Improving the performance of community health workers in humanitarian emergencies: a realist evaluation protocol for the PIECES programme

Gilmore, Brynne; Adams, Ben; Bartoloni, Alex; Alhaydar, Bana; McAuliffe, Éilish; Raven, Joanna; Taegtmeyer, Miriam; Vallières, Frédérique

doi:10.1136/bmjopen-2016-011753

Cited by 22 publications

(31 citation statements)

References 51 publications

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“…Using measures of behaviour change to evaluate the effectiveness of ongoing training is a welcome move towards ensuring meaningful programme evaulation 79 80 ; however researchers and programme managers should be aware of the multiple confounding variables that could influence these behaviours, such as the Hawthorne effect, and the difficulty in assessing these practices longitudinally, as well as the need to approach programme evaluations from a complex interventions standpoint. 81 …”

Section: Discussionmentioning

confidence: 99%

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

O’Donovan

Kuhn

et al. 2018

BMJ Open

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ObjectivesUnderstanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs.DesignSystematic scoping review.Data sourcesMEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC.Study selectionOriginal studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies.ResultsThe scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8).ConclusionsThis scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective.

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Section: Discussionmentioning

confidence: 99%

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

O’Donovan

Kuhn

et al. 2018

BMJ Open

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“…Other less-resourced community-based health workforce literature has recognised the need for context-specific investigations using theory-driven methodologies [ 33 , 90 – 92 ]. In their 2012 systematic review on CBR alternative cadres, Mannan and colleagues highlighted a dearth of studies in this area, with existing resources having contextually specific programmes limiting their ability to synthesise findings [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

A study of human resource competencies required to implement community rehabilitation in less resourced settings

et al. 2017

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BackgroundIt is estimated that over one billion persons worldwide have some form of disability. However, there is lack of knowledge and prioritisation of how to serve the needs and provide opportunities for people with disabilities. The community-based rehabilitation (CBR) guidelines, with sufficient and sustained support, can assist in providing access to rehabilitation services, especially in less resourced settings with low resources for rehabilitation. In line with strengthening the implementation of the health-related CBR guidelines, this study aimed to determine what workforce characteristics at the community level enable quality rehabilitation services, with a focus primarily on less resourced settings.MethodologyThis was a two-phase review study using (1) a relevant literature review informed by realist synthesis methodology and (2) Delphi survey of the opinions of relevant stakeholders regarding the findings of the review. It focused on individuals (health professionals, lay health workers, community rehabilitation workers) providing services for persons with disabilities in less resourced settings.ResultsThirty-three articles were included in this review. Three Delphi iterations with 19 participants were completed. Taken together, these produced 33 recommendations for developing health-related rehabilitation services. Several general principles for configuring the community rehabilitation workforce emerged: community-based initiatives can allow services to reach more vulnerable populations; the need for supportive and structured supervision at the facility level; core skills likely include case management, social protection, monitoring and record keeping, counselling skills and mechanisms for referral; community ownership; training in CBR matrix and advocacy; a tiered/teamwork system of service delivery; and training should take a rights-based approach, include practical components, and involve persons with disabilities in the delivery and planning.ConclusionThis research can contribute to implementing the WHO guidelines on the interaction between the health sector and CBR, particularly in the context of the Framework for Action for Strengthening Health Systems, in which human resources is one of six components. Realist syntheses can provide policy makers with detailed and practical information regarding complex health interventions, which may be valuable when planning and implementing programmes.Electronic supplementary materialThe online version of this article (10.1186/s12960-017-0240-1) contains supplementary material, which is available to authorized users.

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“…In addition to knowledge and skills, the participants also paid attention to work experience. Lack of work experience leads to a lack of self-esteem and self-confidence among health personnel in their ability to use their knowledge of care and academic skills in health education (35). According to previous studies, health care is a profession based on science and practice, and clinical internships play a major role in the development of health professionals' skills in the field of psychomotor learning goals.…”

Section: Discussionmentioning

confidence: 99%

Exploring the Experiences of Health Care Providers Regarding Their Perceived Abilities in Delivering Health Education: A Qualitative Study

et al. 2019

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Background: How health care providers perceive their capabilities affects their performance of their educational duties. Objectives: The present study was conducted on health and treatment staff to explain the experiences of health care providers regarding their perceived capabilities in delivering health education. Methods: The present study is a qualitative study with a conventional content analysis approach, which was conducted in different environments, including hospitals, doctors' offices, and health centers in Isfahan, Iran, using purposive sampling in 2017 -2018. Thirty-two participants with an average experience of 8 years of work in health centers took part in this study. The data were analyzed using the MAXQDA software simultaneously with data collection. Results: Two themes emerged: (1) the ability to gain the audience's trust, with the two main categories of personal characteristics and communication skills, and (2) professional capabilities with the two main categories of attitude to the profession and professional conversance. Some subcategories of both themes acted as both augmenting and diminishing factors affecting the perceived capabilities of the health care providers. Conclusions: An individual has about his own personal characteristics, communication skills, and professional capabilities, which play central roles in the formation of their self-concepts. By enhancing these two factors via interventions based on the findings of such qualitative studies, the health care providers' self-concept related to health education can be improved.

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Improving the performance of community health workers in humanitarian emergencies: a realist evaluation protocol for the PIECES programme

Cited by 22 publications

References 51 publications

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

A study of human resource competencies required to implement community rehabilitation in less resourced settings

Exploring the Experiences of Health Care Providers Regarding Their Perceived Abilities in Delivering Health Education: A Qualitative Study

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