CHWs (14) What are your thoughts on the Guideline? (18)

11 July, 2019

Dear HIFA team,

It is with great pleasure I learnt about CHWs empowerment process through initiatives such as WHO training standardization guidelines, as CHWs are key persons in health chain, closest to people & communities.

We just completed second batch training for CHWs part of/serving Garbage city community of Manshiat Nasr, Cairo/Egypt. First batch was trained in 2018. It was a challenging and beautiful project, funded by private donations (individual small contributions).

I am contributing with some comments based on our experience.

As consultant with PCI (Primary Care International), I have submitted same comments to them, so it might come to you from them as well.

Question 1: What are your thoughts on the Guideline? What questions do you have about it?*

Guidelines well needed as reference to good practice and framework for action. Helps in co-building project with local partners and gives framework for handover.

Lacking aspects of training of trainers, with identifying champions who could receive a specific training added to the standard one, for continuity purposes when there are many stakeholders or when project is funded by external body / organization / trainers who will not be present on site after training completion.

In our project, I have trained 2 doctors (out of 3 in the training team) in project management, training skills, presentation & communication, workshop organizational skills using a large range of participative training techniques. They will be continuing CHW training process in the garbage city community with training other CHWs.

We have also selected 6 CHW from the best trainees (after written & oral assessment based on knowledge and skills) to be running the community center health aspects, and secured some finances for their monthly payment for one year. They will be responsible for delivering health trainings in community and reference for training other CHW.

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Q2. Recommendation 1 suggests certain criteria to use and not to use for selection of CHWs. How do these criteria relate to current practice in your country/experience? Are these criteria implementable in your country/experience?

Literacy level should not be a strict criteria.

We discovered few days before exam session that one of the trainees could not read / write and we had to organize a helping person to sit the exam with her. This CHW attended and participated in every session, was receiving same handout without us noticing she could not read. She passed exam and is an asset to the team.

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Q3. Recommendations 2, 3 and 4 make suggestions on length of pre-service training, competency domains and modalities. How do these suggestions relate to current practice in your country/experience? Are they implementable in your country/experience?

Curriculum should be strongly incorporating exemples and situations inspired by the community CHWs are serving in terms of language, cultural  & religious beliefs/practices, as should training activities be.

Training delivered in CHWs usual work premices helps empowering them in their role and brings an added value & understanding to the whole training process as admin / care providers / members of community might see it happening

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Q4. Recommendation 5 suggests using competency-based formal certification for CHWs who have successfully completed pre-service training. How does this suggestion relate to current practice in your country/experience? Is it implementable in your country/experience?

Certifying training is must.

In our experience, the certification we delivered after written & oral examination process was in itself a training & empowering process! For many CHWs they had never sit exam before, they went through tough stress management process with fear to fail it and were very proudly holding their certificates during ceremony as it was in majority of cases their first degree ever received. Some brought their husbands or children and were referred as role models.

Another suggestion is to have a ceremony or celebration as must as well, to celebrate completion of training, acknowledging CHWs efforts and empowering them in their community they are serving / belonging to.

A celebration of success was organized with delivering of certificates, and another ceremony was held inviting the whole community to discover the new offer CHWs were providing.

Always good to gather top administrators, doctors, nurses, community members, families with CHWs to help putting some light on their work.

I will try to share comments in the french HIFA group as well, as french is my first language. I would love to be participating in this group.

I am currently living in Cairo, but home base is in Geneva/Switzerland, and be returning there for the summer.

I would be available from June 30th to attend meetings should it be needed for this working group.

I have submitted request to join HIFA (french & English) and am waiting for reply, looking forward to working with the team.

warm regards,

Anbreen

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**Dr Anbreen Slama-Chaudhry, **MD, MPH, DAS Patient Education 

ph              +201200067190

Switzerland / Egypt

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HIFA profile: Anbreen Slama-Chaudhry is a medical doctor, NCDs Management Consultant & Patients Health Advisor, Patients-Communities Health Empowerment & Capacity Building, Switzerland / Egypt. https://medicaltrainingservices.ch/home/ anbreen.slama.chaudhry AT medicaltrainingservices.ch