieldworkers showed an increase in knowledge, positive attitudes, and practices around HAP. They developed new technical, interpersonal, and leadership skills. Fieldworkers played a crucial role in building confianza (trust) with the community, bridging resources, and improving outside researchers’ relationships with locals. Recommendations for future researchers include inclusion of additional training courses and adoption of community participatory approaches.

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A Global Review of Training of Community Health Workers

Cited by 6 publications

References 7 publications

The experience of community health workers training in Iran: a qualitative study

The experience of community health workers training in Iran: a qualitative study

Evaluating the long-term impact of Female Community Health Volunteer involvement in a postpartum family planning intervention in Nepal: a mixed-method study at 1 year post-intervention

Unintended Benefits: Leadership Skills and Behavioral Change among Guatemalan Fieldworkers Employed in a Longitudinal Household Air Pollution Study

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