What HIFA2015 members say
Meeting the information needs of community health workers
Please find below highlights from messages sent on the HIFA2015 and CHILD2015 email forums. Profiles of contributing members are shown at the bottom of the page.
“Good primary health care rests on the foundation of well trained, well supervised, contented and effective community health workers.”
Nicholas Cunningham, USA 2010 Source
“The cadres most deprived of information are the Community Health Workers.”
Janet Adonga Acayo, Uganda 2009 Source
Understanding information needs
“The more we understand the [community health workers'] point of view the better able we are to create a nuanced training which makes sense to him and consequently the more he is able to ‘believe’ in it.”
Sengal Toumzghi, Eritrea 2010
“Text designed by literate people is often difficult to comprehend for low-literate/oral people, which goes beyond simply issues of dialect. Most material (which is written by literate people) needs to be fundamentally reworked to make it accessible for CHWs with limited literacy skills… For instance, it is much better to talk about a certain case of diarrhea as a narrative, rather than a bulleted list of danger signs. We’ve discussed this in detail in our paper.”
Jahanzeb Sherwani, Pakistan 2009
Synthesizing knowledge
“Where There Is No Doctor is currently translated in over 80 languages, and having been owned by over 3,000,000 Community Health Workers we are hoping to make the new book and on-line versions more adaptable and useful to the countries implementing primary health care through Community Health Workers. We look forward to participating in the efforts of HIFA2015 and HIFA2015 members that will inform and advise this new edition of the book.”
Alan Curtis (Curt) Wands-Bourdoiseau, USA 2009
“The Open University HEAT (Health Education and Training) team is currently working with 18 Ethiopian health specialists in Ethiopia to support the development of distance education learning resources for rural health workers… The modules currently under development are antenatal care, labour and safe delivery care, postnatal care and integrated management of newborn and childhood illness… All of the materials can be freely accessed, downloaded and versioned to make them relevant in different contexts.”
Lesley-Anne Long, UK 2010
“The National Rural Health Mission (NRHM) in India has recruited hundreds of thousands of Accredited Social Health Activist (ASHA) who are women selected from respective local communities… Experts have developed five printed modules for ASHAs as part of their capacity building program. The NRHM website provides full texts of these modules.”
Atanu Garai, India 2010
“Another problem, at least in several countries, is that in-service education of nurses and community health workers is rarely in local languages. In Tanzania, in 2003, at the community level they had only one book on vaccination practices in Kiswahili, and it dated from 1987. Rural nurses and physicians usually can struggle through English or French texts (if they’re lucky enough to ever get one), but they need teaching materials in local languages. This would allow them to train community health workers and nurse aids, and also get out new health information to local community members.”
Tom O’Connell, USA 2006
“The Palliative Care Toolkit - Improving care from the roots up in resource-limited health settings - A manual meeting the training and leaning needs of community health care workers globally. Responding to the call for on line learning material for medical assistants and nurses and learning material for community health workers this manual demistifyies palliative care. It teaches all the elements essential in that care and how to integrate palliative care into what is already in place particularly home based care.”
Ruth Wooldridge, UK 2010
Making knowledge available
“That is a bold move by Rwandese Government [commitment to provide mobile phones to all community health workers]. Somehow somewhere someone would take the first initiative and am not surprised that it comes from the techno-savvy government of Rwanda. The phones will offer the platform upon which to bridge the Know-Do Gap.”
John Arudo, Kenya 2010
“In our project HealthLine: www.cs.cmu.edu/~healthline — the basic idea is that the CHW uses any phone to call a phone number, at the other end of which is an automated system that is able to understand and speak in the CHW’s local language — and through a conversation with the system, she gets access to the health information she needs. The following video summarizes this approach.”
Jahanzeb Sherwani, Pakistan 2009
Applying knowledge
“1. Select CHW’s for honesty and for caring, nurturing attributes (relatively untrainable!) as well for trainability.
2. Minimize protracted off site training in favour of modular skill training…
3. Make sure the trainers are regularly exposed to life in the bush or barrio, and know how to listen and learn as well as talk…
4. Don’t just talk about good practice but give the CHW’s practice in well run primary care clinics; immerse them there, so that they experience success firsthand…
5. Insist on positive supervision integrated with further modular training for each new skill, after they’ve demonstrated competence in prior acquired skills.
6. Concentrate the provision of career ladder opportunities on those CHW’s with the education, smarts, motivation and demonstrated leadership capacity to make use of same…
7. Make sure that CHW’s remain answerable to both their constituencies: the professionals responsible for the quality of the care they provide, and to the children, parents, and communities whom they serve…”
Nicholas Cunningham, USA 2010
Contributors
Below are the signature profiles of HIFA members at the time the message was sent.
JANET ADONGA ACAYO is a Public Health Specialist (Masters in Community Health) working with local community on improving health care in villages in Gulu/Amuru District, Northern Uganda. This district has just come out of war by Lords Resistance Army and people are just returning home. Janet aims to start mobilisation and awareness creation on public health in her Village and would be grateful for materials to help. She has experience with community based health care in the local community through participatory approach.
JOHN ARUDO is Regional Research Co-ordinator at the Aga Khan University, Nairobi, Kenya.
NICHOLAS CUNNINGHAM is Emeritus Professor of Clinical Pediatrics & Clinical Public Health at Columbia University, New York, USA. He is interested in International Primary Maternal and Child Health Care… community owned, professionally overseen, and supported by $/power interests, encorporating integrated cure/prevention, midwifery/child care, child saving/child spacing, nutrition/infection, health/education (especially female), monitored but not evaluated for at least 5-10 years, based on methods pioneered by David Morley at Imesi (Nigeria) and by the Aroles at the Jamkhed villages in Maharashtra State in India.
ATANU GARAI is a Senior Consultant - Business Analysis, Srijan Technologies, Bhubaneswar, India.
LESLEY-ANNE LONG is Director, Health Education and Training (HEAT) in Africa, and is a Barrister at the Faculty of Health & Social Care, The Open University, Milton Keynes, UK.
TOM O’CONNELL is a health policy consultant based in Princeton, USA, and formerly a member of staff of the WHO. His experiences include working with EPI and GAVI, the WHO’s efforts to implement the findings of the Commission of Macroeconomics and Health, and with the Roll Back Malaria Partnership Secretariat. Consultancies include work with UNICEF, SIGN, GAVI and the World Bank. A Registered Nurse, Tom has a MBA and a MSc in Economics of Development. His areas of interest include expanding access to health services within a framework of poverty reduction, human rights and social justice.
TOUMZGHI SENGAL is a program manager in health and nutrition with Vision Eritrea, Asmara, Eritrea. Vision Eritrea is a national NGO that strengthens community based health care delivery system with the training of community health workers in C-IMCI (Community Integrated Management of Childhood Illness). Toumzghi trained in Northeastern University Boston and had been practising in USA.
JAHANZEB SHERWANI is Adjunct Faculty at Carnegie Mellon University, and is based in USA and Pakistan. His professional interests include speech interfaces for oral (low-literate) users, and health information access by community health workers. He is currently working on a project called HealthLine: www.cs.cmu.edu/~healthline
ALAN CURTIS (CURT) WANDS-BOURDOISEAU is Project Manager of The New “Where There Is No Doctor”, Hesperian - Publishing for Community Health and Empowerment, Berkeley, CA, USA. www.hesperian.org
RUTH WOOLDRIDGE works in a voluntary capacity with Palliative Care Works, UK. She is interested in developing palliative care globally and particularly in resource limited health settings.
Acknowledgement: Our thanks to HIFA2015 volunteer Emma Shillam for help in preparing this web page.
