Continuing education. Putting principles into practice
Kortmann, G.
Healthaction 1994(8): 8-9
1994
ISSN/ISBN: 0886-1986 PMID: 12222411 Document Number: 284726
Community health workers (CHWs) have the largest range of responsibilities and duties of all health workers. They promote health, provide health care, and facilitate community change through the implementation of new programs. Whereas, in order to achieve these goals, CHWs need access to lifelong education, many programs are vertical in nature and impose teaching methods and strategies on CHWs instead of trying to respond to their needs. CHWs also suffer from poor pay and substandard living and working conditions. The motivation of CHWs through continuing education can be enhanced by 1) determining their needs, 2) providing supportive workplace supervision, and 3) providing refresher courses and different forms of assessment. In India, Social Action for Rural and Tribal Inhabitants of India (SARTHI) began a woman's health project in 1987 in the Panchmahals district of Gujarat. This district was underserved by primary health care centers, and most deliveries were aided by traditional birth attendants (TBAs). SARTHI identified and interviewed the TBAs to assess their beliefs, methods, and lives. The group then set up appropriate short training modules which respected the fact that the TBAs had responsibilities for child care, domestic work, and agricultural work and were completely illiterate. An initial 8-day program was followed by 4-day training modules every 2 months. Different approaches were adapted as suitable. Supervisory visits were devoted to a discussion of current work and to problem-solving with the goal of having the TBAs take the initiative in problem-solving. In another training program in Nigeria, continuing education is an integral part of the training and support for TBAs. Supervisors provide monthly updates and reviews, and 3-5 day refresher courses are scheduled annually. The supervisors 1) encourage TBAs to maintain safe and hygienic work practices and refer complex cases to health facilities, 2) help TBAs solve problems, 3) encourage TBAs to attend meetings and refresher courses, and 4) monitor TBA activities to evaluate the programs and the individuals.