CHWs (128) Certification of CHWs (13) New message from Daniel Stern, Tanzania/Uganda (2)

5 July, 2019

Daniel Stern has delightfully covered some interesting themes in his posting: 'Illiterate CHW and their entrance into a different world'; 'Traditional Birth Attendants (TBAs) practicing advanced skills like breech delivery without US Scans'; 'spiritual side of healing'; 'inter professional disharmony and its negative effect on health system strengthening'.

All of which could actually form the basis for deeper discussions and analysis.

For instance more light could have been thrown on how illiterate CHW get to learn the basic knowledge that underpinned the health information that they pass on to the community in their health promotion and prevention roles and if they have to engage in even the most basic treatment roles how do they learn the necessary skills. How would illiterate persons who want to be CHW enter the world that WHO guideline describes: selection, training, certification, practice, etc.

It is very interesting to read that TBAs deliver complex presentations like breech during childbirth without equipment aids. Before US Scan was discovered in health practice, skilled personnel conducted such deliveries, following training and apprenticeship. How do the TBAs learn to do it? And what is their success rate or failure rate?

A very close relative of mine recently pursued the theme of spirituality and healing to a University Masters degree and came up tops with MA (distinction), so it is increasingly an important topic to be on the front burner, especially given the challenges that arise in health and medical practice in a world that is struggling with spiritualism, religion and a spectrum of atheism and Big Bang theory.

It would be nice to hear members comment on inter professional disharmony, which as I said forms a huge spanner that is hindering efforts to strengthen the health system in Nigeria. Does it exist in other countries, what are the causes and effects, and what is being done to stamp it out / control it?

Joseph Ana

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Email: jneana AT