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.
Lecture 6C: Developing and Using Educational Materials/Aids
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Do curso por Johns Hopkins University
Training and Learning Programs for Volunteer Community Health Workers
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Selecting Training Methods, Materials, and Resources
In this module, we will focus on a variety of methods, training logistics, and educational materials. There will be a quiz that covers lecture 5-6 to after completing these lectures in this module.
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William Brieger, DrPHProfessor, Health Systems Program of the Department of International Health
Bloomberg School of Public Health
In the final section where we're talking about all materials and logistics that we
need, we'll talk specifically about how we
can develop our own educational materials and aids.
So we mentioned this can help us save money,
but more importantly, it can help make things culturally appropriate.
Various kinds of educational materials and aids are needed to support training.
These are not actually training methods themselves, they're supported materials.
We can see an example here of a simple guide book on how to manage
children with fever that was produced locally
in Nigeria to give to patent medicine vendors.
So they would know which drugs were appropriate,
how to recognize if the child had malaria.
An exception to
the idea of printed materials being a
support to training, if we actually provide a
reading packet, where people can read on their
own, that is actually a training method itself.
And this allows for self-study.
In the evenings, if people aren't enjoying themselves and
relaxing, but also particularly to take home for self study.
Again, materials and methods, it's important to distinguish that
materials support the learning process, they provide tangible take-home reminders.
Here we have an example of a handbill
that can help health workers remember oral rehydration therapy.
Now, we can also, instead of developing in printed materials and modern
materials, we can also look into the issue of indigenous or local media.
Fables and stories are important for learning.
This is how people in the village learn, by
listening to the grandparents tell stories in the moonlight.
The picture we have here is an old story about the tortoise and the elephant.
The tortoise figures into
a number of African fables.
Tortoise is a, is a tricky and cunning character.
The people in the village were upset because the elephant was
destroying their crops and was causing a lot of havoc and noise.
And so they decided they wanted to get rid of the elephant.
But the they sent people out to the forest, and
the elephant was very clever, and was able to avoid them.
But they knew the tortoise, being a
cunning person, if anybody could capture the
elephant, the tortoise could.
So the villagers dug a big pit and then they
sent the tortoise out to lure the elephant into the town.
So what the tortoise did was to go with a basket of fried bean cakes and a drum.
And made a lot of noise and singing and said, the people in
the village want to make you, Mr. elephant, the king of the village.
And the elephant was astonished and he said, oh, I'm, I'm so happy.
And he then started giving the elephant these fried bean cakes
and singing the elephant's praises and marching back into the village.
And by the time the elephant got close to
the village, the people jumped out from the bush.
He was frightened and fell into the pit.
It doesn't do good for conservation, but at least it is a
way of giving stories about how we can develop trust, or not trust.
If we're talking about health workers, health
workers shouldn't trick the patients, et cetera.
But these kinds of stories exist, and we need
to find them out and take advantage of them.
This is why again, it's important to have training
committees because if you involve the trainees and local community
members in the process, they can think of these
things and include them as part of the training materials.
Stories are an important example of indigenous media.
Not just the fables themselves that had been told for
generations but making up stories, people are good at that.
For example, there were two farmers, and one of them would always carry a small
keg of water from the well at home when he went out to the field.
Whereas the other one said, oh, I'm too tired, I
can't be bothered, and would just drink water from the stream.
Then, of course, the story goes
on further, how the one farmer who didn't carry his water got guinea worm,
et cetera, and people can learn from
that, especially in low literacy training sessions.
It's important also not just to tell the
story, or tell the fable, or give the proverb.
But afterwords, engage the, the audience and ask them
what they have learned, what was important about this.
And ask them for their own examples of stories and proverbs.
And emphasize again, if we're talking about village health workers, that their
role as a health educator can be enhanced if they use these methods.
So the trainer, in fact, is modeling the role.
That the trainees will perform in terms of
health education when they get back to the village.
Here again, we can see the story of
the two farmers, Gani and Taofiq had adjoining farms.
Gani used to carry the small jug of water to his farm.
And again, we can even use local pictures.
We can draw pictures to show as the story goes along in terms of a flip chart.
This draws more attention. And this again, we could make ourselves.
Usually we can find a teacher or somebody in the village who can draw.
Taofiq said, why bother to carry the extra load?
There's a nice cool pond under the trees between our farms.
After some time, Taofiq would drink the pond water every day.
A year later, Gani didn't see Taofiq out in the field, but he found
him sitting under that, supposedly, cool tree,
and he was was suffering from guinea worm.
We can see in the picture, again to help emphasize the story.
At the end of the story,
as we said, it's important to have discussion,
ask people what they've learned from the story, what
are the points of the story, how they
could use the story when they go back home.
You shouldn't be afraid to draw your own materials.
Get them photocopied locally.
Because this not only saves time and
money, but it can reflect the local culture.
Here we have a handout that was given to the Guinea Worm surveillance workers.
It shows the, not necessarily in the right perspective, but the
Guinea Worm field staff coming out on his motorcycle to check
the chief of the village and ask how everyone is doing
in village and whether there are any cases of Guinea Worm.
Trainees can be involved in designing their own materials.
This is an example of a story flip chart that was
developed by high school students who were selected as peer educators.
One of our MPH students in Nigeria had background
in graphic arts, and he got the students to
tell various stories and problems that they had about
the sexually transmitted diseases, and
sexual harassment, reproductive health problems.
And so they put together
this story.
And then they said, okay, well how, how are we going to illustrate this?
What should we show in the pictures?
So they told him, he did rough sketches, and they corrected him.
And back and forth until the artist finalized the pictures.
And they were happy with it. It reflected their story.
So, on the back of each picture was part of the story.
So one of the peer educators could be reading
the story while the audience would look at the pictures.
So far, we've talked about different kinds of
educational materials that can be used in training.
And the trainees can then use in the community.
Some of these things can be locally made by trainees and programs themselves.
Some are produced, at a national or a state level.
Or by NGOs and this obviously this production is a bit costly.
and we need to think about
before we spend money on developing these kinds of materials that will be
used either during training or used by the trainees afterwards is, are they effective
so we really need to pretest them with sample audience of the kind of
people who would be seeing them in the community, to see if they work.
If they pass on the information and messages that we hope, and
of course even with the trainees themselves, if
they are shown a poster Do they understand it?
Do they, does it convey the information?
Do they feel comfortable using it?
So this is an example of a page in a flip chart that was being used to
train community volunteers, and also then using it with
community members to teach them about Guinea Worm Disease.
Which, as you can see in the
man's foot, there's a worm coming out of his leg, expelling larvae.
You really can't see the larvae that well.
You can use a little hand lens or a magnifying glass
and see them in the water, if you, you know, are lucky.
But the point is that they were trying to show in this picture that if your
leg, where the Guinea worm has come out,
gets in contact with water, the disease will spread.
Now, showing this to people, this was
already produced, they had already spent money
on it, and we found that, that
people, the village health workers were asking questions.
Well, why is this man sitting in the water?
What is he doing sitting there?
Why would anybody be doing that?
what's wrong with him, his skin is so black he must have, either
have another disease, or maybe he's been working too hard under the sun.
Something's not normal about this man.
And so they were more distracted by the unusual nature of the
picture, than you know, the message that was trying to get across.
So this was money.
That could've been better spent if the pretesting had been done
and we got feedback from the village volunteers who would use it.
In our next section we're going to take everything we've talked
about in terms of our materials and our content and see
how we can put that together into a simple training
guide to help us capture all the work that we're doing.
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