Reactions of community members regarding community health workers’ activities as a measure of the impact of a training program in Amazonas, Brazil

Abstract

Objectives: The aim of this study was to evaluate the impact of community health worker (CHW) training on recognition and satisfaction regarding the performance of CHWs among members of the community in Amazonas, Brazil, which is a resource-poor area underserved with regard to medical health-care accessibility.Methods: Baseline and endline surveys concerning recognition and satisfaction with respect to CHW performance among members of the community were conducted by interview using a questionnaire before and after implementation of a program to strengthen community health projects in Manicoré, Amazonas, Brazil. One of the components of the project was CHW refresher training, which focused on facilitating adequate use of health-care services and providing primary health care, including health guidance. The baseline survey was performed in February 2004 at the beginning of the project, and the endline survey was performed in February 2006 at the end of the project. There were 82 and 120 CHWs working in Manicoré at the times of the baseline and endline surveys, respectively. Statistical analysis was performed to determine the significance of changes in experience with CHW activities, expected functions of CHWs, and satisfaction regarding the performance of CHWs between the baseline and endline surveys. In addition, qualitative analysis was conducted to evaluate the acceptability, feasibility, and sustainability of CHW refresher training.Results: Overall recognition and level of satisfaction regarding CHW performance among members of the community were improved from the baseline to the endline survey, regardless of type of residential area, such as town and/or remote area. Members of the community came to not expect CHWs to “provide strong medicine” (P < 0.001) and “provide injections” (P < 0.001), and came to appreciate “go to hospital with a sick person” (P = 0.031) as a function and role of CHWs.Conclusions: The results of the present study indicated that steady approaches to motivate and support CHWs in resource-limited settings could improve performance of CHWs and satisfaction of people in the community regarding the activities of CHWs to sustain their health.

Community satisfaction with Enhanced Community Health Workers Activities in Mukono District, Uganda

“…Con rming sick persons in the community was positively associated with community satisfaction. This is similar to a study conducted in Brazil which revealed that community satisfaction was positively associated with con rming sick persons in the community [29]. Therefore, con rming sick persons should be incorporated among CHW programs to improve community satisfaction.…”

“…Monthly home visits were positively associated with community satisfaction. A study conducted in Amazonas, Brazil showed an increased community satisfaction with home visits (OR 26.66) [29]. Home visits enable community members come into contact with their community health workers and have been associated with improvement in maternal and child health [4,[30][31][32].…”

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

“…For example, Zeitz et al 65 reported on a 1-day refresher training course for CHWs that specifically focused on acute respiratory illness in children and used pretesting and post-testing of knowledge as the outcome measure of the training. This is in contrast with Kawasaki et al 48 , who carried out a 2-year study where CHWs received monthly refresher trainings, and the outcome measures were focused on behaviour change at the community level, for example, improved handwashing techniques and the number of household visits carried out by CHWs. This variation, both in terms of duration, structure and content focus, makes direct comparison between studies difficult (see online supplementary table 3 ).…”

Pemberdayaan Masyarakat Dalam Mengendalikan Diabetes Melitus Berbasis Budaya Lokal

“…Pelatihan sukarelawan kesehatan dapat meningkatkan pengetahuan dan keterampilan terkait promosi kesehatan serta meningkatkan motivasi dan kepercayaan diri (Tumbelaka et al, 2018). Selain itu, pelatihan kader juga meningkatkan kemampuan komunikasi bagi kader dan meningkatkan kepuasan terhadap peran sebagai kader (Nasir et al, 2013;Kawasaki et al, 2015). Keberlanjutan pelatihan kader kesehatan mampu meningkatkan peran kader dalam melakukan tugasnya (Kok et al, 2015).…”