[in response to Rebecca Furth, USA: http://www.hifa.org/dgroups-rss/chws-125-certification-chws-10 ]
This is my greatest challenge, in the renew support for CHWs. It is not only leaving those who were trained before behind but how do we ensure the real full engagement of communities when our selection criteria do not fit those they would like or those in the community do not meet the requirements. This is especially significant considering that the main reason they are not selected is because they do not meet the education requirements. During the days long ago when it was promoted that CHWs should use the five essential drugs to prevent mortality at the community level and when all said CHW needed to be literate so they would not give the wrong medication of the five, the famous Dr. Mrs Arole explain to me in working with illiterate women in the CRHP [*see note below], that she did not know of anywhere in the world where women use more flavoring and spices, etc. in cooking than India, however the illiterate women as these women she worked with were, they never mixed them up and put the wrong spices in a dish. This was just like what she had seen in all the many years of working with them. She had not seen these illiterate women given the wrong medicine to any child. Instead with the appropriate training and supervision use by CRHP, these women had even taken what they learned and applied them in such extraordinary ways that proved to be more effective and were making unimaginable progress in improve health and transforming their communities.
That confirm exactly what I had seen and know now from in all these over 30 years. Like I told those in Liberia, we are saying that because we want things to be easy for us. The burden is on us, highly educated and experts to work together, including with those of us in education and training, to come up with creative ways to trained and supervise illiterate CHWs, a means of getting correct and appropriate data and getting them to use their data for decision making as was done by Dr. Mrs Arole and others at Jamkhed, India. I know there are ways, because I have worked with Traditional midwives for over 30 years and have seen what those illiterate women can do that I would not exchange for literate ones because we the experts cannot come up with appropriate methods to teach and supervise them and obtained the right data that can be used to make appropriate decision. So I would like to challenge us not to have literacy as a criteria for exclusion but rather to be creative and come up with appropriate methods of working with them and benefitting from their expertise in community health as we are all teachers and learners as Jane Valla and my peers in “Dialogue Education” would say or be like the US Ambassador to Liberia says and meet these communities where they are and work with them to where they would like to and should be.
HIFA profile: Marion Subah works for JHPIEGO in Liberia. Marion.Subah AT jhpiego.org
[*Note from HIFA moderator (Neil PW): CRHP = Comprehensive Rural health Project]