A Global Review of Training of Community Health Workers

Li, Virginia C.; Goethals, Peter R.; Dorfman, Sharon L.

doi:10.2190/d65x-daqk-27dv-5kwk

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…These interventions may include mentorship and supportive supervision [33, 40]. Refresher trainings held regularly after the initial training may also improve practice [41, 42]. The suboptimal performance scores also may reflect workload challenges: given limited time with each caregiver, health workers may have prioritized some counseling items over others.…”

Section: Discussionmentioning

confidence: 99%

Does health worker performance affect clients’ health behaviors? A multilevel analysis from Bangladesh

Epstein

Moucheraud

Sarma

et al. 2019

BMC Health Serv Res

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Background Suboptimal healthcare quality may be a barrier to achieving child health improvements, yet little is known about the relationship between provider compliance with evidence-based practices and client behavior change. We assess provider compliance in the context of infant and young child feeding (IYCF) counseling, its relationship with client IYCF behaviors in Bangladesh, and explore its potential determinants. Methods We use data from a 2017 evaluation of an IYCF program that includes a health worker survey ( n = 74), caregiver survey ( n = 232), and direct service observation checklists of counseling sessions ( n = 232 observations of 74 health workers). We assess the relationship between provider compliance with recommended IYCF counseling topics and behaviors (standardized to a 100-point scale) and three reported IYCF behaviors among clients using multi-level models with random effects at the health worker and sub-district (sampling) levels. We also evaluate whether health worker self-efficacy, satisfaction, and technical knowledge are associated with provider compliance. Results Health worker compliance was significantly associated with reported exclusive breastfeeding for children under 6 months of age (adjusted odds ratio per 1 percentage point increase in counseling compliance score = 1.06, 95% CI 1.01, 1.12) and marginally associated with minimum dietary diversity (adjusted odds ratio per 1 percentage point increase in counseling compliance score = 1.05, 95% CI 1.00, 1.11). Counseling compliance was significantly and positively associated with both health worker self-efficacy and technical knowledge. Conclusions We find evidence for an association between health worker compliance and client health behaviors; however, small effect sizes suggest that behavior change is multifactorial and affected by factors beyond care quality. Improvements to technical quality of care may contribute to desired health outcomes; but policies and programs seeking to change health behaviors through counseling may also wish to target upstream factors such as self-efficacy, alongside technical skill-building and knowledge, for maximum impact. Electronic supplementary material The online version of this article (10.1186/s12913-019-4205-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Does health worker performance affect clients’ health behaviors? A multilevel analysis from Bangladesh

Epstein

Moucheraud

Sarma

et al. 2019

BMC Health Serv Res

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“…Table (1) shows the socio-demographic characteristics of health workers, according to the age group ranging from (20-56) years old, the highest percentage (51.4%) were in age (20)(21)(22)(23)(24)(25)(26) years and the lowest percentage (2.1%) in age group ≥49 years. In addition, there is a significant difference among age groups (F=160.5, df=4 and p-value =0.001).…”

Section: Socio-demographic Characteristic Of Health Workersmentioning

confidence: 99%

“…There is also a significant difference between the educational level and years of experience where the p-value (0.001) due to the fact that the number of years of study is inversely proportional to the years of experience where the more years of study (the higher the educational level) leads to fewer years of work (experience) in the hospital. (26,27).…”

Section: Socio-demographic Characteristic Of Health Workersmentioning

confidence: 99%

Evaluation of the knowledge toward communicable diseases prevention among health workers at In Al-Sadr Medical City in Najaf Governorate\ Iraq

Alshamarti

Farid

Ibadi

et al. 2022

ijhs

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Communicable diseases represent a severe burden on human life, so control and prevention are essential to maintaining the sustainability of life. Health workers are the first line of defense against these diseases. Poor knowledge and wrong attitudes of health workers can negatively affect efforts to combat infection.The study aims to evaluate the knowledge levels among health workers toward communicable diseases. Also, determine the relationship between dependent and independent variables with participants' levels of knowledge. A cross-sectional analytical study in Al-Sadr Medical City, Najaf Governorate, from mid-November 2021 to the end of June 2022. On 384 health workers who were using a randomly collected self-questionnaire, the data was collected and analyzed using a statistical program. The main results indicate that (66.1%) of the participants are females, the majority of the age group (20-26) years, half of them are married and hold a bachelor's degree, (66.4%) have less than five years of experience, and (35.9%) receive a training course, In terms of profession, (27.3)% were nurses. The results show that (57.2%) had good overall knowledge. it was found that there is a significant relationship between knowledge and training sessions, as for other socio-demographic characteristics, there is no significant association with both knowledge.

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“…The lack of consistent supervision of the activities among FCHVs identified 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 community health workers in low-and middle-income countries [ 20 ]. The United States Agency for International Development Health Care Improvement Project has recommended that community health workers should be updated every six months from their initial training to sustain the practice of their skills [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the impact of female community health volunteer involvement in a postpartum family planning intervention in Nepal: A mixed-methods study at one-year post-intervention

Dhital

Silwal²,

Pokhrel³

et al. 2021

PLoS ONE

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Introduction This is a one-year post-intervention study following an initiative to provide orientation to female community health volunteers (FCHVs) on postpartum family planning in Nepal. In light of 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 one-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 postpartum family planning, data on their community-based counseling coverage and through interviews with postpartum mothers in two selected hospitals. Qualitative data were collected through six key informant interviews with health providers and four focus group discussions with FCHVs involved in the intervention. We performed descriptive and multivariate analyses for quantitative data and thematic analysis for qualitative data. Results In total, 206 FCHVs participated in the one-year post-intervention study with significant improvement in knowledge of postpartum family planning as compared to pre-intervention period. The adjusted odds ratios (AOR) for knowledge of the 5 key messages on postpartum family planning as compared to the pre-intervention period included 1) knowledge on postpartum family planning can be used immediately after birth (AOR = 18.1, P<0.001), 2) postpartum intra-uterine device (PPIUD) can provide protection up to 12 years (AOR = 2.9, P = 0.011), 3) mothers who undergo cesarean section can use PPIUD (AOR = 2.3, P<0.001), 4) PPIUD can be inserted immediately after birth (AOR = 6.2, P <0.001), and 5) women should go for follow-up immediately if the IUD strings are seen outside vulva (AOR = 2.0, P = 0.08). The FCHVs answering 4 or more questions correctly was 10 times higher (AOR = 10.1, P<0.001) at one-year post-intervention, whereas it was 25 times higher at immediate-post-test (AOR = 25.1, p<0.001) as compared to pre-intervention phase. The FCHVs had counseled 71% of the pregnant women (n = 538) within their communities at one-year post-intervention. The postpartum mothers in hospitals had a 2 times higher odds of being counseled by FCHVs during their pregnancy at one-year post-intervention (AOR = 1.8, P = 0.039) than in pre-intervention phase. The qualitative findings suggested a positive impression regarding the FCHV’s involvement in postpartum family planning counseling in the communities, however, supervision and monitoring over a longer term was identified as a key challenge and that may influence sustainability of community-based and hospital-based postpartum family planning services. Conclusion The FCHVs’ knowledge and community-based activities on postpartum family planning remained higher than in the pre-intervention. However, it declined when compared to the immediate post-intervention period. We propose regular supervision and monitoring of the work of the FCHVs to sustain progress.

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A Global Review of Training of Community Health Workers

Cited by 7 publications

References 8 publications

Does health worker performance affect clients’ health behaviors? A multilevel analysis from Bangladesh

Does health worker performance affect clients’ health behaviors? A multilevel analysis from Bangladesh

Evaluation of the knowledge toward communicable diseases prevention among health workers at In Al-Sadr Medical City in Najaf Governorate\ Iraq

Evaluating the impact of female community health volunteer involvement in a postpartum family planning intervention in Nepal: A mixed-methods study at one-year post-intervention

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