Abstract
Background. Use of community health workers (CHWs) to increase access to diagnosis and treatment of malaria is recommended by the World Health Organization. The present article reports on training and performance of CHWs in applying these recommendations.Methods. Two hundred seventy-nine CHWs were trained for 3–5 days in Burkina Faso, Nigeria, and Uganda, and 19 were certified to diagnose and treat only uncomplicated malaria and 235 to diagnose and treat both uncomplicated and severe malaria. Almost 1 year after training, 220 CHWs were assessed using standard checklists using facility staff responses as the reference standard.Results. Training models were slightly different in the 3 countries, but the same topics were covered. The main challenges noticed were the low level of education in rural areas and the involvement of health staff in the supervision process. Overall performance was 98% (with 99% in taking history, 95% in measuring temperature, 85% for measuring respiratory rates, 98% for diagnosis, 98% for classification, and 99% for prescribing treatment). Young, single, new CHWs performed better than their older, married, more experienced counterparts.Conclusions. Training CHWs for community-based diagnosis and treatment of uncomplicated and severe malaria is possible with basic and refresher training and close supervision of CHWs’ performance.Clinical Trials Registration. ISRCTRS13858170.
Highlights
Use of community health workers (CHWs) to increase access to diagnosis and treatment of malaria is recommended by the World Health Organization
Community health workers (CHWs) constitute an important resource in improving maternal and child health, when trained to bridge the gap in access to care in areas where formal health services are distant or limited [1, 2]
When well trained, supervised, and supported, CHWs have demonstrated reductions in severe malaria and mortality in their communities [3, 4]. Such has been their success that global malaria control recommendations encourage their use to reduce malaria morbidity and mortality [5, 6]
Summary
Two hundred seventy-nine CHWs were trained for 3–5 days in Burkina Faso, Nigeria, and Uganda, and 19 were certified to diagnose and treat only uncomplicated malaria and 235 to diagnose and treat both uncomplicated and severe malaria. The study was conducted in rural malaria-endemic areas of Burkina Faso, Nigeria, and Uganda, as a component of a larger study to evaluate access to diagnostics and antimalarials provided by CHWs in their communities [7]. Thereafter, CHWs (and the inventory controller at the health facility in Burkina Faso) were trained by trainers. The training was conducted in the local languages Yoruba in Nigeria; English, Luganda, and Lunyankole in Uganda; and French and Dioula in Burkina Faso (see Supplementary Tables 1–5 for more details)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
