Evaluation of global health capacity building initiatives in low-and middle-income countries: A systematic review

Naal, Hady; Koussa, Maria El; Hamouch, Melissa El; Hneiny, Layal; Saleh, Shadi

doi:10.7189/jogh.10.020412

Cited by 14 publications

(15 citation statements)

References 75 publications

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“…CHW are often able to develop good relationships with members of their communities, and therefore are able to deliver tailored and context-specific health education and related basic services [ 13 ]. A more robust understanding of the impacts associated with these capacity building initiatives will enable more effective training design and delivery, better allocation of resources, and ultimately improved health outcomes for refugees in the MENA region and other settings with similar development landscapes [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluating a capacity building program on women’s health for displaced community health workers in fragile settings in Lebanon

et al. 2021

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Background Displaced populations in fragile settings experience health disparities that are seldom attended to. Task-shifting, which involves training non-specialized community health workers (CHW) to deliver basic education and health services is a favorable strategy to address this problem, however very little data exist on this topic in the Middle East region. We conducted a long-term evaluation of the Women’s Health Certificate delivered to Syrian refugees and host community in informal tented settlements in Lebanon under the Mobile University for Health (MUH) program. The training was delivered through a mobile classroom approach that incorporated a blended learning modality. Methods We collected short-term data from the 42 trained CHW (knowledge assessments and satisfaction measures) during the delivery of the intervention between March and August 2019, and long-term data (semi-structured interviews with 8 CHW and focus group discussion with 9 randomly selected community members) one year later between July and August 2020. The evaluation approach was informed by the Kirkpatrick evaluation model, and the qualitative data were analyzed using qualitative content analysis. Results Data from the CHWs and community members were triangulated, and they showed that the training enhanced access to education due to its mobile nature and provided opportunities for CHWs to engage and interact with learning material that enhanced their knowledge and favorable behaviors regarding women’s health. In turn, CHWs were empowered to play an active role in their communities to transfer the knowledge they gained through educating community members and providing women’s health services and referrals. Community members benefited from the CHWs and called for the implementation of more similar training programs. Conclusion This is one of few studies reporting a long-term community-level evaluation of a task-shifting program on women’s health among displaced populations in Lebanon. Our findings support the need to increase funding for similar programs, and to focus on delivering programs for a variety of health challenges. It is also essential to enhance the reach and length of recruitment to wider communities, to design concise, interactive, and engaging sessions, and to provide tools to facilitate circulation of learning material, and resources for referrals to health services.

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Section: Introductionmentioning

confidence: 99%

Evaluating a capacity building program on women’s health for displaced community health workers in fragile settings in Lebanon

et al. 2021

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“…E-learning and blended learning are not yet commonly used in Africa. A recent systematic review of global health capacity building and evaluations in low- and middle-income countries (2009–2019) showed that despite a sharp recent increase in e-learning or blended courses during the last 4 years, most studies conducted in Africa documented face-to-face teaching modalities (75%) ( 23 ). The same review reported that evaluations, in general lacked standardization, especially regarding the tools, and only face-to-face initiatives were evaluated in the long term beyond the individual level ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review of global health capacity building and evaluations in low- and middle-income countries (2009–2019) showed that despite a sharp recent increase in e-learning or blended courses during the last 4 years, most studies conducted in Africa documented face-to-face teaching modalities (75%) ( 23 ). The same review reported that evaluations, in general lacked standardization, especially regarding the tools, and only face-to-face initiatives were evaluated in the long term beyond the individual level ( 23 ). Many evaluations are restricted to knowledge assessment through pre-and post-tests, which are indicative but limited ( 24 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Three Blended Learning Courses to Strengthen Health Professionals' Capacity in Primary Health Care, Management of Sexual and Reproductive Health Services and Research Methods in Guinea

Millimouno¹,

Delvaux

Kolié³

et al. 2022

Front. Digit. Health

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BackgroundThree blended courses on Primary Health Care (eSSP), Management of Sexual and Reproductive Health Services (eSSR), and Research Methods (eMR) were developed and implemented between 2017 and 2021 by the Maferinyah National Training and Research Center in Rural Health, a training and research institution of the Ministry of Health in Guinea. The study objectives were to evaluate the reasons for dropout and abstention, the learners' work behavior following the training, and the impact of the behavior change on the achievements of learners' organizations or services.MethodsWe evaluated the three implemented courses in 2021, focusing on levels 3 and 4 of the Kirkpatrick training evaluation model. Quantitative and qualitative data were collected through an open learning platform (Moodle), via an electronic questionnaire, during the face-to-face component of the courses (workshops), and at learners' workplaces. Descriptive statistics and thematic analysis were performed for quantitative and qualitative data, respectively.ResultsOut of 1,016 applicants, 543 including 137 (25%) women were enrolled in the three courses. Over the three courses, the completion rates were similar (67–69%) along with 20–29% dropout rates. Successful completion rates were 72% for eSSP, 83% for eMR and 85% for eSSR. Overall success rate (among all enrollees) ranged from 50% (eSSP) to 58% (eSSR). The majority (87%) of the learners reported applying the knowledge and skills they acquired during the courses through activities such as supervision (22%), service delivery (20%), and training workshops (14%). A positive impact of the training on utilization/coverage of services and increased revenues for their health facilities were also reported by some trainees.ConclusionThese findings showed fair success rates and a positive impact of the training on learners' work behavior and the achievements of their organizations.

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“…With regard to the weaknesses, most of the reviewed papers reflected short-term and generic descriptions of a given intervention with little to no report on short- or long-term evaluations or impact assessments. Although the political and social instability throughout FCASs prompts the implementation of short-term interventions, a follow-up strategy for assessing the feasibility, benefits, and impacts of such interventions is crucial as it informs future directions and contributes to the sustainability of capacity building projects [ 92 , 93 ]. The problem of sustainability for research in FCASs is primarily a matter of resources, as demonstrated by the major disparity in spending on research between HIC and LMICs.…”

Section: Discussionmentioning

confidence: 99%

Health research capacity building of health workers in fragile and conflict-affected settings: a scoping review of challenges, strengths, and recommendations

Mansour

Naal

Kishawi

et al. 2021

Health Res Policy Sys

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Background Fragile and conflict-affected settings (FCAS) have a strong need to improve the capacity of local health workers to conduct health research in order to improve health policy and health outcomes. Health research capacity building (HRCB) programmes are ideal to equip health workers with the needed skills and knowledge to design and lead health-related research initiatives. The study aimed to review the characteristics of HRCB studies in FCASs in order to identify their strengths and weaknesses, and to recommend future directions for the field. Methods We conducted a scoping review and searched four databases for peer-reviewed articles that reported an HRCB initiative targeting health workers in a FCAS and published after 2010. Commentaries and editorials, cross-sectional studies, presentations, and interventions that did not have a capacity building component were excluded. Data on bibliographies of the studies and HRCB interventions and their outcomes were extracted. A descriptive approach was used to report the data, and a thematic approach was used to analyse the qualitative data. Results Out of 8822 articles, a total of 20 were included based on the eligibility criteria. Most of the initiatives centred around topics of health research methodology (70%), targeted an individual-level capacity building angle (95%), and were delivered in university or hospital settings (75%). Ten themes were identified and grouped into three categories. Significant challenges revolved around the lack of local research culture, shortages in logistic capability, interpersonal difficulties, and limited assessment and evaluation of HRCB programmes. Strengths of HRCB interventions included being locally driven, incorporating interactive pedagogies, and promoting multidisciplinary and holistic training. Common recommendations covered by the studies included opportunities to improve the content, logistics, and overarching structural components of HRCB initiatives. Conclusion Our findings have important implications on health research policy and related capacity building efforts. Importantly, FCASs should prioritize (1) funding HRCB efforts, (2) strengthening equitable international, regional, and national partnerships, (3) delivering locally led HRCB programmes, (4) ensuring long-term evaluations and implementing programmes at multiple levels of the healthcare system, and (5) adopting engaging and interactive approaches.

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Evaluation of global health capacity building initiatives in low-and middle-income countries: A systematic review

Cited by 14 publications

References 75 publications

Evaluating a capacity building program on women’s health for displaced community health workers in fragile settings in Lebanon

Evaluating a capacity building program on women’s health for displaced community health workers in fragile settings in Lebanon

Evaluation of Three Blended Learning Courses to Strengthen Health Professionals' Capacity in Primary Health Care, Management of Sexual and Reproductive Health Services and Research Methods in Guinea

Health research capacity building of health workers in fragile and conflict-affected settings: a scoping review of challenges, strengths, and recommendations

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