From an interventional study to a national scale-up: lessons learned from the Malakit strategy at the French Guiana–Suriname border

Introduction:An innovative and community-based intervention is implemented in the Guiana Shield to eliminate malaria among people involved in artisanal and small-scale gold mining. The intervention is possible in the field thanks to community health workers (CHWs) who are previously trained to master all intervention’s procedures, including training gold miners to treat themselves for malaria. This article describes thus a training-of-trainers (ToT) program for CHWs, as well as the method and results of its evaluation in terms of quality and effectiveness.Methods: A mixed-method case study was implemented in two steps and based on knowledge survey, satisfaction test, observations and semi- structured interviews. Quantitative and qualitative data were triangulated.Results: The project team’s previous experience and the Guiana Shield countries’ commitment to the WHO E-2025 initiative were identified as levers for the quality of the ToT training, while the complexity of the project context was a challenge. Group dynamics and adaptations were found to be central elements of a high-quality training program. CHWs’ satisfaction was elevated especially regarding training format and learning results. Improvements on knowledge level demonstrated good effectiveness of the training. Nevertheless, some difficulties persisted regarding certain tasks to be carried out by CHWs during the intervention procedure. Further on-the-job training permitted to address them, improving CHWs’ practices in the field.Discussion: High-quality, effective, and appropriate training programs are required for effective and sustainable intervention involving CHWs profiles. Training design is a crucial point to attend quality and effectiveness. ToT model has been shown to allow a high level of satisfaction, good learning results and satisfactory implementation in the field. Initial and continuing training is an indispensable continuum to sustain good practices in the field and CHWs’ motivation. Training evaluation permits to standardize methods and facilitate transferability of successful efforts.

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Training-of-trainers program for community health workers involved in an innovative and community-based intervention against malaria among goldminers in the Guiana shield: a quality and effectiveness evaluation

Carboni,

Maroto,

Galindo

et al. 2024

Front. Public Health

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IntroductionAn innovative and community-based intervention is implemented in the Guiana Shield to eliminate malaria among people involved in artisanal and small-scale gold mining. The intervention consists of the distribution of malaria self-management kits to goldminers and the presumptive treatment for individuals at risk of carrying Plasmodium vivax hypnozoites. The intervention is possible owing to community health workers (CHWs) who are previously trained to master all intervention procedures, including health education activities and goldmining training. This study aimed to evaluate the training program provided to CHWs in terms of quality and effectiveness.MethodsA training-of-trainers program for CHWs has been developed based on the CDC framework. A mixed-method case study was implemented in two steps between February and March 2023. The evaluation was based on a knowledge survey, satisfaction test, observations, and semi-structured interviews. Quantitative and qualitative data were analyzed and triangulated.ResultsA total of 20 CHWs participated in the training and the first-step evaluation. For the second step, four semi-structured interviews were conducted. The Qualitative data showed that group dynamics and adaptations were central elements of a high-quality training program. Quantitative analysis found that CHWs’ satisfaction was elevated (> 4/5 overall), especially regarding format and learning results. Improvements in knowledge level demonstrated good effectiveness (pre-training vs. post-training, p < 0.05). Nevertheless, some difficulties persisted regarding tasks of the intervention procedure, such as informed consent and smartphone application procedures (with an inaccuracy rate of 29.2% and 16.7%, respectively). Further on-the-job training permitted to address these issues. The project team’s previous experience and the Guiana Shield countries’ commitment to the WHO-E-2025-initiative were identified as levers for the quality of the training, while the complexity of the project context was a challenge.DiscussionHigh-quality, effective, and appropriate training programs are required for effective and sustainable interventions involving CHW profiles. Training design is a crucial point to address to accomplish quality and effectiveness. The training-of-trainers model has been shown to allow a high level of satisfaction, good learning results, and satisfactory implementation in the field. Initial and continuing training is an indispensable continuum to sustain good practices in the field and CHWs’ motivation. Training evaluation permits standardizing methods and facilitates transferability.

show abstract

From an interventional study to a national scale-up: lessons learned from the Malakit strategy at the French Guiana–Suriname border

Cited by 3 publications

References 13 publications

Cooperation for malaria control and elimination in the Guiana Shield

Cooperation for malaria control and elimination in the Guiana Shield

Training-of-trainers program for community health workers involved in an innovative and community-based intervention among goldminers in the Guiana Shield: a quality and effectiveness evaluation

Training-of-trainers program for community health workers involved in an innovative and community-based intervention against malaria among goldminers in the Guiana shield: a quality and effectiveness evaluation

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