Empowering community based health workers using simple local language content

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Empowering community based health workers using simple local language content

In recent years, a great deal of analysis has been carried out and numerous approach has been tested to examine the effectiveness of community health workers training towards achieving a quality health-care service delivery in rural communities.

Against the backdrop of health-care reform, policy makers and health systems leaders had initiated several efforts which aims to introduce a more compatible and easy-to-adapt training resources for Frontline Health Workers via chains of cost-effective mobile health tutorial applications.

Community Health Workers represents a significant figure in expanding the Universal Health Coverage in underserved communities, findings from the Global Health Workforce Alliance indicated that by providing adequate and quality training for CHWs will immensely contribute towards achieving the Sustainable Development Goals 4 and 5, improve maternal and child health.

Community Health Workers are extension of Frontline Health Workers who provide initial health consultations and low-cost medical services to the community residents. CHWs delivers high impact health interventions in a variety of areas such as vaccination, reproductive health, First Aid, and they help to restore closeness between community members and the formal health sector. However, applying the global strategic approach in fostering knowledge-based solutions for the next generation of Community Health Workers has inspired more focused innovative concepts which seek to provide additional educational and quality learning materials that will enhance the knowledge and skills of CHWs.

In 2015, InStrat Global Health Solutions in partnership with mPowering Frontline Health Workers, Medical Aid Films, and Digital Campus through a successful collaboration with Ondo State Primary Health-care Development Board launched a tablet-based training application for health workers in Ondo State Nigeria using ORB platform to promote the sharing and reuse of openly licensed health workers training contents. mPowering’s ORB platform connects Frontline Health Workers to mobile-ready training resources. The resources on ORB allows trainers and managers to help health workers refresh their knowledge, learn new information, and provide their communities with quality health-care services.

A reception was held in Washington DC on June 2016 to celebrate ORB’s first year, an ongoing assessment and evaluation of the initiative indicates that the program presents a unique way to provide information and resources for health workers training and may be a promising tool to support primary health-care development at scale. The government of Nigeria is pushing more investment into the health sector and have reassured their commitment to extend critical health needs to the rural health facilities across the nation. Simultaneously with this progress, the leadership of Ondo State Ministry of Health is integrating series of innovative solutions as part of their primary healthcare delivery design to achieve a quality health outcomes in the state–this ambition however, had stimulated a trusted public-private partnership which contributed to the ongoing success of the health workers video training in Ondo State.

The effort continues as new opportunities emerged; recently, ORB partners launched the video training program in two most widely spoken languages in Africa, Yoruba and Hausa. The aim is to leverage the benefits of local language to effectively utilize opportunities that will harness ORB potential. Provision of training resources in one’s own language helps to promote comprehensive learning by displaying the scenes in cultural norms and familiarities which support intuitive understanding. CHWs tends to acquire a deep knowledge of several medical conditions when training is translated into a local context which enables them to offer appropriate health solutions to the community.

 The challenges in maintaining an adequate health workforce that meets the social needs of the people and prepares enabling environment for a demographic, epidemiological and political transition require a sustained effort in addressing workforce planning, development and financing. In complementing this effort and pushing beyond limits some of these factors that supports CHWs proficiency, it’s vital and more essential to

  • Promote Learning Through Mother Tongue and Cultural Norms


Local dialects have a great value to optimize learning habits and helps CHWs to adopt a culminated study frequency. Designing health workers training in a native language will provide health-care-givers in rural settlement who acquire minimal formal education with a clear picture of specific health risk through a reflection of common social practices. Adapting training materials into a native language will also restore confidence between learning and understanding while engaging health workers with the communities where they work. Maternal language is generally spoken and widely accepted in the rural communities to retain history and maintain cultural values and sensitivity. Preparing these learning contents in a native tongue will enhance communication flow between CHWs and rural residents especially when giving a medical advice. This Approach has a measurable impact on the community health and practically tend to promote health ethics that is often translated to an improved health outcomes.

  • Discover How Community Health Workers Feel About These Innovations and Improvement.


Over the past decades, one could barely predict that Frontline Health Workers could successfully use a sophisticated mobile health application such as CliniPAK360 to collect essential patients’ demographic and digitize data reporting process in a primary healthcare settings. This innovation aimed to achieve quality and cost-effective healthcare delivery in the developing countries. Qualcomm Wireless Reach in collaboration with InStrat Global Health Solutions, Vecna Cares Charitable Trust and National Primary Health Care Development Agency were on the forefront of this innovative health intervention in Nigeria which ascertained the potential benefits of mHealth applications as a data capture tool in a low-resource settings. But one question that is often missing is “how does health workers feel about these changes and development?”,– there is a perception that the people in the rural communities do not fully benefit from the infrastructural development provided by the government, CHWs as part of the community are always proud and excited that these transformative initiative from the government and thought leaders were also extended down to the rural areas where there is a critical health challenges due to shortage of health workforce.

I could recall an amazing experience I had with a CHWs who expressed her appreciation over the ORB video training resource, she said

the government has introduced a new way for us to learn and become more efficient in our duties and we are happy about it, we wish that innovations like this will continue to happen, she concluded

She expressed sense of participation and enthusiasm in the equitable governance. Understanding that CHWs feel motivated with this transformative initiative will encourage sustainability planning and the government investment in rural health care reforms would be justified by the CHWs willingness to welcome new ideas and adopt new system for change.

  • Harness the Power of Information Sharing.

There are real-time benefits when appropriate information is collected and properly shared to improve evidence bases to support policy development, this framework enhances service delivery and allows circulation of resources for skill development. Inconsistent and inefficient data collection and information-sharing processes always result in knowledge gaps, but when data are freely available online under creative common licensing, it provides easier access and encouraged re-use of information which helps to raise awareness and trigger information campaign.  The revolution in Information and Communication Technologies (ICT) and the proliferation of mobile devices are helping to identify the potential benefits of information sharing. Around the world, health workers are using their phones to collect data, share video resources and exchange files with their colleagues and supervisors via mobile device connectivity. Enhancing this information sharing networks allows earlier identification of needs and could help to map service provision. CHWs can as well circulate the local language video training resources with their colleagues via peer-to-peer sharing to inform better understanding of specific health issues.

Quality data collection and proper information sharing could also prompt epidemiological alertness which would result in more responsive service and could enable targeted earlier intervention. A good example was shown in a survey conducted by InStrat Global Health and Anadach Group during the Ebola virus epidemic. The research demonstrated the effectiveness of electronic tutorial application in changing the knowledge and behavior of FLHWs to Ebola Virus. The outcome of the finding also proved that education intervention can help to increase awareness and knowledge of symptoms, causes and consequences of diseases to improve disease control and promote health care seeking behavior in populations.

  • Institutionalize the Process to Ensure Sustainability


The future promise of quality video training resources for FLHWs in native languages hopes that by institutionalizing the process will help to achieve sustainability. One of the key targets for designing different set of Community Health Workers programs is to accelerate further development of Primary Health Care Service delivery. Pointing at the roles which CHWs can play in achieving Sustainable Development Goals and Universal Health Coverage in low-income countries, –CHWs needs to be equipped with a set of skills and knowledge that would be essential to deliver early health interventions to the communities, thus helping to reduce the rate of preventable deaths.

 There is a need for a behavioral change in order to foster a community of purpose. Although, change do not occur instantaneously, but rather, a continuous process. The government needs to create accessible platform that will incorporate CHWs aptitude in the fight to reduce maternal and infant mortalities in sub-Saharan Africa. It’s vital to enlighten CWHs on the merit of these training resources to motivate and enable them maximize opportunities. Enabling government policy is necessary to adopt and promote this innovation across health institutions and faculties.  mPowering Frontline Health Workers article on the Global Content for Local Solution also broaden the scope and critical functions of Community Health Workers in rural-health care transformation. A local-buy-in from stakeholders and decision makers in the state will attract confidence and harmonize trust between CHWs, health care organizations, and the private sectors.

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