Abstract
BackgroundCommunity health workers (CHWs) hold potential to support universal health coverage and better health for vulnerable communities. They are integral to the re-engineered Primary Health Care (PHC) strategy, introduced in South Africa in 2011. This study focussed on how to train CHWs in large numbers, especially in resource-limited, rural settings. Skills2Care, a method of cooperative learning for CHWS, has been pioneered in the Eastern Cape of South Africa.AimTo determine whether Skills2Care could improve the cognitive knowledge of CHWs; to understand their response and attitude to the programme; to explore factors that enabled and inhibited learning and to consider its viability as a training method.SettingResearch was conducted in 2019 in the Ngqeleni subdistrict of the O.R. Tambo district, in rural Eastern Cape.MethodsA group-learning model using specifically tailored study modules in booklet format, addressing mother and baby care, was used. A facilitator promoted learning. Knowledge assessment was conducted by pre- and post-study testing using multiple choice questions. Focus group discussions and interviews explored the appropriateness and acceptability of this method, and factors enabling and inhibiting the learning.ResultsThis method of peer group cooperative learning can significantly increase the cognitive knowledge of CHWs. Test scores indicated a significant (13%) improvement. Focus group discussions indicated that participants valued this method as it increased knowledge and boosted their confidence.ConclusionThis innovative approach to district-based, continuing education suggests that CHWs could be trained in large numbers without the need for additional resources.
Highlights
Community health workers (CHWs), holding the potential to support universal health coverage, offer hope of better health for vulnerable communities.[1,2,3] They provide an opportunity for equitable access to safe, primary health services.[4]
The results indicate that most CHWs had good prior knowledge of maternal care, information related to human immunodeficiency virus (HIV) and exclusive breastfeeding, with pre-test scores of 80% or more
Community health workers are integral to health systems, and Primary Health Care (PHC) especially in low- and middle-income countries
Summary
Community health workers (CHWs), holding the potential to support universal health coverage, offer hope of better health for vulnerable communities.[1,2,3] They provide an opportunity for equitable access to safe, primary health services.[4]. Community health workers (CHWs), holding the potential to support universal health coverage, offer hope of better health for vulnerable communities.[1,2,3]. They provide an opportunity for equitable access to safe, primary health services.[4]. The systematic reviews indicated that training is necessary to improve CHWs’ motivation, and increase community confidence in their services.[1,2]. Community health workers (CHWs) hold potential to support universal health coverage and better health for vulnerable communities. They are integral to the re-engineered Primary Health Care (PHC) strategy, introduced in South Africa in 2011. Skills2Care, a method of cooperative learning for CHWS, has been pioneered in the Eastern Cape of South Africa
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