Lecture 10B: Realities Back on the Job

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Del curso dictado por Johns Hopkins University

Training and Learning Programs for Volunteer Community Health Workers

30 calificaciones

Johns Hopkins University

Training and Learning Programs for Volunteer Community Health Workers

30 calificaciones

Curso 6 de 6 en SpecializationFoundations of Global Health

Volunteer community health workers (CHWs) are a major strategy for increasing access to and coverage of basic health interventions. Our village health worker training course reviews the process of training and continuing education of CHWs as an important component of involving communities in their own health service delivery. Participants will be guided through the steps of planning training and continuing education activities for village volunteers. The course draws on real-life examples from community-directed onchocerciasis control, village health worker programs, community case management efforts, peer educators programs and patent medicine vendor training programs, to name a few.

De la lección

Program Evaluation and Follow-Up

In this module, we will focus on evaluation, performance, and supervision. There will be a quiz covering lectures 9-10 after completing the lectures in this module.

Lecture 10A: Monitoring and Measuring Performance23:09

Lecture 10B: Realities Back on the Job6:09

Lecture 10C: Supervision Functions and Eﬀectiveness15:55

Lecture 10D: Overcoming Supervisory Challenges12:54

Lecture 10E: Continuing Education Revisited12:59

Conoce a los instructores

William Brieger, DrPH
Professor, Health Systems Program of the Department of International Health
Bloomberg School of Public Health

In Section B we want to look in

more detail about the realities back on the job.

What is the environment like, are people supportive

of the trainee in applying the new skills?

We found that application of new skills is not always easy.

Response from a trainee attending a workshop.

Every so often I run into people,

I run into someone from the workshop.

And though they are very positive about the trainee experience,

their organizations haven't changed, and they've reverted to their old patterns.

You can see that change is difficult.

Other people who had training programmes had comments.

After the workshop, i went back to my job with new

skills and insights and plans to make things happen in my agency.

It took only a couple of weeks for my bubble to burst.

I had changed, but the rest of my organization hadn't.

They were the same old creaky procedures, and the same red tape and petty rivalries.

These are frustrations that trainees meet. It's not unusual, as we said earlier.

Some people are jealous that they didn't have a chance to

go for the training program and they don't want to listen.

Everyone's busy.

You know, where have you been? We've had to take your work load.

They actually resent the person having gone.

Maybe the work load is so heavy that the trainee doesn't have a

chance to sit down and explain what he or she's learned and share.

Maybe the organization doesn't have proper staff meetings

and things like that where people can exchange ideas.

Maybe the supervisors had not been

consulted before person was sent for training

and they had no idea that the person would come back with new skills.

Maybe, although the training might have been organized around

a new national policy, for example, undergraded management of

childhood illness, maybe the person in charge of the

health center hadn't been informed of this new policy.

And doesn't understand what the person is expected

to do when they come back from the training.

So if we don't take into account these other, broader,

management issues, if we don't involve the various stakeholders in the

diagnostic and evaluation process, the trainees will become frustrated

and won't be able to apply what they've learned.

So what is a trainer to do?

And again, another comment.

As time went on, my plans schedules, new ideas slid away.

And I realized that I had slipped back

into my old attitudes and ways of doing things.

So, few trainers or training organizations in

developing countries are equipped to remedy these problems.

It's difficult to get out to sites.

It's difficult to get stakeholders involved.

It's difficult to, to reach a consensus.

I'm sure that even happens in, in in industrialized countries, too.

So we, need to ask, what is the trainer's responsibility?

What can the trainer do to address these issues that

are bound to come up, often times the trainers funding and

their responsibility ends with the

course evaluation. People are sent

from far and near around the country

and the trainers are ready to start a new round of recruitment people coming

in for the next year's course, so they often loose track

of what happens to the trainees.

There's often no mechanism for help, helping them, giving on-going

help, keeping in touch with the trainees and, it's not an easy task.

And the number of rural districts and a mountain less South

West corner of Uganda, you have to actually trek to the village.

It maybe an hour or more before you can reach and

find the village health worker you trained to see what has happened to him or her.

You know, are the resource available, the

time available to do that kind of followup.

Follow-up is often sporadic.

Some foresighted donors may supply follow-up visits to

assess the impact of the training a few months

or weeks later but these visits are the

exception and may tend to be a one-off event.

So the idea of developing a network interaction

among the trainees and trainers.

Again having a training function within your organization that follows

up on people and make sure they apply their skills.

This is often not thought about.

And so, you wind up repeating training over and over again.

People go to work shops, maybe

their transferred, maybe they become frusterated.

New people go and training becomes more of an

academic exercise than a way of building the organization's capacity.

Some different

options have been thought about to address these problems.

May I mention before that during the late 80s, early 90s,

CDC was working on child survival

activities throughout Africa and our centre

at the University of Ibadan in Nigeria was contracted to hold annual

workshops on Program Planning and Implementation

for health education and child survival.

What was built into that

was the need to visit at 6 months and then a year.

The trainees back in their home setting to find out if they had put their plan into

action, if they had learned about their planning skills,

if they were able to secure budgeting et cetera.

And so this follow up consultation as part of training was an important addition

because when you reach the field you

discover that the trainees may have had difficulty

figuring out the politics of their organization, the

procedures for getting plans approved, the budgeting procedures, etcetera.

And by being on-site, the consultant could help

them work through that, and get their plan accepted.

Another approach to having on-going support for trainees, is

the Management Sciences for Health, family house services project

in Nigeria.

They fostered the creation of a core group of trainers and consultants.

These people could follow up on the trainees,

so this was encouraged and, and was funded.

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