02996nas a2200385 4500000000100000008004100001653001000042653001100052653001100063653000900074653001600083653002400099653002400123653003500147653005000182653001100232653003100243653002500274653003500299100001500334700001800349700001600367700001200383700001400395700001900409700001700428700001600445245016500461250001500626300000700641490000700648050001600655520188800671020005102559 2016 d10aAdult10aFemale10aHumans10aMale10aMiddle Aged10aInterviews as Topic10aQuality Improvement10aClinical Competence/ standards10aCommunity Health Workers/ education/standards10aMalawi10aProgram Evaluation/methods10aQualitative Research10aTranslational Medical Research1 aRitchie L.1 avan Lettow M.1 aBarnsley J.1 aChan A.1 aSchull M.1 aZwarenstein M.1 aMartiniuk A.1 aMakwakwa A.00aLay Health Workers experience of a tailored knowledge translation intervention to improve job skills and knowledge: a qualitative study in Zomba district Malawi a2016/02/11 a540 v16 a[IF]: 1.3123 a

BACKGROUND: Like many sub-Saharan African countries, Malawi is facing a critical shortage of skilled healthcare workers. In response to this crisis, a formal cadre of lay health workers (LHW) has been established and now carries out several basic health care services, including outpatient TB care and adherence support. While ongoing training and supervision are recognized as essential to the effectiveness of LHW programs, information is lacking as to how these needs are best addressed. The objective of this qualitative study was to explore LHWs responses to a tailored knowledge translation intervention they received, designed to address a previously identified training and knowledge gap. METHODS: Forty-five interviews were conducted with 36 healthcare workers. Fourteen to sixteen interviews were done at each of 3 evenly spaced time blocks over a one year period, with 6 individuals interviewed more than once to assess for change both within and across individuals overtime. RESULTS: Reported benefits of the intervention included: increased TB, HIV, and job-specific knowledge; improved clinical skills; and increased confidence and satisfaction with their work. Suggestions for improvement were less consistent across participants, but included: increasing the duration of the training, changing to an off-site venue, providing stipends or refreshments as incentives, and adding HIV and drug dosing content. CONCLUSIONS: Despite the significant departure of the study intervention from the traditional approach to training employed in Malawi, the intervention was well received and highly valued by LHW participants. Given the relative low-cost and flexibility of the methods employed, this appears a promising approach to addressing the training needs of LHW programs, particularly in Low- and Middle-income countries where resources are most constrained.

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