Mapping of training resource packages on sexual and
reproductive health and maternal, newborn, child,
and adolescent health for community health workers
This mapping was undertaken between October and
December 2012 with the objective of organizing and
classifying training resource materials for Community
Health Workers (CHWs) in sexual and reproductive health
and maternal, newborn, child, and adolescent health
(SR/MNCAH) that had been developed by UN agencies
and other partners. The training resource packages
were gathered from key informants and online search of
targeted websites and through general search engines.
Training resource packages targeting CHWs and including
both job aids and a training guide on topics related to SR/
MNCAH were included in the mapping. The following were
excluded from the analysis: job aid alone, policy guidance
alone, programme manager guide alone, materials on
community-based activities not related to CHW training.
Relevant materials in English, French, and Spanish
produced in or after 2000 were included. The materials
were classified according to the SR/MNCAH continuum of
care as defined by WHO. Information was extracted from
the selected training packages as per the following areas:
purpose, description, scope and training methodology of
the tool; integration of the tool in countries and health
systems; strengths and limitations. To assess the strengths
and limitations of the tools, the following questions were
applied: 1. Did the interventions of the training package
match the home/community interventions recommenced
by WHO? ; and 2. Did the training package use: role- and
context-specific contents, competency- and practicebased training, supportive supervision, continuing and
refresher training, sound training and pedagogy including
pre-training, training and post-training steps, inclusion of
job aids, and integration of acquired skills into the overall
CHW role? Two reviewers carried out the quality review,
data abstraction and synthesis of materials and crosschecked their findings. When feasible, the results were
verified with the authors or relevant authoring agencies.
A technical consultation organized by the World Health
Organization (WHO) and the United Nations Population Fund
(UNFPA) on behalf of the United Nation health agencies
(H4+) was subsequently held to review the mapping and
discuss the training of CHWs in SR/MNCAH. (The report
is available from WHO/Department of Maternal, Newborn,
Child and Adolescent Health website or at [email protected]).
This mapping exercise was led by Nguyen-Toan Tran,
an independent consultant. Kirsten Beek provided support.
Annie Portela of WHO/MCA and Luc de Bernis of UNFPA
provided technical oversight and guidance. The authors
are grateful for the contributions from agencies and
individuals for the identification of training resource
packages,and for the thoughtful recommendations from
participants during the expert meeting. This mapping was
possible thanks to the funding from the H4+ grant from
the government of Canada.
1
Integrated packages (package addresses more than 1 health area)
01
02
03
04
05
06
07
08
09
10
11
Tool name,
year, author
Community Health
Worker Trainer’s Manual.
Millennium Villages Project.
2011/2013 Update
Training manual for volunteers
on maternal and newborn
health care. Society for Family
Health (in collaboration with
PSI and Gates Foundation).
Revised edition, 2012
Timed and Targeted
Counselling. World Vision,
2010 (in partnership with WHO,
UNICEF, ACNM)
Guide for Training Community
Health Workers/Volunteers to
Provide Maternal and Newborn
Health Messages (USAID,
POPPHI, BASICS, 2009)
Training manual for cluster
representatives and health
volunteers, Module 1 and
Module 3. WHO, 2009
(2 VOLUMES OUT OF 3).
Community-Based Health
Planning and Services
(CHPS), Community Health
Volunteers Training Manual,
The Population Council,
Ministry of Health/ Ghana
Health Service, 2009
Linking Communities with
the Health System: the Kenya
Essential Package for Health at
Level 1. MOH Kenya, 2007
CHW Certificate Program Facilitator’s Guide (selected
modules). National Department
of Health, Papua New
Guinea, 2006
Reproductive Health Manual
for Trainers of CHWs. CEDPA
(Centre for Development
and Population Activities),
India, 2003
Health Surveillance Assistants
Training Curriculum,
MoH Malawi, 2006
Health Extension Worker
Program of Training Packages
Ethiopia, Ministry of Health
Federal Democratic Republic of
Ethiopia, The Earth Institute at
Columbia University Centre for
National Health Development in
Ethiopia, 2003/2004.
Link /Source
Early revision draft shared by
Anne Liu, Columbia University,
NY. Contact authoring agency
Contact authoring agency
Draft version can be obtained
from polly.walker@worldvision.
org.uk or michele.gaudrault@
wvi.org
(Shared by WPRO, Contact
authoring agency.)
http://www.basics.org/
documents/CHW-trainingguide-Final-1.pdf
http://applications.emro.who.
int/dsaf/dsa1139.pdf;
Contact authoring agency
http://www.hennet.or.ke/
downloads/20070706-225amCHW%20Training%20
Manual%20Mar07%20-%20
MC%20-%20CLEAN.pdf
Contact authoring agency
http://www.k4health.org/sites/
default/files/Reproductive%20
health%20manual_for%20
comm%20health%20workers.
pdf
Contact authoring agency
http://cnhde.ei.columbia.edu/
training/index.html
To train CHWs in conducting
household visits once per
quarter, each CHW covering
150-200 households,
and equipped with key
competencies* in maternal,
newborn and child health,
in addition to reporting
To equip health volunteers from
target states in Nigeria with
core knowledge and skills in:
By the end of the training,
CHWs, or any other appropriate
community-based volunteer
cadre, will be equipped with:
To build the capacity of
CHW/CH volunteers to
use counselling cards with
effective communication and
negotiation skills for promoting
and negotiating desired
health behaviours to improve
maternal and newborn health in
their communities.
To train health volunteers
and cluster representatives
on their specific roles and
responsibilities, and on simple
and timely actions to prevent
and manage common diseases
and health-related issues.
The purpose of this training
manual is three-fold:
To build the capacity of
CHWs to be able to lead
their communities in health
improvement initiatives in
terms of disease prevention,
health promotion, and simple
curative care. In this way the
CHW is able to motivate and
advocate for the key household
health practices in his area
of coverage. The CHWs are
expected to engage with the
communities in the processes
of assessing their health
situation, dialogue with them
on causes, and current actions
in order to identify gaps
that may require additional
knowledge and skills and thus
influence improvement of
health practices and therefore
health status.
As part of the general two year
Community Health Worker
Certificate Program in Papua
New Guinea, participants are
trained to:
The goal of this manual is
to develop the capacity of
community-based workers to
mobilize the community and
increase access to quality
reproductive health information
and services in rural and
urban communities.
This training emphasises the
acquisition of skills basic
to the promotion of health
workers and the prevention
and recognition of hazards
contributing to personal and
community health problems.
The HSA graduate will be
proficient in motivating and
informing persons at the
community level on positive
health practices and health
issues peculiar to Malawi,
and referring personal and
community problems to
the appropriate resource
and performing selected
tasks relative to: community
assessment, growth
monitoring, child spacing,
village hygiene, safe water
supply, immunizations along
with disease surveillance and
follow up (p6).
As part of the Health Extension
Program of Ethiopia, Health
Extension Workers undertake
a one year basic health
care training course. This
course is based on 16 major
training packages.
1. Identification
of the tool
1. Identification
of the tool
1. Identification
of the tool
Purpose
-----
2. Purpose,
description
and scope of
the tool
reproductive health
and rights
pregnancy care
care of the mother and baby
after delivery
referral and record keeping
• Competency in
communication skills and
building good relationships
with the family when
making home visits,
following a standardized,
story-based household
counselling approach.
• Knowledge and
understanding of all of
the technical content and
recommended behaviours to
be introduced to households.
• Competency in carrying
out the data collection
and monitoring functions
associated with their home
based counselling.
The goal of this workshop is to
not only expose participants to
new ideas, skills, and problemsolving approaches,
but to change their knowledge,
attitudes and behaviours, where
required (p2).
Specifically, CHWs will be
able to:
• Develop effective
communication skills to
establish open conversations
with women, families,
and other community
members on MNH.
• Develop information
skills to identify, select,
and convey the technical
elements accurately to
pregnant women, families,
and community members.
• Use the counselling cards
with effective communication
skills to promote key healthy
behaviours among women
and their families.
• Advocate for improved
community behaviours
through building the
capacity of community
leaders, religious leaders,
and relevant communitybased organizations.
• Commence facilitation
of community
mobilization activities.
• Take necessary steps
to seek and collect the
necessary predetermined
newborn and maternal health
information/data, review
them, and transmit them
appropriately to the
Ministry of Health
and implementing
organizations (p11).
http://applications.emro.who.
int/dsaf/dsa1137.pdf
It is expected that more
extensively trained community
representatives and health
volunteers will be able to
assist the health system in
improving the access of the
target population to primary
health care services and in
helping to ensure the provision
of timely health services to the
entire population (p5), starting
with communities by involving
them in a sustainable way at
grass-roots level.
1) To serve as a set of resource
materials that health
managers can use to train
community volunteers
2) To make the training of
health volunteers more
systematic and standardised
3) To provide skills to
volunteers to improve
teamwork, develop their
personality and improve
attitudes for health
promotion and community
development (piv).
As a result of attending this
training community health
volunteers should be able to
achieve key objectives*
Specifically, by the end of the
training course the CHWs are
expected to be equipped with
key skills*
• Deliver family
planning services
• Provide care for
pregnant women
• Provide care for women in
labour and childbirth
• Manage
Obstetric emergencies.
As a result of completing these
aspects of the two year training
program, participant CHWs
are expected to acquire key
knowledge and skills.*
By the end of the workshop,
the participants will be able to:
• describe the basic concepts
of reproductive health and
family planning
• discuss the reproductive
rights of every client
• counsel and refer clients for
safe motherhood and care of
the newborn
• counsel and provide clients
with family planning services
and referrals
• counsel and refer clients for
reproductive tract infections.
This training course was
introduced with the aim of
producing Health Surveillance
Assistants with essential skills*
Objectives of this one year
course relevant to this exercise
include the following:
For Health Extension Workers:
• To provide antenatal, delivery,
postnatal and child health
services as a package to
prevent mothers and children
that constitute a majority of
our population, from illness,
death and disability
• To create a conducive
environment in communities
for the prevention and control
of HIV/AIDS. To reduce the
spread of the virus and death
from AIDS.
• To work to produce a healthy
adolescent population that
is physically, mentally and
socially well-developed.
• To work to reduce
morbidity and mortality
of mothers and children
by spacing child-bearing;
preventing unplanned and
unwanted pregnancy.
• To make children healthy and
competent citizens and the
provide adequate health care
to women of child-bearing
age; provide full information
and education about
vaccination; reduce and
control the illness, death and
disability among children
and women, caused by
vaccine preventable diseases.
• By preventing diseases that
are caused by malnutrition,
create a healthy society
that has a balanced
physical structure.
2
Integrated packages (package addresses more than 1 health area)
01
02
03
04
05
06
07
08
09
10
11
Tool name,
year, author
Community Health
Worker Trainer’s Manual.
Millennium Villages Project.
2011/2013 Update
Training manual for volunteers
on maternal and newborn
health care. Society for Family
Health (in collaboration with
PSI and Gates Foundation).
Revised edition, 2012
Timed and Targeted
Counselling. World Vision,
2010 (in partnership with WHO,
UNICEF, ACNM)
Guide for Training Community
Health Workers/Volunteers to
Provide Maternal and Newborn
Health Messages (USAID,
POPPHI, BASICS, 2009)
Training manual for cluster
representatives and health
volunteers, Module 1 and
Module 3. WHO, 2009
(2 VOLUMES OUT OF 3).
Community-Based Health
Planning and Services
(CHPS), Community Health
Volunteers Training Manual,
The Population Council,
Ministry of Health/ Ghana
Health Service, 2009
Linking Communities with
the Health System: the Kenya
Essential Package for Health at
Level 1. MOH Kenya, 2007
CHW Certificate Program Facilitator’s Guide (selected
modules). National Department
of Health, Papua New
Guinea, 2006
Reproductive Health Manual
for Trainers of CHWs. CEDPA
(Centre for Development
and Population Activities),
India, 2003
Health Surveillance Assistants
Training Curriculum,
MoH Malawi, 2006
Health Extension Worker
Program of Training Packages
Ethiopia, Ministry of Health
Federal Democratic Republic of
Ethiopia, The Earth Institute at
Columbia University Centre for
National Health Development in
Ethiopia, 2003/2004.
General overview
Curriculum developed in the
context of the Millennium
Village Project to address
the human resources crisis.
It consists of:
The provision of home care
to women during pregnancy,
delivery, post partum as well as
care for the newborn is a key
objective of SFH’s MNH care
project project in target states
of Nigeria. The curriculum is
based on and adapted from
‘Community-based reproductive
health promoters and traditional
birth attendants manual’. In most
rural communities, Traditional
Birth Attendants still remain
the most acceptable traditional
care givers to women during
pregnancy, childbirth and care of
the newborn, especially during
the first month of the baby’s life.
SFH and its partners require that
the Volunteers be trained before
they go into the communities to
provide the counseling services
in MNH care. This training
manual is therefore developed to
respond to this need by tailoring
the training content to meet the
specific knowledge and skills
for home-based care during
pregnancy, delivery as well as
care for the newborn.
Timed (neither too early or too
late) and Targeted (to those
practicing taught behaviours,
or those influencing behaviour
adoption) Counselling (ttC)
refers to a CHW/Volunteer
approach to extending primary
health care and nutrition
counselling on preventive
and care-seeking behaviours
to the household level. Build
around evidence-based,
cost-effective interventions
for pregnant women
(7 interventions) and children
<2y.o. (11 interventions)*
over 12 scheduled visits:
pregnancy (3, 4, 6, 8, 9m),
postpartum (1, 4 wk), children
(6, 9, 12, 18, 24m). Training
package includes:
This document presents a
guide to a three-day training
course designed to train
CHWs to improve maternal
and newborn health in their
communities. This publication
is one in a series of that
make up the USAID/BASICS
Newborn Health tool kit. This
tool kit comprises:
The community-based
initiatives programme of the
WHO Regional Office for
the Eastern Mediterranean
produced this training manual
for cluster representatives
and health volunteers in
coordination with the 17
relevant technical units in the
Regional Office.
This Reproductive Health
Manual for Trainers of
Community Health Workers
has been developed by The
Centre for Development
and Population Activities
(CEDPA) to help organisations
who provide reproductive
health services through the
Community-Based Distribution
approach, train their CHWs in
reproductive health.
The Health Assistants
Training Program focuses its
activities on the Ministry of
Health’s Human Resources
Development Plan which
highlights the number of Health
Surveillance Assistants (HSAs)
needed to fulfil the goal of the
National Health Policy.
The Training Manual provides
guidelines for community
involvement in health actions,
addresses comprehensive
primary health care and is
comprised of four modules:
This manual for training
CHWs aims at building their
capacity to accompany the
households and communities
in their efforts to improve
their health. Recognising that
households and communities
are fully engaged in addressing
their own health issues,
the training intends to enable
CHWs to assist communities
in assessing their situations,
identifying gaps and reflecting
on the causes of gaps in order
to take action.
Community Health Workers in
Papua New Guinea undergo
a 2 year training program
which includes aspects of SR/
MNCAH, together with other
basic health services.
• Facility level tools:
The Community-based Health
Planning and Services (CHPS)
initiative is the Government
of Ghana’s strategy to bring
quality health care to the
door step of the people.
In collaboration with the Ghana
Health Service, the CHPSTechnical Assistance project
has developed this training
material for Community Health
Volunteers (CHVs) and Village
Health Committees (VHCs)
(both called health volunteers
in this manual).
The Health Extension Program
is designed to achieve
significant basic health care
coverage in Ethiopia over five
years through the provision of
a staffed health post to serve
every 5000 people, with a
total of over 72 million people
served. This new communitybased health care delivery
system will improve access and
equity in health care through a
focus on sustained preventive
health actions and increased
health awareness.
There are four training modules
in this manual:
The manual describes the
information, knowledge and
skills that a CHW should
have in order to be effective in
influencing key household and
community action to improve
their own health situation.
This document provides
facilitators with technical
content, presentations,
and handout materials for use
as deemed necessary (pp9-10).
1. Identification
of the tool
• Trainer’s Manual but NO
trainee manual
• Job aids for trainees
• CHW Supervision Trainer’s
Manual & checklists
The Trainer’s Manual is divided
into 4 units:
• Unit 1: General overview and
2. Purpose,
description
and scope of
the tool
preparation: CHW role in a
health system, CHW rights
and support system, using
information to improve
health, prep work and
household visit structure,
identifying danger signs
• Unit 2: care of the healthy
child, preventing illness
(bednets, vaccination,
watsan hygiene food safety,
proper nutrition)
• Unit 3: care of the sick child,
treating illness (cough,
diarrhea, fever)
• Unit 4: caring for the
pregnant woman (danger
signs, ANC promotion,
pregnancy counselling,
birth prep) and newborn
(danger signs, counselling
the mother to keep the baby
warm and breastfeeding)
Curriculum consists of: Trainers’
manual & Job aids
Covers 3 Modules:
MODULE I: OVERVIEW
1) Overview of maternal and
neonatal deaths,
2) Concept of Health Education,
3) Reproductive Health and
Reproductive Rights
4) Roles and responsibilities
of Volunteers,
5) Anatomy and Physiology of
Female reproductive organs,
6) Counselling
MODULE II:PREGNANCY
AND ANTE-NATAL CARE:
1) Role of men in Reproductive
Health,2) Women at Risk
of Pregnancy,
3) Signs of Pregnancy,
4) Common Discomforts/
complaints in pregnancy,
5) Ante-natal Care (ANC),
6) Personal hygiene and
maintenance of good health
in pregnancy,
7) Nutrition in pregnancy,
8) Danger signs in pregnancy,
9) Signs of miscarriage,
10) Getting ready for Baby.
• Trainers’ Guide + CD
• Facilitator’s Manual (3
modules: M1: country
context, id pregnant women
in community, BCC, comms
& counselling skills + visit
1-3; M2: visit 4-6; M3:
visit 7-11)
• CHW Manual (one-stop
reference for literate CHWs)
• CHW Job Aids: illustrated
story flip book
• Household reminder tool:
illustrated handbook
In addition: introductory
materials (country readiness
guidelines, CHW program
functionality assessment)
& data collection/
monitoring system
Reference Manual, Technical
Presentations, Facilitator’s
Guide, Participant’s
Notebook, Clinical
Logbook with Learning and
Evaluation Checklists
• Community level tools
(this document): Guide
for Training Community
Health Workers/Volunteers
to Provide Maternal and
Newborn Health Messages
• Set of Counselling cards
Training sessions in
this manual address
key competencies*
The training approach focuses
on specific messages and the
practical use of counselling
cards related to maternal and
newborn health, with role plays
and immediate feedback to
improve counselling skills (p2).
1) Family Health: Birth and
emergency planning; Birth
spacing; Child health,
Nutrition and Dental hygiene
2) Emergencies, environmental
health and food safety:
Emergency planning, First
aid, Health environment,
Food and chemical safety,
3) Communicable diseases:
Tuberculosis; AIDS and
sexually transmitted
infections; Malaria;
Childhood diseases
and immunisation,
4) Noncommunicable diseases:
Noncommunicable
diseases, Prevention and
control of blindness; Active
and healthy ageing and old
age care; Mental health and
substance abuse; Tobacco
and health.
Module 1 and Module 3 will
be the focus of this summary.
1) The CHPS Concept:
• communication skills
• interpersonal relationships
• teamwork
• conflict prevention,
management and resolution
2) Community mobilisation
and tools
• Developing a
community profile
• Community
based surveillance
• Community mobilisation
and participation
• Community
participatory tools
3) The work of the
health committee
• selection and training
of volunteers
• Advocacy for health
• Managing
community resources
• Supervision of volunteers
4) The work of community
health volunteers
• Home visiting
• Disease prevention and
environmental sanitation
• Nutrition education
• Reproductive and child health
• Home management of
minor ailments
• Assisting the CHO to provide
services (ppix-x).
The content of the course is
organised into the following
9 modules:
1) Concepts of health
and development
2) Community strategies for
Kenya Essential Package
for Health
3) Health promotion
4) Mother and child
5) Community nutrition
6) STI, HIV/AIDS
and Tuberculosis
7) Water safety and
sanitation and hygiene
related conditions
8) Disability
9) Monitoring and evaluation
Training sessions relevant to
this mapping exercise include
key areas*
Training units in this manual
address the following areas:
• Basic concepts of
reproductive health and
family planning
• Safe motherhood and care of
the newborn
• Contraceptive
technology update
• Reproductive Tract Infections,
Sexually Transmitted
Infections and HIV/AIDS
The training of HSAs will
help in the successful
implementation of the Human
Resources Development Plan
by ensuring the availability of
appropriate and adequately
trained human resources to
provide curative, preventive
and promotive health services
in line with the Essential
Health Package.
The HSA Training Program
includes the following
19 modules:
1) HSA job description,
2) Introduction to Essential
Health Care Package,
3)Reproductive Health,
4) Nutrition,
5) Growth Monitoring,
6) EPI,
7) Common Diseases,
8) Community Water Supply,
9) Vector Control,
10) Village Sanitation,
11) Food Hygiene,
12) Village Inspection,
13) Community Assessment/
Health and Vital Statistics,
14) Formation and Training of
Village Health Committees,
15) Social Mobilisation and
Health Education,
16) Planning Health Activities,
17) Use and Maintenance of
a Bicycle,
18) Formation of Village
Support Group,
19) Patient Follow
Up (pp9‑12).
Every health post (current
or to be built) will be staffed
by two Health Extension
Workers (HEW), who will
have undergone a one year
training course.
The training program for Health
Extension Workers includes
16 training packages under the
following 4 components:
1) Hygiene and
Environmental Sanitation
2) Family Health Services
3) Disease Prevention
and Control
4) Health Education
and Communication.
Training packages most
relevant to this mapping
exercise fall under
components 2 and 3.
These Training Packages are:
• Maternal and Child Health
• Adolescent
Reproductive Health
• Family Planning
• Vaccination services
• Nutrition
• HIV/AIDS and Tuberculosis
Prevention and Control
The HEW training packages
provide guidance rather
than curricula.
…
3
Integrated packages (package addresses more than 1 health area)
Tool name,
year, author
1. Identification
of the tool
01
02
03
04
05
06
07
08
09
10
11
Community Health
Worker Trainer’s Manual.
Millennium Villages Project.
2011/2013 Update
Training manual for volunteers
on maternal and newborn
health care. Society for Family
Health (in collaboration with
PSI and Gates Foundation).
Revised edition, 2012
Timed and Targeted
Counselling. World Vision,
2010 (in partnership with WHO,
UNICEF, ACNM)
Guide for Training Community
Health Workers/Volunteers to
Provide Maternal and Newborn
Health Messages (USAID,
POPPHI, BASICS, 2009)
Training manual for cluster
representatives and health
volunteers, Module 1 and
Module 3. WHO, 2009
(2 VOLUMES OUT OF 3).
Community-Based Health
Planning and Services
(CHPS), Community Health
Volunteers Training Manual,
The Population Council,
Ministry of Health/ Ghana
Health Service, 2009
Linking Communities with
the Health System: the Kenya
Essential Package for Health at
Level 1. MOH Kenya, 2007
CHW Certificate Program Facilitator’s Guide (selected
modules). National Department
of Health, Papua New
Guinea, 2006
Reproductive Health Manual
for Trainers of CHWs. CEDPA
(Centre for Development
and Population Activities),
India, 2003
Health Surveillance Assistants
Training Curriculum,
MoH Malawi, 2006
Health Extension Worker
Program of Training Packages
Ethiopia, Ministry of Health
Federal Democratic Republic of
Ethiopia, The Earth Institute at
Columbia University Centre for
National Health Development in
Ethiopia, 2003/2004.
Literate CHWs. But this is not
an exclusion criteria, as it gives
the option to train non-literate
CHWs (focusing on job aid
exercises and verification
of memory)
Community health workers
and/or community
health volunteers.
The target audience for this
training is:
Community Health Volunteers
and Village Health Committees
(who serve as a link between
the community and the health
care system) (piv).
Community Health
Workers, who must have the
following characteristics:
Community Health
Worker trainees.
Community Health WorkersThe community-based
reproductive health approach
entails the identification,
recruitment, training,
and fielding of community
residents to provide FP
information and services to
their neighbours (pix).
Admission requirements for
trainees are as follows:
Health Extension Workers.
General overview
…
MODULE III: CARE OF
MOTHER AND BABY
AFTER DELIVERY
1) Common complications in
mother after delivery,
2) Common complaints in the
newborn (complications
after baby is delivered),
3) Low birth weight,
4) Exclusive breast feeding
5) Immunisation
MODULE IV: REFERRAL
AND RECORD KEEPING
1) Two-way referral system
2) Record keeping
Target
audience: trainees
Must be literate, have
completed primary school, with
some secondary school; must
be from the local community.
2. Purpose,
description
and scope of
the tool
Target
audience: trainers
Bachelor’s degree, often
masters and occasionally
medical. From the country,
but might not be local.
Volunteers who should be:
• Female
• Able to speak the local
language (some level of
English and writing skill will
be an advantage)
• Accepted and respected in
the community.
• Able to interact with others.
• Ready to volunteer time
and services.
• Honest and willing
to participate without
monetary incentive.
• Interested in RH
programme/women
development activities.
• Not younger than 18 years
of age.
• Available to perform
after training.
• Resident in the community
• Obtained consent from
spouse to participate as
a volunteer
Nurse/midwives who have
had previous experience in
training volunteers
Facilitators from WV, MOH,
or partner agencies, involved
in field implementation.
Information about level
required not found
• Cluster representatives
[note: Each village is
divided into clusters of
25 to 40 households.
Each cluster elects one
representative (http://www.
jointcenter.org/hpi/sites/
all/files/13-Tackling%20
Social%20Determinants.
pdf)]
• Health volunteers (no further
criteria stated).
Ideally, trainers will
already have interpersonal
communication and
counselling skills. However,
those needing more
information may consult
guides offered in the additional
reading listed at the end of this
guide (p2).
Not stated. Cluster
representatives and health
volunteers are generally trained
by «specially selected trained
nurses and technicians working
in the nearest health facility
to the CBI site supervised
by members of the CBI
intersectoral team and related
technical programmes at the
district level» (p5).
No indication given in this
manual that these nurses and
technicians will facilitate this
training. Instead, it is stated
that «In using this manual
health volunteers and cluster
representatives will be trained
on their specific roles and
responsibilities…» (p5)
implying self-directed learning
but this is unclear.
Community Health Officers,
District Health Management
Team/ Community-based
Health Planning Services.
No other criteria listed.
• Must be a respected literate
member of the community
• Must be creative,
hardworking and responsible
• Should be a good example
in matters of health
and development
• Should be approachable and
able to motivate others
• Should be willing to
volunteer for a period of five
years (p10)
Not stated.
CHWs must be functionally
literate, from the same
community, married and an
FP acceptor.
Not stated. Community Health
Worker Certificate Program
developed by the National
Department of Health Human
Resource Management Branch
Curriculum Development and
Training Unit- trainers may be
provided by this organisation?
Not stated.
• The course is designed
to train NEW HSAs for
employment in Malawi.
• Females and males are
encouraged to apply.
• JCE education minimum.
• Physical and mental
capability to perform job
tasks of HSA.
Not stated.
Not stated.
4
Integrated packages (package addresses more than 1 health area)
01
02
03
04
05
06
07
08
09
10
11
Tool name,
year, author
Community Health
Worker Trainer’s Manual.
Millennium Villages Project.
2011/2013 Update
Training manual for volunteers
on maternal and newborn
health care. Society for Family
Health (in collaboration with
PSI and Gates Foundation).
Revised edition, 2012
Timed and Targeted
Counselling. World Vision,
2010 (in partnership with WHO,
UNICEF, ACNM)
Guide for Training Community
Health Workers/Volunteers to
Provide Maternal and Newborn
Health Messages (USAID,
POPPHI, BASICS, 2009)
Training manual for cluster
representatives and health
volunteers, Module 1 and
Module 3. WHO, 2009
(2 VOLUMES OUT OF 3).
Community-Based Health
Planning and Services
(CHPS), Community Health
Volunteers Training Manual,
The Population Council,
Ministry of Health/ Ghana
Health Service, 2009
Linking Communities with
the Health System: the Kenya
Essential Package for Health at
Level 1. MOH Kenya, 2007
CHW Certificate Program Facilitator’s Guide (selected
modules). National Department
of Health, Papua New
Guinea, 2006
Reproductive Health Manual
for Trainers of CHWs. CEDPA
(Centre for Development
and Population Activities),
India, 2003
Health Surveillance Assistants
Training Curriculum,
MoH Malawi, 2006
Health Extension Worker
Program of Training Packages
Ethiopia, Ministry of Health
Federal Democratic Republic of
Ethiopia, The Earth Institute at
Columbia University Centre for
National Health Development in
Ethiopia, 2003/2004.
Training
methodology,
including
clinical practice
and assessment
of competencies acquired
• Very detailed step by step
Participatory and embrace adult
learning principles. Includes:
• Overall approach: session
This training manual suggests
trainers use interactive methods
to stimulate active participation
and ensure that learning
objectives are met.
These methods include: group
discussions, small group
work, role play, brainstorming
sessions, demonstrations,
practical sessions, recording
of key points, issues,
suggestions, new practices and
solutions identified during the
workshop (p4).
Assessment of competence
to be undertaken during
training (before and after
the course) and/or posttraining during supportive
supervision. Checklist for
Evaluating Community
Health Workers in Using
Counselling Cards contained in
Guide (pp112‑113).
Possibly self-directed learning
and/or workshop format and/or
a combination of the two.
Role-play dialogues included
for some units, but no
accompanying instructions
for use.
Group work included for
some units.
Assessment is based on
pre‑and post-testing of
each unit.
The manual states that,
due to the educational
level of volunteers, training
sessions should be very
practical and interactive.
A variety of participatory
methodologies should be
employed in the sessions,
e.g. use of pictures, drama,
film, case studies, role plays,
songs, storytelling, jokes,
discussions, group work, site
walkthroughs, field activities,
translation of key words into
local languages (pv).
Training methodology listed
for use throughout the
modules include:
«The Facilitator’s Guides for
selected modules state that
learners must demonstrate
competence in the assessment
criteria for all learning outcomes.
Assessment criteria for each
learning outcome are tabulated in
respective Facilitator’s Guides.
This curriculum has an
emphasis on skill training
supported by lecture sufficient
to understand the specific skill,
and hands on training provided
by structured laboratory and
practical training activities at
selected sites in Primary Health
Care Training Centres (p6).
The training package
documents provided for the one
year HEW training program are
presented as guidance rather
than curricula.
It is suggested that CHO
and DHMT/CHPS training
coordinators should collect real
life stories from communities
and training sessions and
adapt them for volunteers
training. They should also
learn the most appropriate
ways of communicating and
imparting knowledge and skills
in various communities and
employ them in their training
sessions. This will enhance the
training programmes and make
them realistic to the needs of
the volunteers. The use of the
local language and picture
teaching was found to enhance
comprehension in all pretested
districts pv).
• Role play
The manual has been
designed as a self-contained
curriculum for training CHWs
on community mobilization
and reproductive health. It is
important that the CHW be
trained in all the topics before
s/he begins her/his work in
the community. The method of
training is participatory, i.e.,
brainstorming, group work,
demonstration, role play,
illustrated trainer presentation
and case studies. The training
consists of four major units
or modules.
1. Identification
of the tool
2. Purpose,
description
and scope of
the tool
instructions for facilitator,
with tips and caveats
• Interactive presentations,
small group work, group
discussions, case studies,
role plays
• Within each unit, regular
quizzes to ensure that
participants grasp concepts
• At the end of each sub-unit,
trainees go through a written
test to assess knowledge.
• Demonstration and practice:
using job aids, filling
reporting forms, entering data
into mobile phone, asking
and looking for danger signs,
giving pre-referral treatment
for danger signs (D: 1st dose
ORS & Zinc, Pneumonia:
antibiotics, malaria:
Coartem), and HOW to do
so (arranging for transport,
advising caregiver…)
• Does not appear to have a
systematic assessment of
competencies against gold
standard for each trainee
• Lecture/discussion
• Brainstorming
• Discussion
• Repetition
• Case studies
• Demonstrations and
return demonstration.
• Role play
• Field trip to facilities
• Observation
• Group work
• Singsongs
Typical session format:
• Learning objectives
• Training and
learning methods
• Resource materials
• Pre-session preparation
• Content
• Summary
• Evaluation.
No clinical practice to
recognize danger signs
The suggested methods of
evaluation include pre- and
post-tests, rapid feedback,
and continuous questions
and answers at the end of
each topic.
Evaluation is at the end of
each session. No competencybased assessment.
introduction, brainstorm
to determine what CHWs
already know, give relevant
info, reinforce information
through story telling, role
plays (problem/positive
behaviours), small group
discussions and practice.
• Core: simulation of the
4 HH visit steps (review
of previous meeting and
actions, problem story,
positive story, dialogue and
‘negotiation’), story-based
dialogue counselling
• Centered on utilization of
job aids
• Training on data collection
for each visit
• Trainees demonstrate
skills by role-playing with
debriefing in small group.
• Story telling
• Group work
• Plenary
• Games and other activities
• Brainstorming
• Demonstration
• Story analysis
It is further stated that the learner
must provide a range of evidence
that demonstrates competence
in a number of assessment
situations, and through a number
of assessment tools for each
module. Suitable assessment tools
are listed to include (but not be
limited to):
• Experience sharing
• observation by tutor or assessor
• an introduction page which
of clinical skills
• reports from supervisor or tutor
• case studies
• assignments
• role-plays.
summarises the tasks to be
performed by the CHW,
• learner objectives,
• contents and
materials required.
• methods of training which
detail training steps and
include trainer’s notes, and
• time allotments for the
module (pxi).
• Group discussion
• Lectures and mini-lectures
• Individual work
• Group presentations
• Practical exercises
• Field exercises
• Skills practice
Methods of assessment
not stated.
In addition to general assessments
for each module, module specific
conditions of assessment include
the following:
1) Family planning:
• End of module test
2) Care for Pregnant Women
• End of module test
• The learner must have access
to a range of health facilities
where they can demonstrate
their abilities to provide care for
pregnant women
• The learner must witness
5 pregnant women being
interviewed and examined,
and then interview and
examine 10 pregnant women
under supervision
3) Manage Obstetric Emergencies:
• End of module test
4) care for Women in Labour
and Childbirth
• End of module test
• The learner will require access
to a model pelvis to demonstrate
abdominal palpation, vaginal
examination, and partograph offthe-job
• The learner will require access
to foetus (baby doll) with cord,
placenta and membranes to
demonstrate foetal assessment
and management of birth,
cutting cord, and assessing
placenta off-the-job
• The learner will require access
to scales and measuring jug
to weigh newborn and assess
blood loss
…
Each module includes:
Evaluation is based on pre- and
post-tests for each module.
Teaching methods:
(a) Lectures
and demonstration.
(b) Practical teaching: so that
an HSA student can acquire
skills by performance of
similar skills.
(c) Discussing methods: the
trainer using spontaneous
conversation in which all
students may take part, e.g.
brainstorming, role-play,
syndicates, etc. (p5).
Requirements for the
completion of this course
are as follows:
Satisfactory completion of
EACH module in the course:
Includes skill performance,
written examination at a
70% and personal and
professional behaviour
appropriate to that of
an HSA:
• Weekly written and
practical examinations.
• The student must
complete each module of
instruction satisfactorily.
• Student will demonstrate
knowledge (70%);
appropriate behaviour;
and satisfactory performance
of practical skills.
• Student will be provided
the opportunity to take
supplemental examinations
in the event of not being able
to achieve 70%.
• The final grade will
be a composite of
all assessments.
5
Integrated packages (package addresses more than 1 health area)
Tool name,
year, author
1. Identification
of the tool
01
02
03
04
05
06
07
08
09
10
11
Community Health
Worker Trainer’s Manual.
Millennium Villages Project.
2011/2013 Update
Training manual for volunteers
on maternal and newborn
health care. Society for Family
Health (in collaboration with
PSI and Gates Foundation).
Revised edition, 2012
Timed and Targeted
Counselling. World Vision,
2010 (in partnership with WHO,
UNICEF, ACNM)
Guide for Training Community
Health Workers/Volunteers to
Provide Maternal and Newborn
Health Messages (USAID,
POPPHI, BASICS, 2009)
Training manual for cluster
representatives and health
volunteers, Module 1 and
Module 3. WHO, 2009
(2 VOLUMES OUT OF 3).
Community-Based Health
Planning and Services
(CHPS), Community Health
Volunteers Training Manual,
The Population Council,
Ministry of Health/ Ghana
Health Service, 2009
Linking Communities with
the Health System: the Kenya
Essential Package for Health at
Level 1. MOH Kenya, 2007
CHW Certificate Program Facilitator’s Guide (selected
modules). National Department
of Health, Papua New
Guinea, 2006
Reproductive Health Manual
for Trainers of CHWs. CEDPA
(Centre for Development
and Population Activities),
India, 2003
Health Surveillance Assistants
Training Curriculum,
MoH Malawi, 2006
Health Extension Worker
Program of Training Packages
Ethiopia, Ministry of Health
Federal Democratic Republic of
Ethiopia, The Earth Institute at
Columbia University Centre for
National Health Development in
Ethiopia, 2003/2004.
Family Planning; Pregnancy
care; Postpartum care;
Newborn care; HIV; RTIs/STIs.
Family Planning; Pregnancy
care; Childbirth Care;
Postpartum care; Infancy and
childhood care.
Family Planning;
Pregnancy care; Childbirth
Care; Postpartum care;
Newborn care; Infancy and
Childhood care.
See objectives above.
Adolescent reproductive health.
Training
methodology,
including
clinical practice
and assessment
of competencies acquired
Aspect of the
continuum of
SRMNCAH
care covered
2. Purpose,
description
and scope of
the tool
…
• The learner must assist with and
witness at least 5 normal births,
and manage at least another 5
normal births under supervision
to achieve competency in
this module
• The learner must have the
ability to suture episiotomies
and second degree tears in
an emergency. This may be
demonstrated in a simulated
environment or in the workplace
if the opportunity presents.»
Care of the healthy child
Pregnancy care
Pregnancy care
Pregnancy care
Care of the sick child
Newborn and post partum care
Infant and child care <24m
Childbirth care
Pregnancy and newborn care
Postpartum care
Newborn care
Other health
subjects covered
Births and deaths (incl.
stillbirths and miscarriages)
reporting, using mHealth/sms
platform: Childcount+ with real
time information and feedback
(see www.childcount.org)
Reproductive rights
Duration of
training course
5 days for the whole package of
4 units (the first unit takes 3d,
unit 2: 1d, units 3 and 4: 1d)
4-5 days
• CHW training: Total of 20
days, in 3 blocks over 9-12
months. M1: 10d - 4-6m
practice interval, M2:
5d - 3m practice interval M3: 5d)
• TOT: 6 days
5-Day Training. This guide
recommends at least three
days of training in a classroom
setting followed by at least two
days of practical application.
Module 1- Family Health:
Childbirth Care; Postpartum
care; Newborn care; Infancy
and childhood care.
Module 3- Communicable
Diseases: HIV/AIDS and STIs;
Pregnancy care; Newborn care;
Infancy and childhood care.
Not stated.
Briefly covers: Family Planning;
Safe Abortion care; Pregnancy
care; Childbirth Care;
Postpartum care; Infancy and
childhood care.
Pregnancy care; Childbirth
Care; Newborn care; Infancy
and Childhood care.
See module outlines above.
See list of skills
The suggested training
schedules are two (2) training
sessions per year per CHPS
zone with four (4) to eight
(8) topics per session.
In addition to being organised
as standalone trainings,
volunteer training can also be
tagged unto other integrated
training programmes in the
District Health Management
System such as HIV & AIDS,
Guinea worm eradication and
TBA training. The other topics
in Modules 1 and 2 can be
incorporated into other DHMT
and CHO volunteer meetings
and fora.
The basic course is designed
to take six weeks, organised
into three phases of two weeks
each (p12)
Selected training modules
form part of the 2 year
Community Health Worker
Certificate Program.
The manual provides a
thirty-hour curriculum. It can
be covered in full five days
or if necessary, trainers and
participants can adapt it as per
the need of their program (pxii).
The training of HSAs to this
curriculum takes 10 weeks.
One year to complete
16 Training Packages.
This document states that CHW
training should be lifelong. It is
suggested in the manual that
continuing education could be
three days a trimester, based on
their own priorities (p12)
See training
methodology above.
Community Health Worker
roles to be undertaken with
supervisor support for
tasks listed.
Not stated.
Not stated.
Family Planning;
Pregnancy care; Childbirth
Care; Postpartum care;
Newborn care.
For training newly recruited
volunteers, a five-day training
programme has been found to
be adequate, and a suggested
training schedule has been
attached to the modules (pv).
Follow-up
training and
supervision
(if planned)
Strong supervision and
management system of CHWs,
who report to a Senior CHW
at the village level, who in turn
reports to a CHW Manager,
who reports to an overall
Health Coordinator
Mentions about the
importance of:
----
monitoring and supervision
collection of Data
from Volunteer
Quarterly review meetings
and updates
BUT does not go into detail
• Include data collection,
monitoring, supervision
review and regular
CHW debriefings
• Recommends to hold yearly
refresher training to keep
CHWs updated to new
interventions and local
health initiatives.
Adequate competence (in
meeting training objectives)
will require additional
follow-up supportive
supervision (p11).
Not stated.
Not stated.
6
Integrated packages (package addresses more than 1 health area)
01
02
03
04
05
06
07
08
09
10
11
Tool name,
year, author
Community Health
Worker Trainer’s Manual.
Millennium Villages Project.
2011/2013 Update
Training manual for volunteers
on maternal and newborn
health care. Society for Family
Health (in collaboration with
PSI and Gates Foundation).
Revised edition, 2012
Timed and Targeted
Counselling. World Vision,
2010 (in partnership with WHO,
UNICEF, ACNM)
Guide for Training Community
Health Workers/Volunteers to
Provide Maternal and Newborn
Health Messages (USAID,
POPPHI, BASICS, 2009)
Training manual for cluster
representatives and health
volunteers, Module 1 and
Module 3. WHO, 2009
(2 VOLUMES OUT OF 3).
Community-Based Health
Planning and Services
(CHPS), Community Health
Volunteers Training Manual,
The Population Council,
Ministry of Health/ Ghana
Health Service, 2009
Linking Communities with
the Health System: the Kenya
Essential Package for Health at
Level 1. MOH Kenya, 2007
CHW Certificate Program Facilitator’s Guide (selected
modules). National Department
of Health, Papua New
Guinea, 2006
Reproductive Health Manual
for Trainers of CHWs. CEDPA
(Centre for Development
and Population Activities),
India, 2003
Health Surveillance Assistants
Training Curriculum,
MoH Malawi, 2006
Health Extension Worker
Program of Training Packages
Ethiopia, Ministry of Health
Federal Democratic Republic of
Ethiopia, The Earth Institute at
Columbia University Centre for
National Health Development in
Ethiopia, 2003/2004.
Training course
evaluated,
and key results
Challenges identified by
evaluation include: quality
standards, user-friendliness
of job aids, how to make the
training modular enough
To follow up
?
• Final reports available for
Evaluation of a training
workshop conducted to
this curriculum in Amman
(September 2012) showed
an overall increase in content
knowledge from 50% to
97% (through pre- and posttesting). Participants reported
that sessions on planning
for safe delivery and family
planning required more than
the allotted time, while the
session on child health was too
long. Generally, participants’
training expectations were
met and it is reported that the
training workshop successfully
covered its intended topics.
Unknown.
Training was provided for
community health extension
workers and community
health workers.
In total, 274 CHEWS and
3,100 CHWs were trained
and deployed using the new
guidelines. Pilot community
units have been established in
Nyanza since 2006. In 2006/07
FY, a total of 129 community
units were established and
became functional, of which 78
are per the new guidelines.
The functionality and
effectiveness of these units
have not been reviewed.
Unknown.
Unknown.
Unknown.
BASICS technical areas of:
• Newborn survival and health
• Health timing and spacing
of pregnancy.
Contain mention of this
training but provide no
details on key results or
evaluation specific to this
training guide.
Available at:
http://www.basics.org/
reports/FinalReport/
Newborn-Final-Report_
BASICS.pdf
http://www.basics.org/
reports/FinalReport/HTSPFinal-Report_BASICS.pdf
While some improvement has
been observed
in health indicators since 2000,
it is important
to be cautious in interpreting
and attributing
improvements to HEWs,
of which the first
graduates were only deployed
in the beginning of
2005. According to 2005
statistics, infant mortality
was 77 per 1000 (down from
97 in 2000); under
five mortality was 123 per 1000
(down from 160 in
2000); and DPT 3 coverage
rose from 38% in 2000
to 80%.
Early results from areas where
HEWs are deployed
are encouraging: immunization,
contraceptive use,
and personal and
environmental hygiene
all appear
to be improving (Report
available at www.who.int/
workforcealliance/knowledge/
case…/Ethiopia.pdf).
Integration of
curriculum into
national health
system for
implementation
at scale
Will cover half a million people
over 10 countries. Integration
into the following national
CHW curricula: Tanzania,
Uganda, Rwanda, Malawi
To follow up
Under field testing
Unknown.
Unknown.
Yes- Ghana.
Yes- Kenya.
Yes- PNG
Unknown.
Yes- Malawi.
Yes- Ethiopia.
Countries where
curriculum
has been
implemented
and number
4 countries: Malawi, Uganda,
Rwanda, and Tanzania. 6 future
countries: Ethiopia, Ghana,
Kenya, Mali, Nigeria, Senegal
target communities in Gombe
state, Nigeria
Field testing in numerous
countries in Africa, Latina
America and Asia
Unknown.
• All community health
Ghana.
Kenya (see above for #).
PNG
India.
Malawi.
Ethiopia- It is reported that
as of June 2007, more
than 17,000 HEWs have
been deployed (Report
available at www.who.int/
workforcealliance/knowledge/
case…/Ethiopia.pdf).
Estimated cost
of training
course (USD)
USD 2,619 for about 50 CHWs
for 5 days including printing
costs [granted, this was
combined also with the
mHealth training]
To follow up
Unknown.
Unknown.
Unknown.
Unknown.
Unknown.
Unknown.
Unknown.
Unknown.
1. Identification
of the tool
2. Purpose,
description
and scope of
the tool
workers in Southern Jordan
trained on the manual
last September.
• 2 countries of the region:
Iran and Morocco are doing
routine training of volunteers
using an adapted version
of the manual into their
local language.
• Sudan, Pakistan, Somalia
and Yemen have used the
manual on a small scale.
• Other countries are
in different stages of
implementation based on
their needs and priorities.
3. Sustainability
Unknown.
7
Integrated packages (package addresses more than 1 health area)
01
02
03
04
05
06
07
08
09
10
11
Tool name,
year, author
Community Health
Worker Trainer’s Manual.
Millennium Villages Project.
2011/2013 Update
Training manual for volunteers
on maternal and newborn
health care. Society for Family
Health (in collaboration with
PSI and Gates Foundation).
Revised edition, 2012
Timed and Targeted
Counselling. World Vision,
2010 (in partnership with WHO,
UNICEF, ACNM)
Guide for Training Community
Health Workers/Volunteers to
Provide Maternal and Newborn
Health Messages (USAID,
POPPHI, BASICS, 2009)
Training manual for cluster
representatives and health
volunteers, Module 1 and
Module 3. WHO, 2009
(2 VOLUMES OUT OF 3).
Community-Based Health
Planning and Services
(CHPS), Community Health
Volunteers Training Manual,
The Population Council,
Ministry of Health/ Ghana
Health Service, 2009
Linking Communities with
the Health System: the Kenya
Essential Package for Health at
Level 1. MOH Kenya, 2007
CHW Certificate Program Facilitator’s Guide (selected
modules). National Department
of Health, Papua New
Guinea, 2006
Reproductive Health Manual
for Trainers of CHWs. CEDPA
(Centre for Development
and Population Activities),
India, 2003
Health Surveillance Assistants
Training Curriculum,
MoH Malawi, 2006
Health Extension Worker
Program of Training Packages
Ethiopia, Ministry of Health
Federal Democratic Republic of
Ethiopia, The Earth Institute at
Columbia University Centre for
National Health Development in
Ethiopia, 2003/2004.
Strengths
• Integrated package focusing
• Training packages are context
• Integrated package of focused
• Competence based
• Integrated package of
• Curriculum is congruent with
• Congruent with
• Competence based
• Curriculum specific to the
• Curriculum is congruent
• The 16 training
on 20 key tasks related
to MNCH
• Thorough approach, e.g.
handwashing: how to
wash hands, how to set up
washing station, where to
buy soap, how to assess
household at each visit
• Multi-country
implementation & monitoring
• Not only technical
information, but also
covers the role, including
a code of conduct,
and rights of CHWs within
a wider system with strong
supportive supervision and
reporting mechanisms.
• Detailed prep work and how
to structure the flow of each
household visit, including
tips for good communication
and active listening
• Emphasis on mHealth and
reporting (1.5 days)
• Includes a CHW Supervision
Training Manual
and Checklists
specific and integrated into
the Gombe state, Nigeria.
• Volunteer training appears
congruent with local policy
and priorities.
• Job aids contextualized
• Encourage
men’s participation
interventions, covering
clinical, M&E, and effective
communication issues
• Modular approach possible
• ToT manual with
detailed preparation
instructions for training,
including pre-training
homework assignment
• Session on developing
communication skills (e.g.
respect, body language,
asking questions, listening,
praising, responding,
check understanding)
• Emphasis on filling and
using CHW register which
has pictorials that are easy
for CHWs to manage,
including illiterate groups
• Also addresses nonliterate CHWs
• Training alternates
with several months
long practice intervals
allowing reinforcement
of competencies
• ‘Country Readiness Process’
to help planning staff through
the various steps required
to adapt the curriculum to
local contexts.
with instructions for
assessing competence
• Provision of tools/resources:
counselling cards
• Curriculum specific to the
CHW role and includes
components on the roles
and responsibilities
of Community Health
Workers/Volunteers, basic
communication skills and
negotiation in addition
to technical knowledge
and skills.
materials covering essential
primary health care topics
• Provides job aids
(e.g., questionnaires,
birth and emergency
preparedness card).
• Context specific (regionally
based) with brief guidance
on further adaptation within
member states.
government policies.
• Provides training on generic
health worker skills (e.g.,
communication, community
mobilisation, communitybased surveillance, advocacy
for health etc.) together with
technical components.
• Guidance given on adapting
training to participant needs
and local context.
• Training can be incorporated
into other existing courses
and fora.
• Provides job aids.
government policy.
• Includes details on the roles
and tasks of CHWs.
• Addresses generic skills
required by CHWs.
• Addresses adolescent sexual
and reproductive health.
and assessed.
• Selected modules form part
of an accredited training
course for CHWs.
• Congruent with
government policy.
• Context specific curriculum
(including addressing local
cultural issues and barriers).
• Supervisor
involvement detailed.
• Provides clear
guidance for follow-up,
including assessment.
CHW role
• Certification and resourcing
of CHWs recommended
(not accreditation)
• Includes practical learning
guides to aid skill practice
• Component
addressing adolescent
reproductive health
with government policy
and planning.
• Competence-based
and assessed (required
competencies of
HSAs converted into
learning objectives).
• Comprehensive assessment
including demonstration of
knowledge, behaviour and
practical skills.
• Integrated package that
goes beyond SRMNCH and
addresses determinants of
health at community level
(e.g. building location,
protection of water
source, others)
packages provide an
integrated approach
which goes beyond,
but includes, SRMNCH.
• Training packages are context
specific and integrated into
the national health system
and processes.
• HEW training is congruent
with government policy
and priorities.
• Each package contains
guidance on information
management, monitoring
and evaluation.
• Contains a package
specific to adolescent
reproductive health.
• Does not address: benefits of
• Training methodology: may
• Does not address the SRH
• Does not address:
• Does not address:
• Does not address:
• Does not address:
• Selected modules do
• Does not address:
• Target trainee audience
• Documents provide guidance
family planning, counselling
and distribution of basic FP
methods; awareness of signs
of GBV; education about
consequences of unsafe
abortion; support for WLHIV;
newborn stimulation and
play; birth registration
• Clinical modules (units
2, 3, 4) may be too short
(few hours each) to
ensure competency
• Lack systematic assessment
of trainees competencies
against standards
• Job aids lack pictorials for
the client/caregiver side
be too didactic and not
practical enough.
• Not competencybased assessed
• Does not address:
-- Awareness of signs of
domestic and sexual
violence and referral
-- Support for women living
with HIV (pre & postpartum
-- Recognition of blues/
depression (postpartum
-- Prevention of indoor air
pollution (newborn)
-- Newborn stimulation and
play (newborn)
• No details given on
assessment or follow-up.
needs throughout the
lifecycle such for adolescents
or non-pregnant women,
Needs of children >2yo
not addressed.
• Promotes basic principles of
health timing and spacing of
pregnancy for all women but
does not address it in depth
• Does not address: awareness
of signs of GBV; education
about consequences of
unsafe abortion
• Lack systematic assessment
of trainees competencies
against standards
• Still undergoing field testing
throughout 2013
• Large amount of materials
to be printed and laminated,
which can be costly.
Support for women living
with HIV
-- Assessment of signs
of domestic violence
and referral
-- Prevention of indoor air
pollution (newborn)
-- Newborn stimulation and
play (newborn)
-- Birth registration (newborn)
• Limited guidance on
follow-up through
supervisor support and/
or refresher training/
continuing education.
Support for WLHIV
-- Assessment of signs
of domestic violence
and referral
-- Newborn stimulation
and play
• No clear definition provided
of ‘Cluster Representatives’
or ‘Health Volunteers’ (i.e.,
the trainee target audience).
• Training strategy and
methodology- whether
workshop format and/or selfdirected learning unclear.
• Instructions for training/
trainers lacking.
• Trainer target
audience unclear.
• Not competence based
or assessed.
• Assessment by pre- and
post-testing only.
• Follow up to training and
supportive supervision
not mentioned.
Adolescent sexual and
reproductive health
(family planning
-- Emergency contraception
-- Awareness of signs of
domestic and sexual
violence and referral
-- (Post abortion care
mentioned only as an
available service)
-- Support for women living
with HIV
-- (Childbirth care,
postpartum care, infancy
and childhood care
discussed in no detail)
• Covers key technical
areas briefly.
• Target trainee audience
is Community
Health Volunteers,
not CHWs (overlap?).
• Criteria for trainers lacking.
• No supervisor
involvement stated.
• No guidance on followup given.
• Not competence based
or assessed.
Support for transport
(childbirth care
-- Companion of choice
to support the woman
to attend a facility
(childbirth care)
• Generic skills for CHWs
covered but superficial
on SRMNCH.
• Not competence based or
assessed. No details on
assessment provided.
• Target trainer audience
not stated.
• Details on follow-up lacking.
• Details on supervisor
involvement lacking.
not address:
-- adolescent sexual and
reproductive health
specifically (mentions
young unmarried
women only in Family
Planning component).
-- Awareness of signs of
domestic and sexual
violence and referral
(family planning/
postpartum).
-- Prevention of indoor air
pollution (newborn)
-- Newborn stimulation and
play (newborn)
• The PNG concept of CHWs
goes beyond what is usually
expected from CHWs to
perform during household
visits (e.g. skilled delivery).
The extent of training (2
years) is more in line
with the curriculum of
auxiliary nurses.
Awareness of signs of
domestic and sexual
violence and referral
-- Support for women living
with HIV-Reporting birth
and death (postpartum)
-- Use of insecticide treated
bed nets (postpartum
-- Prevention of indoor air
pollution (newborn)
-- Newborn stimulation and
play (newborn)
-- Birth registration (newborn)
• Not competence based/
assessed. Evaluation is by
pre/post-testing only
• Limited guidance on
follow-up through
supervisor support and/
or refresher training/
continuing education.
is Health Surveillance
Assistants (equate
with CHWs?).
-- Does not address:
-- Awareness of signs of
domestic and sexual
violence and referral
(family planning)
-- Recognition of blues/
depression (postpartum)
-- Prevention of indoor air
pollution (newborn)
-- Newborn stimulation
and play
• No details given for target
trainer audience.
• Guidance on supervisors
involvement lacking.
• Guidance on followup lacking.
rather than curricula
Does not address:
-- Awareness of signs of
domestic and sexual
violence and referral
-- Support for women
living with HIV (pre
& postpartum)
-- Support for care for the rest
of the family (childbirth)
-- Support for
transport (childbirth)
-- (Support for exclusive
breastfeeding until
4 months of age only)
-- Recognition of blues/
depression (postpartum)
-- Prevention of indoor air
pollution (newborn)
-- Newborn stimulation and
play (newborn)
• Target trainees are facility
based (Health Post)- not
specific to CHWs.
• No details given on trainers.
• No details given on
assessment or follow-up.
1. Identification
of the tool
4. Strengths
and limitations
Limitations/
Weaknesses
--
--
--
--
--
--
8
Family planning
1. Identification
of the tool
1. Identification
of the tool
1. Identification
of the tool
2. Purpose,
description
and scope of
the tool
01
02
03
04
05
06
Tool name,
year, author
Training Resource Package for Family Planning. WHO,
UNFPA, USAID, 2012
Population, Health and Environment (PHE) Communitybased Distribution and Peer Education System: A Guide
for Training PHE Community-based Distributors. Balanced
Project (Coastal Resources Center, PATH Foundation
Philippines, Conservation International), 2012.
Training for community-based delivery of injectable
contraceptives. FHI360, Child Fund Zambia. 2009
(2011 update)
Postpartum Family Planning for Community Health
Workers. Jhpiego, ACCESS-FP / USAID, 2010.
Community Health Worker Postpartum Family Planning Training Package for CHW Trainers, USAID (2008)
Offering CycleBeads: a Toolkit for Training Community
Health Workers. Institute for Reproductive Health,
Georgetown University, 2008.
Link /Source
www.fptraining.org
http://www.k4health.org/sites/default/files/CBD_
Manual_508_FINAL.pdf
http://www.k4health.org/toolkits/cba2i/sample-communityhealth-worker-training-curriculum
http://reprolineplus.org/resources/postpartum-familyplanning-community-health-workers-learning-resourcepackage
http://www.k4health.org/toolkits/miycn-fp/communityheal-0
http://www.irh.org/?q=SDM_training_tools
Purpose
The training Resource Package for Family Planning is
designed as a generic tool to be used and adapted by
trainers of health care providers. It is not a curriculum per
se, but instead a toolkit from which curricula can be built to
match local contextual and trainee needs.
The package covers combined oral contraceptives (COCs),
male and female condoms, implants, IUDs, and FP
counselling. To take COCs, as an example, trainees will
be able to:
The objectives of this training are to increase understanding
and general knowledge of the training participants on
PHE linkages, reproductive health (RH)/ family planning
(FP), and on the mechanics and operation of the PHE CBD
system that will support community-based, integrated PHE
education and FP services.
To equip CHWs with skills in delivering injectables
as part of community-based access to modern
contraceptives, including:
To equip CHWs with skills on how to counsel (not provide
FP methods) accurately and effectively mothers and
families on:
To train CHWs on PPFP (LAM and other methods),
and interpersonal communication skills.
(Lack of clarity on learning objectives)
To equip CHWs with the following competencies:
• Providing family planning counselling, including
• PPFP, including
• Teach women and their partners how to use CB
• healthy spacing of pregnancy,
• Talk with a woman or couple about ways to manage the
1) List the key messages about COCs
2) Describe the characteristics of COCs in a manner
that clients can understand, including: how it works,
effectiveness, side effects, non-contraceptive health
benefits, dual protection, ease of use, return to fertility,
possible health risks
3) Demonstrate the ability to: screen clients for medical
eligibility, explain to clients how to use COCs and what
to do when pills are missed, explain when to return to
the clinic, address common concerns, misconceptions,
and myths, conduct follow-up for COC clients in a
way that enhances continuing safety, satisfaction,
and acceptance
4) Describe when to initiate COCs (postpartum, switching
from another method)
5) Explain how to manage side effects
6) Identify new conditions that may require a client
to switch to another method or to temporarily stop
COC use
7) Identify clients in need of referral for COCrelated complications
• Describe the benefits of PHE linkages/integration and
informed choice counselling
• Correctly screening clients for medical eligibility using
the checklist
• Correctly using Reinjection Job Aid to determine client
reinjection window, if applicable
• Administering the Depo intramuscular injection safely
and competently
The Training Resource Package for Family Planning is
a global resource package for trainers, supervisors and
program managers. It contains materials and resources for
designing, conducting and evaluating training for family
planning providers. The resource package is specifically
designed for mid-level providers but also contains more
advanced materials for physicians and can be adapted for
use with lower-level community health workers.
This training guide was developed for use in courses
to train population, health and environment (PHE)
Community-based Distributors (CBDs) who work on
integrated PHE activities. A PHE CBD is a Ministry of
Health (MOH) community volunteer, local storeowner,
storekeeper, accredited drug dispensary, community village
worker, or a member of a people’s organization (PO) or a
cooperative, etc. that/who is trained to provide information
on PHE, family planning (FP) methods, and the stocking
and sales of FP commodities (p1).
• Developed as part of a pilot study in Zambia,
the curriculum focuses on topics related to the safe
provision of DMPA, and includes a refresher on basic
reproductive health, the full range of FP methods,
counselling, referral, and recordkeeping.
Materials include:
Generic package developed to be used alone or with
other MNH training materials. Covers counselling skills
and counselling on suitable PPFP choices, primarily for
breastfeeding mothers, with strong emphasis on LAM,
and why and when to transition from LAM to another
modern method.
Covers: MNH situation in Afghanistan, interpersonal
communication and counselling, current CHW tasks in
pregnancy care, breastfeeding, basic LAM concepts and
providing LAM services, healthy timing and spacing of
pregnancy, FP methods, advocacy to community leaders
and community at large, Islam perspectives on FP.
A package of modular training resources to train CHWs
on Standard Day Methods (SDM) using CB. It includes
adaptable lesson plans and supporting materials for
developing training courses. It covers:
• Trainer’s binder
Materials include:
Materials include:
• Who can use CB
• CBD’s binder
• Trainer’s manual
• Trainer’s manual
• When to start using CB
• Participant’s manual
• Counselling cards
General overview
The Training Resource Package for Family Planning
includes the following resources:
By the end of this training, participants will be able to:
• Explain the effects of rapid population growth on human
health and natural resources;
explain what PHE is in their context;
• return to fertility,
• Offer CycleBeads within the context of informed choice
• Check to see if CB will work for a woman and her partner
days she can get pregnant
• appropriate birth spacing or limiting methods.
• Refer a woman or couple to a more experienced health
provider or clinic when needed
• Describe the human reproductive anatomy and the
fertility process;
• Describe the roles, functions and responsibilities of an
effective PHE CBD;
• Discuss how to social market contraceptive information,
products and services, and manage PHE CBD outlets,
including the effective management of the supply and
re-supply of commodities;
• Provide and discuss options regarding the use of
contraceptives with sexually-active men and women in
communities using correct information;
• Address rumours and gossip about contraceptive
methods, and
• Report and monitor PHE CBD activities (p7).
• Counselling flipbook: main tool used by CBD agents to
counsel their clients, based on WHO’s DMT
• Brochure for new DMPA clients
• LAM card
• FP and informed choice
• How to use CB
• Asking about breastfeeding and FP
• Helping the couple use CB successfully
• Practice counselling with CB
• PowerPoint Slides
This manual was developed by the BALANCED Project,
which promotes wider adoption and use of effective PHE
approaches worldwide.
• Handouts
This training contains the following modules:
• Evaluation Tools
• PHE Integration
• Storyboard for a 2-hour training only
• Ecosystems- overview and the link between ecosystem
• Knowledge improvement tool (checklist for supervisors)
• Illustrative Module Session Plan
• Facilitator’s Guide
• References
Modules within this curriculum include:
• Combined Oral Contraceptives
• Condoms- Female
• Condoms- Male
• Contraceptive Implants
• Family Planning Counselling
• Intrauterine Devices
• Counselling guides: Nigeria, Guinea, Afghanistan.
Materials include:
• Trainer’s toolkit
• Job aids («insert panels») & set of CB.
health and human well-being
• Human reproductive anatomy
• Human fertility
• Overview of the PHE CBD system
• Social marketing of contraceptives for PHE CBDS
• Gossip and rumours
• Sexually Transmitted Infections, including HIV
• Communicating PHE and FP information to PHE
CBD clients
• Management information system for PHE CBD
• Evaluation
9
Family planning
1. Identification
of the tool
01
02
03
04
05
06
Tool name,
year, author
Training Resource Package for Family Planning. WHO,
UNFPA, USAID, 2012
Population, Health and Environment (PHE) Communitybased Distribution and Peer Education System: A Guide
for Training PHE Community-based Distributors. Balanced
Project (Coastal Resources Center, PATH Foundation
Philippines, Conservation International), 2012.
Training for community-based delivery of injectable
contraceptives. FHI360, Child Fund Zambia. 2009
(2011 update)
Postpartum Family Planning for Community Health
Workers. Jhpiego, ACCESS-FP / USAID, 2010.
Community Health Worker Postpartum Family Planning Training Package for CHW Trainers, USAID (2008)
Offering CycleBeads: a Toolkit for Training Community
Health Workers. Institute for Reproductive Health,
Georgetown University, 2008.
Target
audience: trainees
Depending on module:
PHE CBD is a Ministry of Health (MOH) community
volunteer, local storeowner, storekeeper, accredited drug
dispensary, community village worker, or a member of a
people’s organization (PO) or a cooperative, etc.
This training may:
Meant for CHWs who have already been trained in the
provision of oral contraceptive pills and condoms.
In Zambia: trainees with at least 9th grade.
At least sixth-grade reading level.
Resident in local area, age 20-50, volunteer, motivated,
respected in the area.
«Some» primary education. The training does «not require
a high reading level»
• Mid-level providers
• Physicians, nurses and midwives
• Other health care providers
• Lower-level CHWs (with adaptation)
Basic literacy: an advantage but not essential.
• Target new PHE CBDs,
• Provide refresher training to existing PHE CBDs, or
• Be used to add new tasks to jobs of existing PHE
CBDs (p5).
Target
audience: trainers
Clinical trainers and pre-service educators with a thorough
understanding of adult learning principles and the ability
to provide clinical training on Family Planning topics in
pre-service or in-service settings.
Facilitators who use this guide should have participated in
the PHE Community-based Distribution and Peer Education
System Training-of-Trainers (TOT)
(training guide for ToT available at: http://www.crc.uri.edu/
download/TOT_Manual_for_PHE_CBD_and_Adult.pdf).
No mention
Trainers must be nurses, midwives or other health care
providers with at least 10th-grade reading level.
No mention
Trainers must be nurses, midwives or other health care
providers with at least 10th-grade reading level.
Training methodology,
including clinical
practice and
assessment of
competencies acquired
All of the parts needed to develop a curriculum for each
module are included in the TRP.
Each of the 12 modules contains participatory learning
exercises for teaching the topic covered in that module.
The exercises are based on adult learning principles and
designed to help participants retain the information learned.
Each module has a ‘Facts to Know’ section that gives
the training team key information to emphasize while
conducting an exercise.
• Adult learning methods: interactive presentations, games,
• Competency-based training: interactive, small-group
• Competency-based training: participatory discussion,
• Competency-based training: interactive, small-group
role plays, demonstration, practice (in classroom and
clinic). Injectable skills practiced first on fruits such
as mangoes.
• Cascade training approach for scale up in Zambia
• Assessment: includes a pre- and post-training
questionnaire, but also a very detailed competency
checklist for clinical practicum.
work, demonstration and practice, case studies, games
and role plays.
• Focuses on the use of the counselling guides
• Assessment: simulated and actual practice of the PPFP
counselling using the CHW PPFP counselling checklist.
short presentations to conceptualize the basic principles,
group work, exercises and role‐play of key skills in
decision making, counselling and negotiation, classroom
and clinic-based practice.
• Unclear how assessment of skills is made
work, demonstration and practice, case studies, games
and role plays.
• Heavily focused on job aids and CB practice
• Assessment: competency checklist
Family Planning.
FP
Postpartum FP, postpartum care
Postpartum FP, to some extent: pregnancy care,
postpartum care
FP
Population Health and Environment (PHE).
n/a
n/a
2 Days (see pp9-14 for program).
3 weeks total. Theoretical training: 1 week of classroom
training. Practical training: supervised clinic-based
practicum over a period of about 2 weeks
3 days. 4 days to add skill-building practice.
4-5 days
2-3 hours
The manual recommends that the training be followed up
with periodic refresher training and exercises and/or onthe-job mentoring during supervisory visits (p2).
Refresher trainings are being held during the scale up
phase. Supervision is integrated into the curriculum
not addressed
CHW trainers need to provide 3 supportive supervision
visits to each group of trainees every 4 months for a year.
Addressed and highly recommended. The institute
also developed a ‘knowledge improvement tool’ with a
comprehensive checklist to help supervisors oversee
CHW’s competencies.
2. Purpose,
description
and scope of
the tool
The Facilitator’s Guide for each component provides a
diagram which shows how the different elements of the
module fit together. Each piece of the modules may be
adapted to fit the circumstances in the country where
they will be used, the trainers who will be conducting
training, and the level of expertise and skills of the trainees.
The modules can be adapted to fit any kind of training e.g.,
face-to-face or self-study combined with clinical practicum,
on-the-job training, etc. The modules can be used as a
stand-alone module or as part of a comprehensive course
in FP.
The modules can be used as a resource for refresher
training or for training new providers. Whenever possible,
the modules should be translated into the local language.
The trainer can provide the information contained in the
‘Facts to Know’ through a short lecture either before or after
the ‘Exercise’ to reinforce and strengthen the learning.
The guide provides guidance on when to use lectures, but it
is the prerogative of the trainer/training team to decide how
to provide this information (p3).
Evaluation is through pre- and post-testing.
Each module is competency-based and assessed.
Aspect of the
continuum of
SRMNCAH
care covered
Family Planning
Other health
subjects covered
Duration of
training course
Follow-up training
and supervision
(if planned)
Dependent on adaptation. Illustrative Training Schedules
provided for each module.
n/a
10
Family planning
1. Identification
of the tool
01
02
03
04
05
06
Tool name,
year, author
Training Resource Package for Family Planning. WHO,
UNFPA, USAID, 2012
Population, Health and Environment (PHE) Communitybased Distribution and Peer Education System: A Guide
for Training PHE Community-based Distributors. Balanced
Project (Coastal Resources Center, PATH Foundation
Philippines, Conservation International), 2012.
Training for community-based delivery of injectable
contraceptives. FHI360, Child Fund Zambia. 2009
(2011 update)
Postpartum Family Planning for Community Health
Workers. Jhpiego, ACCESS-FP / USAID, 2010.
Community Health Worker Postpartum Family Planning Training Package for CHW Trainers, USAID (2008)
Offering CycleBeads: a Toolkit for Training Community
Health Workers. Institute for Reproductive Health,
Georgetown University, 2008.
Training course
evaluated,
and key results
n/a
Unknown. Mid-term evaluation of the Balanced
Project released August 2011 (available at http://www.
ghtechproject.com/files/1%20523%20BALANCED%20
Evaluation%20FINAL10.28.11_508.pdf) but this pre-dates
the included curriculum.
The curriculum has not been rigorously evaluated, but it
has evolved overtime based on the feedback from end users
(trainers and trainees). It is also updated with the latest
normative guidance.
Afghanistan:
Unknown
Unknown
2. Purpose,
description
and scope of
the tool
• Under the five-year Health Services Support Project
(HSSP), which focuses on improving the delivery of
high-quality health care services in health facilities
across 21 provinces in Afghanistan, there were 14,389
CHWs trained on PPFP across all 34 provinces of the
country and integrated within the Basic Package of Health
Services. The BPHS forms the core service delivery
package in primary health care facilities, including
health posts.
• The National Reproductive Health Strategy (2012-2016)
includes the expansion of community-based PPFP using
CHWs and community-based distribution of FP methods.
• An uptake of FP services at the health post level in 13
USAID provinces was observed. CPR also increased
nationally from 10 to 20%.
Bangladesh: Findings at 12 and 18 months post-delivery
showed significantly higher contraceptive prevalence
among study participants compared with the control
group in 4 unions of Sylhet District (42% versus 27%
at 12 months, and 47% versus 34% at 18 months postdelivery, respectively).
Nigeria: ACCESS endline evaluation revealed that the
proportion of women receiving FP counselling during
both antenatal and postnatal services increased from
80% to 90% and 58% to 65%, respectively. Even with
an ongoing commodity shortage, contraceptive method
mix was improved, especially for long-acting methods,
and postpartum women were more likely to be using a
modern method, increasing from 1% to 11%. This is much
higher than 1-2% contraceptive prevalence rate from DHS.
Furthermore, the proportion of women delivering with a
skilled birth attendant increased from 20% to 25%.
3. Sustainability
4. Strengths
and limitations
Integration of
curriculum into
national health system
for implementation
at scale
n/a
Unknown.
No MOH countries to date. But some of the job aids were
included into Uganda’s MOH’s National Community-Based
FP Curriculum.
Yes: Afghanistan, Bangladesh (Sylhet District), Nigeria
(Northern Part), Tanzania
Integrated into the national community-based health care
program, under the leadership of the MOPH.
Unknown
Countries where
curriculum has
been implemented
and number
n/a
The Balanced Project has field initiatives in the Philippines,
Tanzania, Zambia and Ethiopia.
Zambia and Liberia.
Some of the job aids were included in the Uganda MOH’s
National Community-Based FP Curriculum, and in the
ChildFund Senegal’s CBA2I curriculum.
Curriculum adapted and implemented in 4 countries:
Afghanistan, Bangladesh, Nigeria, Tanzania.
13 provinces of Afghanistan
Unknown
Estimated cost of
training course (USD)
n/a
Unknown.
On average, USD 20,000 for 20 CHWs (5 days classroom,
10 days practicum)
Varies by location and timing and depends on: Stakeholder
meetings with government officials for collaboration,
Performing formative research or needs assessment,
Developing/Adapting IEC materials and messages,
Adapting training materials, Training costs for CHWs and
supervisors, as well as any other field staff responsible
for implementation, Printing costs for IEC materials,
monitoring and supervision tools, and training materials,
Travel costs for supervision and field visits by stakeholders,
Staffing costs for any new employees
Unknown
Unknown
Strengths
• Clear guidance on adaptation to local context (including
• Provides sample tools for use on-the job (e.g., reporting
• Competency-based approach to injectables.
• Addresses issues of counselling couples and men
• Developed locally and integrating local knowledge,
• Dynamic, highly interactive, and hands-on training
to national standards and guidelines) provided.
• Clear guidance on adaptation to different types of health
workers and their varying learning experience and needs.
• Competency-based and assessed.
• Each module of the TRP provides a complete set of
learning resources needed to meet learning objectives.
• Job aids and tools provided.
and monitoring forms, referral slip).
• Includes generic health worker skills together with
technical components.
Role plays with different and realistic scenarios
(adolescents, breastfeeding, new clients, etc.). Intensive
clinic practices.
• Based on decision-making tool/DMT for clients and
providers - promote women’s choice and gives IEC on
all methods
• Provides examples of counselling guides from
• Richly illustrated job aids, allowing training of low-
3 different countries
• Comprehensive PowerPoint presentations available to
back up lectures.
• Extensive evaluation in various countries
attitudes (e.g. Islam and FP) and practices (e.g. wet warm
cloths with some honey applied to small tears of
external genitalia).
• Training put in the context of overall pregnancy and
postpartum care, including refresher information
• Not specifically targeted to CHWs (though
• Does not address:
• Job aid for CHWs/CBDs relatively wordy and is not
• Does not provide examples on how to integrate the
• Document format is dense, wordy and difficult to
• Does not provide examples of how to integrate the
adaptation possible).
• Not a curriculum per se. Building blocks for creating
curricula provided.
Adolescent sexual and reproductive health
-- Awareness and signs of domestic violence and referral
• Guide recommends follow-up through refresher training,
exercises and/or on the job mentoring during supervisory
visits but details and tools lacking.
• Evaluation is by pre- and post-testing only.
• Not competence based or assessed.
• Target trainee audience is broad- CBDs,
not exclusively CHWs.
adequate for low-literacy CHWs
• Limited information regarding health system integration,
but this training needs to be fitted within the overall FP
training for CHWs.
package into other FP/MCH packages for CHWs.
• Does not address the issue of supportive supervision and
health system integration.
• Limited information for counselling WLHIV
• Limited training on record keeping
navigate. At times, too theoretical.
• Competencies to be acquired not well defined, lack of
final assessment.
• Unclear structure for home visits (when and what
to counsel/check)
• Some issues may be too complex to be addressed in a
short time period (e.g. breast pathologies in 60 min)
• Some contents may be too theoretical or difficult for lowliteracy trainees (e.g. LAM vs. BF, LAM vs. amenorrhea)
package into other FP/MCH packages for CHWs however, encourages trainers and managers to think
about these aspects before organizing the training
• No training on record keeping
Limitations/ Weaknesses
--
literacy CHWs
• Provides a supervision tool
11
Safe abortion care
Pregnancy care
01
Tool name, year, author
1. Identification
of the tool
01
1. Identification
of the tool
Link /Source
See integrated packages tab
1. Identification
of the tool
Tool name, year, author
Purpose
General overview
Link /Source
Target audience: trainees
Target audience: trainees
Purpose
Target audience: trainers
Target audience: trainers
Target audience: trainers
Training methodology, including clinical practice
and assessment of competencies acquired
2. Purpose,
description
and scope of
the tool
Training methodology, including clinical practice
and assessment of competencies acquired
Aspect of the continuum of SRMNCAH
care covered
2. Purpose,
description
and scope of
the tool
Training methodology, including clinical practice
and assessment of competencies acquired
Aspect of the continuum of SRMNCAH
care covered
Other health subjects covered
Other health subjects covered
Aspect of the continuum of SRMNCAH
care covered
Duration of training course
Duration of training course
Follow-up training and supervision (if planned)
Follow-up training and supervision (if planned)
Other health subjects covered
Training course evaluated, and key results
Training course evaluated, and key results
Duration of training course
Integration of curriculum into national health
system for implementation at scale
Integration of curriculum into national health
system for implementation at scale
Follow-up training and supervision (if planned)
Training course evaluated, and key results
3. Sustainability
Integration of curriculum into national health
system for implementation at scale
Countries where curriculum has been
implemented and number
Countries where curriculum has been
implemented and number
3. Sustainability
Estimated cost of training course (USD)
4. Strengths
and limitations
Strengths
Limitations/ Weaknesses
See integrated packages and FP tabs
Link /Source
General overview
Target audience: trainees
3. Sustainability
Tool name, year, author
01
Purpose
General overview
2. Purpose,
description
and scope of
the tool
Only briefly mentioned in: Community-Based Health
Planning and Services (CHPS), Community Health
Volunteers Training Manual, The Population Council,
Ministry of Health/ Ghana Health Service, 2009 (see
Integrated Packages tab)
Postpartum care
Countries where curriculum has been
implemented and number
Estimated cost of training course (USD)
4. Strengths
and limitations
Strengths
Limitations/ Weaknesses
Estimated cost of training course (USD)
4. Strengths
and limitations
Strengths
Limitations/ Weaknesses
12
Childbirth care
01
1. Identification of
the tool
02
03
Also see integrated packages tab
Tool name, year, author
Prevention of Postpartum Hemorrhage at Home Birth - A Program Implementation Guide. Access Program / Jhpiego. 2009
Prevention of postpartum hemorrhage at home birth - Facilitator’s guide & Reference manual. MOH&Population Nepal, 2005
Link /Source
http://reprolineplus.org/resources/prevention-postpartum-hemorrhage-home-birth-program-implementation-guide
http://www.k4health.org/sites/default/files/2b%20NP%20Trainers%20Notebook-PPH_0.pdf
Purpose
To prepare CHWs to give information to women, families and community on the causes and prevention of PPH. Will provide
CHWs with knowledge and skills to provide misoprostol to pregnant women in case of home birth - message about skilled
birth attendance is reinforced as the best way to prevent PPH.
To equip Female Community Health Volunteers (FCHVs - self-motivated local community women, selected by local mothers’
group for health) with the knowledge and skills to talk to women, support persons, families and community to:
• recognize PPH
• act to prevent PPH using Misoprostol
• act if bleeding persists
General overview
2. Purpose,
description and
scope of the tool
Guide developed to provide the managers of reproductive health programs with a step-by-step approach to setting up a
community-based misoprostol program. It is intended to provide organizations and agencies with the information they need to
introduce, implement and sustain a program of community-based distribution of misoprostol as an approach to the prevention
of PPH.
Curriculum developed to train FCHV on PPH prevention at home births using misoprostol, although messages about
attendance of ANC with midwife and skilled birth delivery are also reinforced. Focus on the use of misoprostol to prevent
excessive bleeding after childbirth at home birth and will provide FCHVs with the attitudes, knowledge, and skills needed to
provide miso to pregnant women in their communities.
The guide includes 2 sections:
Training package include:
I: Program implementation guide on how to bring innovation to scale, ensure enabling policy, establish a technical advisory
group, site selection, adaptation of materials, miso procurement etc, with examples and lessons learnt from the field
(Afghanistan, Indonesia, Nepal)
II: Resources for training community volunteers, including training curriculum, competency checklist, postcourse
questionnaire, and training tips. Curriculum appears to be largely drawn from the Nepali one.
• Facilitator’s guide (outline of training agenda)
Target audience: trainees
Trainees can be literate or illiterate
Non-distributor (of Misoprostol) FCHV must have completed basic FCHV training. Distributor FCHV (of Misoprostol) need to
be in addition: literate, able to travel frequently to her coverage area and working in maternal health.
Target audience: trainers
No ToT manual but: trainers should be at least midwives, experienced in training, with understanding of group dynamics, train
people with low levels of basic education, can model strong interpersonal skills that students can replicate, ensure local words
for bleeding, vomiting, pain, etc are used in the training so that the training context is culturally appropriate, include students’
experiences in role plays and discussions, valuing their contribution
No ToT manual identified but: trainers need to have been trained in district ToT on community-based maternal and neonatal
care. One of the trainers must be an assistant nurse midwife
Training methodology, including
clinical practice and assessment of
competencies acquired
• Much of the curriculum and approach appears to be drawn from the Nepali training package for FCHV
• Illustrated lectures and group discussions, role plays, exercise, demonstration, brainstorming, games
• Illustrated lectures and group discussions, role plays, exercise, demonstration, brainstorming, games
• Intensive use of repetitive demonstration and role plays for key intervention steps: interpersonal and communication skills;
• Competency-based: participants must score 85% on knowledge assessment and 100% on steps and tasks (checklist)
identification and registration of pregnant women (& calculate estimated date of delivery); IEC provision to women, family,
community; provision of misoprostol to women at 8 months; follow up visit and data recording; retrieval of used/nonused Misoprostol.
• Mid-course and end of course assessment by trainer, 80% score in knowledge assessment, 100% in steps/tasks.
Aspect of the continuum of SRMNCAH
care covered
Childbirth care
Childbirth care
Other health subjects covered
none
none
Duration of training course
3 days
3 days
Follow-up training and supervision
(if planned)
Not mentioned in available materials
Not mentioned in available materials
Training course evaluated, and key results
Info not found. But is based on training materials from Nepal, Afghanistan and Indonesia
• Evaluation of training course per se: info not found
Integration of curriculum into national health
system for implementation at scale
Nepal, Afghanistan, Bangladesh, Mozambique
Developed by Nepal MOH&Pop
Countries where curriculum has been
implemented and number
11: Bangladesh, Ghana, Mozambique, Nigeria, Pakistan, Tanzania, Zambia, Rwanda, Madagascar, Liberia, South Sudan
Nepal
Estimated cost of training course (USD)
Unknown
Unknown
Strengths
• Curriculum is part of comprehensive implementation guide that summarizes field experiences and pearls from different
• Short evidence-based hands-on training for a very specific life-saving intervention, taking into consideration the context
settings, including samples of IEC, M&E, checklists and other supportive materials.
• Train CHWs on common implementation pitfalls and solutions (e.g. sharing medication)
• Outline of job descriptions for CHW, CHW supervisor, and pharmacists
• Simple and contextualized language (miso is called matri suraksha chakki - mother’s protection tablet)
• Reference manual (technical information for facilitators)
• Job aids and forms [not available online]: Prevention of Excessive Bleeding at Home Births: Nepali Flipchart, FCHV
Distributor Register, excessive bleeding after childbirth Referral form, birth and death registration form.
• Positive results from different ops research (e.g. Rajbhandari IJGO 2010)
3. Sustainability
4. Strengths
and limitations
of Nepal
• Critical steps are rehearsed intensively, with competency-based assessment at the end
• Emphasis on data monitoring/register
Limitations/ Weaknesses
• Beside job description for CHW supervisors, little on supportive supervision
• Supportive supervision not mentioned
• Missed opportunity to train/refresh on other pregnancy danger signs
• Missed opportunity to train/refresh on other pregnancy danger signs [but this may be covered in the more general MCH
• Suggests curriculum to be integrated into wider MCH training for CHWs, but does not provide practical ways on how.
• Relies on women remembering counselling messages (vs. leaving them with IEC materials)
training for FCHV]
• Relies on women remembering counselling messages (vs. leaving them with IEC materials)
13
Newborn, infant and childhood care (note that some packages, such as 1 and 5, also briefly address pregnancy and postpartum care)
1. Identification
of the tool
01
02
03
04
05
06
07
08
Tool name,
year, author
Caring for the newborn at home, a training
course for community health workers.
WHO, UNICEF, 2012
Care for child development: improving
the care of young children. WHO,
UNICEF, 2012.
The Community Infant and Young Child
Feeding Counselling Package: Facilitator
Guide, September 2012, UNICEF & URC/
CHS
Caring for the sick child in the community.
WHO, UNICEF, 2011
Manual de agente comunitario de salud:
Atencion integrada a las enfermedades
prevalentes de la infancia (AIEPI) [IMCI].
PAHO, 2010.
Community IMCI. MOH Cambodia, 2008
Infant young child feeding counselling: An
integrated course. WHO, UNICEF, 2006.
How to Train Community Health Workers in
Home-Based Newborn Care. The SEARCH
Team, 2006.
Link /Source
http://www.who.int/maternal_child_
adolescent/documents/caring_for_
newborn/en/index.html
http://www.who.int/maternal_child_
adolescent/documents/care_child_
development/en/index.html
http://www.unicef.org/nutrition/files/
Facilitator_Guide_Oct_2012.pdf
http://www.who.int/maternal_child_
adolescent/documents/imci_community_
care/en/index.html
http://www2.paho.org/hq/
dmdocuments/2011/Manual%20
Agente%20Comunitario%20de%20
Salud_LR.pdf, http://www2.paho.org/hq/
dmdocuments/2011/Agente-Comun-SaludGuia-Facilitador-LR.pdf
Contact authoring agency and CD-ROM
http://whqlibdoc.who.int/
publications/2006/9789241594769_eng.pdf;
http://archive.k4health.org/toolkits/pc-mnh/
how-train-community-health-workershome-based-newborn-care
1. Identification
of the tool
1. Identification
of the tool
http://whqlibdoc.who.int/
publications/2006/9789241594752_eng.pdf;
http://www.who.int/nutrition/publications/
infantfeeding/9789241594745/en/index.
html;
http://whqlibdoc.who.int/
publications/2006/9789241594776_eng.pdf;
Purpose
To equip CHWs with the following
competencies during home visits:
• promotion of ANC and skilled care
at birth
• counselling on care for the newborn
in the 1st week of life (immediate
postpartum care, breastfeeding, weight,
optimal care)
• recognition of NB danger signs
and referral
• special care for LBW babies
Detailed competencies are listed below*
2. Purpose,
description
and scope of
the tool
Health workers and other counsellors to
become competent in counselling families
and communities on, and promoting and
supporting child development (through
communication and play)
This is a generic resource designed to
equip community workers (including CHWs
and volunteer health workers, referred to
as CWs), and primary health care staff to
support mothers, fathers and caregivers
to optimally feed their infants and
young children.
To equip CHWs with the following
competencies in assessing and treating
sick children 2 to 59 months of age during
home visits:
The training component of the package is
intended to prepare CWs with technical
knowledge on the recommended
breastfeeding and complementary
feeding practices for children from 0 up
to 24 months, enhance their counselling,
problem-solving and reaching-anagreement (negotiation) skills, and prepare
them to effectively use the related
counselling tools and job aids (Facilitator
Guide p1).
diarrhea and fever
• identification and referral of children with
severe malnutrition
• referral of other problems needing
medical attention
• advise on home care and prevention
of illness
The Facilitator Guide contains information
on conducting Training of Master
Facilitators/Trainers (ToMT), Training of
Facilitators/Trainers (ToT), and Training of
Counsellors (ToC) workshops.
By the end of each training component,
participants will have developed
specific skills*.
The ultimate goal of training in the
Community IYCF Counselling Package is
to change the behavior of both the CWs
(the learning participants) and the mothers,
fathers and caregivers that they counsel
(Facilitator Guide p5).
• identification and referral of children with
danger signs
• treatment (or referral) of pneumonia,
• To equip CHWs with the following
general competencies:
• To help families protect the health of
pregnant women and children through the
practice of key preventive measures
• To recognize the danger signs in pregnant
women and children, and refer
For details on competencies, see * below.
This curriculum was developed to train
Village Health Support Group members,
who are community-level educators,
to deliver effective health education and
promotion at the village level for caretakers
of children up to five years old (preface).
Objectives of this course include improving
participants’ ability to:
• Communicate effectively with and give
advice to caretakers so that caretakers
adopt new behaviours that improve their
children’s health
• Educate caretakers of children under 5
in their communities on basic disease
prevention and health promotion
• Educate caretakers about proper home
care for sick children
• Educate caretakers about why, how,
and when to use the health centres
• Refer children who show danger signs
of severe sickness to health centres
for treatment
• Mobilise and organise people in their
communities to work towards improved
health for children
• Assist with village health
information gathering
• Provide reports on their activities
(Facilitator’s Manual p9).
This document states that there is an
urgent need to train all those involved in
infant feeding counselling, in all countries,
in the skills needed to support and protect
breastfeeding and good complementary
feeding practices (Director’s Guide p2).
This course is designed, therefore, to give
health workers the competencies required
to carry out effective counselling for
breastfeeding, HIV and infant feeding and
complementary feeding.
This manual presents a set of materials for
training village health workers to deliver
basic yet comprehensive home-based
neonatal care at the community level.
Upon successful completion of this
training, the CHW will be able to perform
key skills*
After completing this course, participants
will be able to:
• counsel and support mothers to carry
out WHO/UNICEF recommended feeding
practices for their infants and young
children from birth up to 24 months
of age
• counsel and support HIV-infected
mothers to chose and carry out an
appropriate feeding method for the first
two years of life (Director’s Guide p4).
See below for detailed competencies*.
14
Newborn, infant and childhood care (note that some packages, such as 1 and 5, also briefly address pregnancy and postpartum care)
1. Identification
of the tool
01
02
03
04
05
06
07
08
Tool name,
year, author
Caring for the newborn at home, a training
course for community health workers.
WHO, UNICEF, 2012
Care for child development: improving
the care of young children. WHO,
UNICEF, 2012.
The Community Infant and Young Child
Feeding Counselling Package: Facilitator
Guide, September 2012, UNICEF & URC/
CHS
Caring for the sick child in the community.
WHO, UNICEF, 2011
Manual de agente comunitario de salud:
Atencion integrada a las enfermedades
prevalentes de la infancia (AIEPI) [IMCI].
PAHO, 2010.
Community IMCI. MOH Cambodia, 2008
Infant young child feeding counselling: An
integrated course. WHO, UNICEF, 2006.
How to Train Community Health Workers in
Home-Based Newborn Care. The SEARCH
Team, 2006.
General overview
Package of training materials promoting
access to essential interventions for
pregnant and lactating women and their
newborn infants. Provides guidance for
CHWs to conduct home visits in the ANC
and PNC periods. Drawn on experiences
from several research studies.
Package to prepare persons who work with
families to promote
the healthy growth and psychosocial
development of children. NOT TARGETING
CHWs per se.
The primary objective of training
community workers (CWs) or primary
health care staff as IYCF Counsellors is to
equip them with the knowledge, skills and
tools to support mothers, fathers and other
caregivers to optimally feed their infants
and young children (Facilitator Guide p3).
Package of training materials to assess and
treat sick children 2 to 59 months at home,
using selected interventions and requiring
the use of four simple medicines: antibiotic,
antimalarial, ORS and zinc tablets.
This course was first developed in 2004
to train Village Health Support Groups to
deliver health education and promotion for
caretakers of children up to five years old at
the community level.
Materials include:
• Participant manual
Training Materials include:
• CHW manual
• Facilitator guides
• Counseling cards
• Facilitator Guide
Modular training package to be tailored to
the needs of each country. The facilitator’s
guide has 2 sections. Section 1 deals with
adult learning principles and preparatory
information and actions facilitators need
to be aware of before, during and after the
training, including supportive supervision.
Section 2 deals with building the
CHW competencies.
This manual is based on the programme
developed by SEARCH to train CHWs in
home-based newborn care (HBNC) in
Gadchiroli District, Maharashtra, India.
This manual is part of the home-based
newborn care training package developed
to assist organisations or governments
in implementing this approach
in communities.
• CHW manual
• Guide for clinical practice
• Participant Materials
• CHW register
• Framework for M&E
• Counseling cards
• Photo book
The course has 35 sessions, covering IMCI
topics including:
• Counselling cards
• Poster: recommendations for care for
• Key Messages Booklet
• DVDs: demonstrations and exercises
• Pregnancy care & nutrition
1) Breastfeeding,
2) Complementary feeding,
3) Micronutrients,
4) Hygiene,
5) Immunisation,
6) Malaria,
7) Psychosocial development,
8) Continued feeding when children
are sick,
9) Appropriate treatment for sick children,
10) Recognising child illnesses and refer to
the health centre,
11) Appropriate treatment and follow-up,
12) Antenatal care
The WHO and UNICEF developed The
Global Strategy for Infant and Young Child
Feeding in 2002 to revitalize world attention
to the impact that feeding practices have on
the nutritional status, growth, development,
health, and survival of infants and young
children. This strategy is based on the
conclusions and recommendations of
expert consultations, which resulted in
the global public health recommendation
to protect, promote and support exclusive
breastfeeding for six months, and to provide
safe and appropriate complementary foods
with continued breastfeeding for up to two
years of age or beyond.
• Mother and baby card
• Referral note
• CD-ROM: training resources
Materials include:
• Facilitator notes
child development
• CD-ROM: training, advocacy,
technical resources
• Framework for M&E
• Take-home brochures
• Training Aids
• Planning Guide
• Adaptation Guide
• Supportive supervision/Mentoring and
• Facilitator’s notes
• Chart booklet (simple decision-
making tool)
for identifying signs of illness; rapid
diagnostic test for malaria
• Postpartum care
• Newborn care until 2 months
• Care of the child from 2 months to
5 years
• Care of the sick child (cough/cold,
diarrhea, fever, malnutrition, anemia)
Monitoring 1-day training
• Orientation Presentation
• Child development
Sessions of this training include:Why
IYCF matters,
preventive measures, including against
influenza pandemic
• Care of the sick child (cough/cold,
diarrhea, fever)
• Clinical practice
• Register
• Common situations that can affect
2. Purpose,
description
and scope of
the tool
Materials include:
breastfeeding,
• How to counsel,
• How to breastfeed,
• Complementary feeding and foods,
• Common breastfeeding difficulties:
symptoms, prevention and ‘what to do’,
• Action-oriented groups, IYCF support
groups, and home visits,
• Women’s nutrition,
• Feeding the sick child,
• IYCF in the context of HIV,
• Integrating IYCF support into community
services,
• Field practice and feedback.
• Accident prevention, and other
Materials include:
• Facilitator’s guide
• CHW’s manual, where job aids
are attached
• Video for classroom demonstration
The curriculum was developed according to
the twelve Key Family Practices that make
up the Community Integrated Management
of Childhood Illness strategy:
This training manual is to be used in
conjunction with the 12 Key Family
Practices flip chart and a smaller job aid
developed in complement (available from
National Centre for Health Promotion)
(Facilitator’s Manual p6).
This curriculum was developed to serve as
one of many tools required to implement a
successful community health program. It is
organised into the following Modules:
0) Introduction
1) Adult learning and basic
communication skills
2) Antenatal, delivery and postnatal care
3) Breastfeeding and complementary
4) Micronutrients
5) Immunisation
6) Hygiene
7) Home care of sick children
8) Psychosocial development of the child
9) Malaria prevention and treatment
(area specific)
Supplementary module: Community case
management of pneumonia, diarrhoea
and fever.
However, many children are not fed in the
recommended way.
To address this, the Infant and Young Child
Feeding Counselling: An Integrated Course
combines three existing courses available
from WHO/UNICEF:
1) Breastfeeding Counselling:
A Training Course,
2) HIV and Infant Feeding Counselling:
A Training Course,
3) Complementary Feeding Counselling:
A Training Course
The integrated course is not designed
to replace these three standalone
courses, but rather was designed in
acknowledgement that in many situations
there is not enough time for health workers
to attend all of the above courses (Director’s
Guide pp2-3).
The package consists of:
1) A manual for training CHWs in HomeBased Newborn Care: including
• CHW progress book
• Photograph album of newborn conditions
and congenital anomalies
• Health education flipchart
• Health education film in Hindi (Nanhisi
Jaan) and Marathi (Tanhula)
• Survey forms and newborn health records
2) Training of Trainers (ToT) manual
for home-based newborn care
(under preparation)
3) Traditional birth attendant (TBA) manual
for home-based newborn care
In addition to the clinical objectives
mentioned above, the manual also
covers a range of topics including:
• Selection and training of a community
health worker in each village
• Community cooperation •Making and
regularly updating a list of pregnant
women in the community •Health
education to mothers and groups
Materials available to support this
training include:
• Director’s Guide,
• The Trainer’s Guide,
• Slides, •Participant’s Manual,
• Guidelines to Follow-Up After Training,
• Answer sheets,
• Forms and checklists (including job aids)
• Story cards,
• Updates (available at CAH and
NHD websites),
• Training aids.
The Training course is comprised of the
following sessions:
1) An introduction to infant and young
child feeding,
2) Why breastfeeding is important, 3 How
breastfeeding works,
4) Assessing a breastfeed,
5) Listening and learning,
6) Listening and learning exercises,
7) Practical Session 1, Listening and
learning. Assessing a breastfeed,
8) Positioning a baby at the breast, Practical
session: Positioning a baby using dolls,
9) Growth charts,
10) Building confidence and giving support,
11) Building confidence and giving
support exercises -Part 1, 12 Practical
Session 2: Building confidence and
giving support. Positioning a baby at
the breast,
…
15
Newborn, infant and childhood care (note that some packages, such as 1 and 5, also briefly address pregnancy and postpartum care)
1. Identification
of the tool
Tool name,
year, author
01
02
03
04
05
06
07
08
Caring for the newborn at home, a training
course for community health workers.
WHO, UNICEF, 2012
Care for child development: improving
the care of young children. WHO,
UNICEF, 2012.
The Community Infant and Young Child
Feeding Counselling Package: Facilitator
Guide, September 2012, UNICEF & URC/
CHS
Caring for the sick child in the community.
WHO, UNICEF, 2011
Manual de agente comunitario de salud:
Atencion integrada a las enfermedades
prevalentes de la infancia (AIEPI) [IMCI].
PAHO, 2010.
Community IMCI. MOH Cambodia, 2008
Infant young child feeding counselling: An
integrated course. WHO, UNICEF, 2006.
How to Train Community Health Workers in
Home-Based Newborn Care. The SEARCH
Team, 2006.
This course is aimed at the following
groups of people:
The CHWs in both the SEARCH and Ankur
programmes are women with limited
education, some having as little as four
years of schooling (although a few have
up to 12 years). The vast majority of these
women are married and have children (p1).
Selection of CHWs:
General overview
…
13) Taking a feeding history,
14) Common breastfeeding difficulties,
15) Expressing breast milk,
16) Cup-feeding,
17) Overview of HIV and infant feeding,
18) Counselling for infant feeding decisions,
19) Breastfeeding and breast-milk options
for HIV-infected mothers,
20) Breast conditions,
21) Replacement feeding in the first
six months,
22) Hygienic preparation of feeds,
23) Preparation of milk feeds –
measuring amounts,
24) Practical Session 3: Preparation of
milk feeds,
25) Health care practices,
26) International Code of Marketing of
Breast-milk Substitutes,
27) Counselling cards and tools:
Counselling scenarios,
28) Importance of complementary feeding,
29) Foods to fill the energy gap,
30) Foods to fill the iron and vitamin
A gaps,
31) Quantity, variety and frequency
of feeding,
32) Building confidence and giving support
exercises -Part 2,
33) Gathering information on
complementary feeding practices:
Practice scenarios,
34) Feeding techniques,
35) Practical Session 4: Gathering
information on complementary
feeding practices,
36) Checking understanding and
arranging follow-up,
37) Feeding during illness and low-birthweight babies,
38) Food demonstration,
39) Follow-up after training (Trainer’s
Guide ppi-ii).
2. Purpose,
description
and scope of
the tool
Target
audience: trainees
• At least 8 years of formal school
education & literacy
• Preferably women
• Clear plan for CHWs to start work soon
upon successful completion of training
Not targeting CHWs per se
Training of Counsellors:
Training participants may be community
workers and/or traditional birth. They
may also be primary health care workers
or project staff with more advanced IYCF
training who act as ‘points of referral’ for the
less experienced CWs and together form a
community network of IYCF support.
It is assumed that training participants will
have basic literacy.
Supervisors are encouraged to attend the
training so that they are familiar with the
training content and skills, and thus better
able to support and mentor the training
Participants on an ongoing basis.
Literacy
CHWs must live in the community,
be elected by the community, work must
be volunteer based, teach by example,
preferably be able to read and write,
maintain and promote good interpersonal
relations, and have a vocation to help.
Target trainees are Village Health Support
Group (VHSG) members. Each village
has one VHSG. The VHSG includes one
VHSG Leader and other supporting VHSG
members. VHSG membership is determined
by the needs of the community and can
include other specialised VHSG members in
the village such as:
• Red Cross volunteers
• Community Based Distributors
• Village Malaria Workers
• Community Home Based Care Teams
• Community Direct Observation of
Therapy Watchers
• Traditional Birth Attendants
• Community-Based Peer Educators for
Chronic Disease
• Mother Support Groups
• Other health volunteers (i.e.. VHVs).
Most organisations that currently work
with VHSGs require VHSGs to be literate
to a level where they can fill out forms,
read BCC materials, etc. Given this, this
curriculum assumes that participants
possess a certain level of functional reading
ability (Facilitator’s Manual pp7-8).
• Lay counsellors
• Community health workers
• PMTCT counsellors (first level
counsellors at district level)
• Primary Health Care nurses and doctors-
especially if supervising and/or a referral
level for lay counsellors, community
health workers or PMTCT counsellors;
clinicians at first referral level.
Course participants are not expected to
have any prior knowledge of infant feeding
(Director’s Guide p4).
The method of selecting CHWs in
Gadchiroli (and followed in the Ankur
project) involved:
• setting eligibility criteria
• wide publicity and community
involvement to get the maximum number
of eligible candidates
• personality testing of the candidates in a
3 day workshop
• objective evaluation and finally, testing in
the field (p13).
NOTE- this is what has been done.
No further details on trainee selection or the
tools mentioned above given.
16
Newborn, infant and childhood care (note that some packages, such as 1 and 5, also briefly address pregnancy and postpartum care)
1. Identification
of the tool
01
02
03
04
05
06
07
08
Tool name,
year, author
Caring for the newborn at home, a training
course for community health workers.
WHO, UNICEF, 2012
Care for child development: improving
the care of young children. WHO,
UNICEF, 2012.
The Community Infant and Young Child
Feeding Counselling Package: Facilitator
Guide, September 2012, UNICEF & URC/
CHS
Caring for the sick child in the community.
WHO, UNICEF, 2011
Manual de agente comunitario de salud:
Atencion integrada a las enfermedades
prevalentes de la infancia (AIEPI) [IMCI].
PAHO, 2010.
Community IMCI. MOH Cambodia, 2008
Infant young child feeding counselling: An
integrated course. WHO, UNICEF, 2006.
How to Train Community Health Workers in
Home-Based Newborn Care. The SEARCH
Team, 2006.
Target
audience: trainers
• Technical knowledge and skills in MNH
no further analysis done
Training of Master Facilitators/Trainers
(ToMT) and Training of Facilitators/
Trainers (ToT):
• Technical knowledge and skills in IMCI)
no mention
The Facilitator’s Manual advises that
community educators will be trained by
provincial, operational district, and health
centre staff, who will themselves need to be
trained on this curriculum before being able
to train others (Facilitator’s Manual p6).
There should be one trainer for each group
of four participants. Trainers should be
interested in and available and given the
support to conduct other training courses in
the future. Trainers are ideally people who
are already involved in the promotion and
support of infant and young child feeding
and who have some previous training
experience. They should:
In the Ankur project, the trainers who used
this manual were mostly graduates. Since
many trainers did not have significant
teaching experience, the manual is very
detailed, giving step-by-step instructions
to trainers and providing them with readymade training aids and tools such as model
role play scripts and skill checklists.
Eligible Trainers:
• be convinced that infant and young child
The personal qualities and attitudes
(openness, ability to communicate,
respect and empathy for trainees), and the
willingness to train village women (CHWs)
are very important eligibility criteria.
(e.g. trained in IMCI)
• Experience with training CHWs
• Must have attended the course previously
as trainees.
The agency sponsoring a training event
should select 2 individuals who will be
trained as focal persons during both
Training of Master Facilitators/Trainers
(ToMT) and Training of Facilitators/
Trainers (ToT).
The training responsibilities for Master
Facilitators/Trainers and Facilitators/
Trainers (ToT) of IYCF Counsellors need to
be reflected in job descriptions and TORs
(Facilitators Guide pp2-3).
Training of Facilitators/Trainer (ToT)
participants [and Master Facilitators/ Trainer
(ToMT participants? unclear] should:
• Be currently involved in the promotion of
2. Purpose,
description
and scope of
the tool
infant and young child feeding (IYCF) for
the Government (e.g. Ministry of Health,
Nutrition agency), a training institution,
an NGO, a UN agency or other type of
institution specializing in nutrition and
child health.
• Have previous training experience
and skills, including strong
communication skills.
• Have basic knowledge of IYCF.
• Have IYCF Program Experience.
• Be proficient in English (mandatory).
• Be interested in becoming a Community
IYCF Counselling Facilitator/Trainer
(is motivated and enthusiastic) and to
conduct in country training courses.
• Be committed to mentoring community
workers learn about how to support IYCF.
• Be willing and able to attend the entire
course (mandatory).
• Have scope for the following duties to
become part of the candidate’s job
description (or for them to undertake
the following duties through
contractual agreements):
-- Conduct in country Community IYCF
Counselling Trainings in at least
some of
the MYCNSIA sites
-- Provide follow-up assessment and
mentoring of new counsellors
-- Submit a simple 1 page preformatted
report on their accomplishments
related to this training programme
every 6 months. (Facilitator
Guide pp190‑191).
• Experience with training CHWs
• Must have attended the course previously
as trainees.
The following training cascade is proposed:
1) National Centre for Health Promotion/
Communicable Disease Control
Department (IMCI) National Master
Trainers ®
2) Provincial Health Department/
Operational District Provincial Master
Trainers ®
3) Health Centre Staff Trainers (and
Provincial Master Trainers when Health
Centre staff are not adequate) ®
4) Village Health Support Group ®
5) Community Members (Facilitator’s
Guide p7).
feeding is important
• be interested in becoming a trainer in
the Infant and Young Child Feeding
Counselling: An Integrated Course
• be a trainer on the WHO Breastfeeding
Counselling: A training course
• ideally also be a trainer on the other two
WHO feeding courses: Complementary
Feeding Counselling: A training course
or HIV and Infant Feeding Counselling: A
training course
• be willing and able to attend the entire
course, including the preparation
for trainers
• be willing and able to conduct other
courses in future
• be available to conduct the follow-up
assessment of participants.
Professional background of the trainers
should be diverse.
In the experience of SEARCH, a team of
three persons makes the ideal combination
of trainers.
1) a doctor (MBBS or non-MBBS),
2) a nurse and
3) a social worker (p2).
NOTE- it is noted that a Training of Trainers
manual is under preparation (p1). Unable
to locate.
The preparation of trainers takes place
before the participants’ training and
takes approximately five days (Director’s
Guide pp24-25).
17
Newborn, infant and childhood care (note that some packages, such as 1 and 5, also briefly address pregnancy and postpartum care)
1. Identification
of the tool
01
02
03
04
05
06
07
08
Tool name,
year, author
Caring for the newborn at home, a training
course for community health workers.
WHO, UNICEF, 2012
Care for child development: improving
the care of young children. WHO,
UNICEF, 2012.
The Community Infant and Young Child
Feeding Counselling Package: Facilitator
Guide, September 2012, UNICEF & URC/
CHS
Caring for the sick child in the community.
WHO, UNICEF, 2011
Manual de agente comunitario de salud:
Atencion integrada a las enfermedades
prevalentes de la infancia (AIEPI) [IMCI].
PAHO, 2010.
Community IMCI. MOH Cambodia, 2008
Infant young child feeding counselling: An
integrated course. WHO, UNICEF, 2006.
How to Train Community Health Workers in
Home-Based Newborn Care. The SEARCH
Team, 2006.
Training
methodology,
including clinical
practice and
assessment of
competencies
acquired
• Competency-based approach
no further analysis done
Hands on practice is the focus of the
training, with emphasis on counselling
skills. The competency-based participatory
training approach reflects key principles
of behaviour change communication
(BCC) with a focus on the promotion of
small doable actions, and recognition of
the widely acknowledged fact that adults
learn best by reflecting on their own
personal experiences.
• Competency-based approach
• Competency-based training: interactive,
• Based on adult learning principles
small-group work, demonstration
and practice including at clinic and
household levels, case studies, games
and role plays.
• Includes daily evaluation of the workshop
(achievements, challenges, solutions)
• Assessment by competency checklist
This curriculum was developed with the
12 Key Family Practices (KFP) as its
starting point, and therefore use of the
12 KFP flipchart figures prominently
in each module. A smaller job aid has
been developed to complement the
12 KFP flipchart.
The training course comprises 39 sessions
which use a variety of teaching
methods, including:
Training activities in this manual focus
on adult learning methods that require
participation, including large and
small group discussions, role plays,
demonstrations, games, case presentations,
case studies and practice in both classroom
and in communities (p1).
Training methods used in this
course include:
• role-play
• Based on adult learning principles
• Recommends ratio of 1 facilitator /
4 trainees max
• Includes classroom learning, group
discussions, games, demonstration
(video, role plays) and
most importantly, hands-on supervised
field practice in a health facility and in
the community.
• Teaching steps in classroom sessions:
introduction, determine what CHWs
already know, give relevant info, discuss
and explain, reinforce learning through
exercise, skills demonstration and
practice, summary
• Revolves around practice with job aid
(counselling card) following key steps:
greet the family, ask/listen/understand
the situation, tell the story, check
understanding & discuss, praise, solve
any problems the family has in adopting
positive behavior.
• Competency-based assessment
against checklist
The approach uses the experiential learning
cycle method and prepares Participants for
hands-on performance of skills.
The course employs a variety of training
methods, including the use of counselling
materials, visual aids, demonstrations,
group discussion, case studies, role plays
and practice.
Participants also act as resource persons
for each other, and benefit from clinical and/
or community practice, working directly
with breastfeeding mothers, pregnant
women and mothers/fathers/caregivers
who have young children (Facilitator
Guide pp5-6).
• Includes classroom learning, group
discussions, games, demonstration
(video, role plays) and most importantly,
hands-on supervised practice with many
sample cases, but also in outpatient clinic
• Centered around the use of job aids,
and sick child recording form that
outlines a systematic clinical approach
with detailed decision-making algorithm:
1) identify problem (ASK & LOOK - any
danger signs?)
2) DECIDE: refer (if danger sign) or treat at
home (if no danger sign)
3) Refer&TREAT (with first dose of treatment
given) or TREAT at home and ADVISE,
4) Check vaccines received & advise,
5) Other problem that needs referral
6) When to follow up
7) Findings on follow up visit.
• Health Centre tour
It is advised in the Facilitator’s Guide
that the necessarily limited scope of this
curriculum did not allow for inclusion of
other facilitation techniques like puppet
shows, drama, song, etc., due to the
difficulty of training trainers and VHSGs
to use these techniques, and high level
of resources (time, equipment, creative
ideas, etc.) required to use these ideas
successfully. Programs that are interested
and able to employ these other types of
facilitation are encouraged to do so instead
of, or in combination with, the activities in
this curriculum (Facilitator’s Manual p6).
conduct 2 cascade trainings for
Facilitators/Trainers and/or Counsellors;
and the Facilitator/Trainer needs
to conduct 2 cascade trainings for
Counsellors before they can be certified,
• Facilitators/Trainers need to conduct 2
cascade trainings for Counsellors before
they can be certified,
• Newly trained Counsellors must counsel
five mothers, as well as conduct two
Action oriented Groups or IYCF Support
Groups (Facilitator Guide p193).
Other health
subjects covered
• Pregnancy care
no further analysis done
• Postpartum care
Nutrition: (young child and infant feeding).
•Infancy and childhood care
Pregnancy care
Newborn, infant and child care up to 5 years
Infancy and childhood care
Final Evaluation and Certification of CHWs
conducted in a final workshop of 3 days:
1) Revision of all (17) the earlier modules.
2) Final evaluation
3) Certification of those CHWs who score
minimum 70 % (p605).
Evaluation plan:
Two tier evaluation:
1) Evaluation of CHWs by trainer/
supervisors:
I: A written test
II: For assessing the attitudes and strengths
of individual CHWs, the trainers/
supervisors use their accumulated
knowledge of the trainee, and complete
the questionnaire using a scale.
III: Skills of CHWs are assessed and
recorded by the trainer/supervisors by
observing skills in the field using the
CHW progress book (p605).
The gaps in the skills should be
corrected by the trainer/supervisor in
the field itself and followed-up and
rechecked in the next visit.
2) Field evaluation by external evaluators:
An independent evaluation of the CHWs
conducted by an external evaluator.
Training Evaluation Field Guide provides
guidelines for evaluation of CHWs by a
member other than the regular trainers/
supervisors (p606).
Assessment is through pre- and posttesting.
Postpartum care
• Newborn care to 1 week of age
This course is based on a set of
competencies which participants
are expected to learn during training
and follow‑up*.
Facilitators are encouraged to adapt and/
or make training activities more appropriate
for their situations. This curriculum is a
guide that facilitators can adapt according
to their needs and their participants’ needs.
While the activities in this curriculum can
be implemented as they are written, they do
not necessarily have to be followed to the
letter. Having said that, technical content
of activities should be kept consistent
with messages in this curriculum,
as the technical content contained here is
reflective of current national health policies
(Facilitator’s Manual p9).
• The Master Facilitator/Trainer needs to
Aspect of the
continuum of
SRMNCAH
care covered
• practical work
• exercises.
• lecture
UNICEF/MOH should discuss and agree
on the criteria for certification of Master
Facilitators/Trainers and Facilitator/Trainers
of IYCF Counsellors (Facilitator Guide p3).
Requirements for the award of certificates:
participants with one trainer
The sessions are structured around four
2-hour practical sessions, during which
participants practise counselling and
technical skills with mothers, caregivers
and young children (Director’s Guide p34).
• question and answer
Certification Requirements:
2. Purpose,
description
and scope of
the tool
• work in smaller groups of four
• group discussion
• role play
role plays
• demonstrations
• games
• demonstration
• Assessment of performance through
• lectures
Preventive measures to keep the family
healthy, including pandemic influenza
(this was developed following the 2009
influenza threats)
Newborn care; Infancy and childhood care.
Childbirth care; Newborn care; Infancy
and childhood care- re: Breastfeeding,
complementary feeding and replacement
feeding only.
Newborn care.
Treating minor ailments in the
community: basic care of wound and
skin problems, using paracetamol and
aspirin, handwashing.
Stock keeping and treatment records.
18
Newborn, infant and childhood care (note that some packages, such as 1 and 5, also briefly address pregnancy and postpartum care)
1. Identification
of the tool
01
02
03
04
05
06
07
08
Tool name,
year, author
Caring for the newborn at home, a training
course for community health workers.
WHO, UNICEF, 2012
Care for child development: improving
the care of young children. WHO,
UNICEF, 2012.
The Community Infant and Young Child
Feeding Counselling Package: Facilitator
Guide, September 2012, UNICEF & URC/
CHS
Caring for the sick child in the community.
WHO, UNICEF, 2011
Manual de agente comunitario de salud:
Atencion integrada a las enfermedades
prevalentes de la infancia (AIEPI) [IMCI].
PAHO, 2010.
Community IMCI. MOH Cambodia, 2008
Infant young child feeding counselling: An
integrated course. WHO, UNICEF, 2006.
How to Train Community Health Workers in
Home-Based Newborn Care. The SEARCH
Team, 2006.
Duration of
training course
• 6 days for ToT
• 3 days
• 6-Day Training of Trainers/Facilitators
• Version 1: 3.5 days (id illness, referral,
• Training of Trainers preparation course-
treat diarrhea at home)
• Version 2: 6 days (same as above + treat
fever and fast breathing at home)
Modular depending on local needs.
Minimum is 10 days.
• Modules 0- 9 total 12.5 days.
• 5-Day Basic Course (common content
• Supplementary module is an additional
5 days.
• Participants’ course- full time for 5 days:
The course is divided into 39 sessions,
which take approximately 35 hours
without meals or the opening and closing
ceremonies. The course can be conducted
consecutively in a working week,
or can be spread in other ways (Trainer’s
Guide p10).
The manual is divided into seven
training workshops containing a total of
17 modules. Training during the Ankur
project was divided into seven training
workshops spread out over a period of
one year. The sequence of the modules
and the grouping of topics have been
carefully planned for maximum learning
and while trainers are encouraged to follow
the sequence, the manual is flexible and
changes can be made when needed.
• Option 1: 2 blocks of 3 and 4 days
separated by a few weeks, or Option 2: 6
continuous days
Follow-up training
and supervision
(if planned)
Mentions about importance of regular
supervision but does not provide detail on
possible ways of doing so.
for Training of Trainers/Facilitators and
Training of Counsellors
• 3- Day Training – Abbreviated
Community IYCF Counselling Package
• 3-Day Training – Integrating IYCF
Support into Emergency Activities.
no further analysis done
Training of Counsellors (ToC) Participants
& Training of Trainers (ToT) Participants
(UNCLEAR- ASSUMED):
Management Follow-up:
2. Purpose,
description
and scope of
the tool
mentor learner, reinforce behaviours, plan
practice activities, expect improvement,
encourage networking among learners,
be realistic, utilize resources, provide
supportive on-going supervision and
mentoring, motivate, continuously monitor
and improve quality.
Facilitator follow-up:
provide follow up refresher or problemsolving sessions; Learner- know what to
expect and how to maintain improved skills,
be realistic, practise to convert new skills
into habits, be accountable for using skills.
Management & Facilitator: follow-up
provide feedback, monitor performance;
Management & Learner- provide feedback,
monitor performance; Management &
Facilitator & Learner- provide feedback,
monitor performance, commit to
system of on-going supervision or
mentoring; Facilitator & Learner- provide
feedback, evaluate.
no mentioned in documents
3 days.
Each training day is a total is 7 hrs.
duration which includes:
• 6 hr. training (3 hrs. in the morning &
3 hrs. in the afternoon)
• 1 hr. optional break times for snacks and
other activities.
• Facilitators are encouraged to be flexible
in how they arrange module trainings
throughout the year. It may be that
specific topics are conducted slightly
before or during months in which that
topic is important for communities.
For example, diarrhea prevention and
treatment is taught in the wet months,
micronutrients is taught before or during
national campaign months, malaria is
taught in common malaria months, etc.
• Although facilitators are welcome and
encouraged to use modules in any order
they find convenient, please keep in mind
that topics should be taught according to
local priorities (Facilitator’s Manual p8).
Outlines the importance and guiding
principles for supportive supervision
without going into the details of how.
Not stated.
Most of the modules are taught in one
training workshop, with the exception of
Module 3, Treating Minor Problems, which
is spread out over the first two workshops.
The planners felt that the CHW would be
accepted more readily by the community
if she could attend to minor problems—
headache, body ache, and minor wounds—
from the very beginning of her training.
With further experience, SEARCH felt the
need for more flexible training schedule for
the diverse situations. Hence, three different
training schedules covering the contents of
this manual are suggested [see pp5-6] (p4).
Guidelines for Follow-up After Training
manual provided (http://www.who.int/
nutrition/publications/IYCF_Guidelines_
for_followup_after_training.pdf).
The objectives of this follow-up after
training are to:
1) Reinforce the theoretical knowledge learnt
in the course;
2) Reinforce the counselling and practical
skills learnt in the course;
3) Identify problems faced by course
participants in their work situation
which affect implementation of infant
feeding counselling;
4) Assess the theoretical, counselling and
practical skills of participants after
the course.
Field supervision (two visits in each month
to each CHW) is a crucial component of
the HBNC.
It should be viewed as an extension of
training and support to CHWs rather
than inspecting.
It should result in improved skills,
motivation and performance of CHWs,
problem solving and community support.
The time requirement for the work of
supervision is 8 hours per day per
20,000 population (p13).
Follow-up should include a visit by a
trainer to the workplace of trainees and
the completion of an assessment of
competencies at 1-3 months post-training
course (Guidelines for Follow-up After
Training pp2-12).
Facilitator (Master Facilitator/Trainer &
Facilitator/Trainer (ToT) follow-up:
During the ToT, each participant will be
asked to make an implementation “Plan of
Action”, which will be monitored every 6
months thereafter by UNICEF colleagues
until December 2014.
(Facilitator Guide p186-188).
ToT participants will receive a certification for
completion of the course. It will be necessary
for newly-trained Facilitators/Trainers to
conduct cascade training before they can
be certified. UNICEF will also require the
participant’s first 6-month “Plan of Action
Monitoring Report” before the certificate will
be granted (Facilitator Guide p 189).
19
Newborn, infant and childhood care (note that some packages, such as 1 and 5, also briefly address pregnancy and postpartum care)
1. Identification
of the tool
01
02
03
04
05
06
07
08
Tool name,
year, author
Caring for the newborn at home, a training
course for community health workers.
WHO, UNICEF, 2012
Care for child development: improving
the care of young children. WHO,
UNICEF, 2012.
The Community Infant and Young Child
Feeding Counselling Package: Facilitator
Guide, September 2012, UNICEF & URC/
CHS
Caring for the sick child in the community.
WHO, UNICEF, 2011
Manual de agente comunitario de salud:
Atencion integrada a las enfermedades
prevalentes de la infancia (AIEPI) [IMCI].
PAHO, 2010.
Community IMCI. MOH Cambodia, 2008
Infant young child feeding counselling: An
integrated course. WHO, UNICEF, 2006.
How to Train Community Health Workers in
Home-Based Newborn Care. The SEARCH
Team, 2006.
Training course
evaluated,
and key results
• All the Community Health Workers found
no further analysis done
Evaluation not yet complete- will be pursued
in 2013.
• Overall the CHWs found the course
No training evaluations due to insufficient
human and financial resources
No evaluation yet conducted.
To follow.
This manual is based on the programme
developed by SEARCH to train community
health workers (CHWs) in home-based
newborn care (HBNC) in Gadchiroli District,
Maharashtra, India. The success of the
programme—a significant reduction in
neonatal mortality—led to replication of
the SEARCH HBNC model programme
by other nongovernmental organizations
(NGOs) through the Ankur Project,
supported by Save the Children US. During
the implementation of the Ankur Project,
this manual was field-tested by seven
NGOs in Maharashtra state, where 100 new
CHWs were trained. Using CHWs’ actual
experiences during the training, the manual
was revised to make it more effective and
user friendly. The manual was then sent to a
number of national and international experts
in newborn health for review. The revised
version was translated into Hindi, Marathi
and Oriya languages and used in the field
trial in 5 states by the Indian Council of
Medical Research. The experience gained
was used to further improve this version of
the manual (Training Manual p1).
the course easy to learn.
• There was need to develop a
comprehensive and appropriate training
video for the course
2. Purpose,
description
and scope of
the tool
very interesting and useful and rated the
materials as easy to read and understand.
• The CHW appreciated the outpatient and
inpatient clinical practice sessions in
health centers and hospitals as they were
able to have hands on practice in applying
the knowledge and skills.
• Most of them were very confident
in asking the caregiver about child’s
problem, performing the RDT test on
sick children, interpreting it correctly,
and following the steps of managing a
sick child.
• In general all CHWs were able to interpret
the RDT results without any difficulty and
this gave them a lot of confidence.
From the experience in the Ankur field test,
the training was assessed as «extremely
effective» in an extensive evaluation
(Training Manual foreword).
Results of evaluation were presented at a
convention in New Delhi in 2006 (report
available at:
http://nipccd.nic.in/mch/fr/nbc/erl27.pdf)
Integration of
curriculum into
national health
system for
implementation
at scale
Ethiopia, Malawi, Rwanda,
no further analysis done
In most countries listed below, local
adaptation of the package has been
adopted as the national material for IYCF
for community based cadres. In some,
such as Bangladesh, it is used in selected
areas only.
Ethiopia, Malawi, Rwanda, Madagascar,
Mozambique, Uganda, Zambia.
Adapted and implemented in Nicaragua,
Mexico, Panama, Ecuador, Colombia, Peru
Cambodia- course developed by the
National Centre for Health Promotion
(Cambodia) and the Communicable Disease
Control Department of the Ministry of
Health (Cambodia).
To follow.
Unknown.
Countries where
curriculum has
been implemented
and number
Ethiopia, Malawi, Rwanda,
no further analysis done
There are 21 countries using the training
package in some way with UNICEF
involvement: Sierra Leone, Nigeria,
Ghana, DRC, Kenya, Somalia, Tanzania,
Rwanda, Malawi, Zambia, Zimbabwe,
Namibia, Mozambique, Nepal, Bangladesh,
Afghanistan, Indonesia, Philippines, Laos,
Timor Leste and Uzbekistan. This does not
include countries where there may be use of
the package at sub-national level by partners
(such as in India or Haiti).
7: Ethiopia, Malawi, Rwanda, Madagascar,
Mozambique, Uganda, Zambia.
6: Nicaragua, Mexico, Panama, Ecuador,
Colombia, Peru
Cambodia.
To follow.
India. The SEARCH approach has also
been implemented in Bangladesh, Bolivia,
Ethiopia, Malawi, Nepal, Pakistan, Uganda
and Zambia ( http://businesstoday.intoday.
in/story/innovation-in-health-dr-bangsearch/1/186625.html)
Unknown
Not obtainable
No cost estimation available.
To follow.
Training a CHW costs SEARCH
approximately RS 15000 (approximately
$280 USD), including RS 1500
(approximately $28 USD) for
equipment (http://businesstoday.intoday.
in/story/innovation-in-health-dr-bangsearch/1/186625.html).
3. Sustainability
Countries are at various stages of
implementation- from adaptation and
translation of the materials to large scale use
(such as in Zimbabwe, Rwanda, Zambia and
Sierra Leone).
Estimated cost
of training
course (USD)
Unknown
no further analysis done
Costs reported for different countries are
$5,000, $13,000 (for CHWs), $7,300,
$17,000, $24,000 & $30,000 (to
train trainers).
20
Newborn, infant and childhood care (note that some packages, such as 1 and 5, also briefly address pregnancy and postpartum care)
1. Identification
of the tool
01
02
03
04
05
06
07
08
Tool name,
year, author
Caring for the newborn at home, a training
course for community health workers.
WHO, UNICEF, 2012
Care for child development: improving
the care of young children. WHO,
UNICEF, 2012.
The Community Infant and Young Child
Feeding Counselling Package: Facilitator
Guide, September 2012, UNICEF & URC/
CHS
Caring for the sick child in the community.
WHO, UNICEF, 2011
Manual de agente comunitario de salud:
Atencion integrada a las enfermedades
prevalentes de la infancia (AIEPI) [IMCI].
PAHO, 2010.
Community IMCI. MOH Cambodia, 2008
Infant young child feeding counselling: An
integrated course. WHO, UNICEF, 2006.
How to Train Community Health Workers in
Home-Based Newborn Care. The SEARCH
Team, 2006.
Strengths
• Integrated maternal and newborn package,
no further analysis done
• Includes training on generic skills for
• Systematic clinic-based approach with
• Modular, standard curriculum on IMCI
• Curriculum is congruent with
• Comprehensive set of training materials,
• Comprehensive coverage of newborn care.
CWs (e.g., problem solving, negotiation)
together with technical components.
• Includes a comprehensive set of
training resources (Facilitator Guide,
Participant Materials, Counselling cards,
Key Messages Booklet, Framework for
M&E, Take-home brochures, Training
Aids, Planning Guide, Adaptation Guide,
Supportive supervision/Mentoring
and Monitoring 1-day training,
Orientation Presentation).
• Provides participants with job aids
(e.g., counselling cards, take home
brochures etc.).
• Provides a cascade structure for training:
Training of Master Trainers Training of
Trainers Training of Counsellors.
• Generic tool which includes a guide
for adaptation.
• Provides clear guidance on supportive
supervision, mentoring and monitoring,
and follow-up mechanisms.
• Includes clear instructions on work to be
undertake pre-, during- and post-training.
• Includes field practice.
• Details trainer profile and criteria.
• Competency based and assessed. Criteria
for certification given.
iterative learning through games, role
plays, and hands on practice
• Very thorough job aids where key steps
are covered in a logical clinical algorithm
• Curriculum evaluated and implemented in
several countries
in Spanish
• Implemented in several countries
• Package has a section on workshop
preparation, adult learning principles,
facilitation skills and follow
up considerations
• Richly illustrated job aids attached to the
CHW manual (with one side for client,
one for CHW)
• Provides useful generic checklists and
forms for: competency assessment,
workshop evaluation, client clinical form
that is logical and directive, indicators for
household visits
• Includes practice at clinic and
household levels
government policy.
• Local context specific (based on locally
developed and evaluated curricula).
• Further adaptation recommended to meet
participant needs and local priorities.
• Provides a clear cascade training
strategy integrated into existing health
system structures.
• Flip charts and job aid provided for
participant use on the job.
• Designed to complement existing tools.
including: Director’s Guide, Trainer’s
Guide, Slides, Participant’s Manual,
Guidelines to Follow-Up After Training,
Answer sheets, Forms and checklists
(including job aids), Story cards, Updates
(available at CAH and NHD websites) and
Training aids.
• Competence-based and assessed.
• Counselling skills taught in combination
with technical components.
• Provides tools for use on the job (job
aids, forms and checklists).
• Training guides cover pre-, during and
post-training strategies.
• Curriculum includes 4 timetables
practical sessions.
• Provides clear instructions for
comprehensive follow-up including
continued assessment of competencies.
• Guidance on integration of this training
with existing courses given.
• Guidance on local adaptation give.
• Curriculum includes field practice.
• Follow up instructions provided but target
• Requires good level of literacy,
• Does not provide examples of
• Does not address:
• Does not address:
not adapted for non-literate CHWs
• Does not address issues of health
system support, supportive supervision,
supply chain.
training agenda
• Requires good level of literacy to use the
CHW manual
• Does not train CHWs to administer
treatment for home management or
before referral
• Does not address: blues/depression,
domestic violence, birth registration
Prevention of indoor air
pollution (newborn).
• Not specifically targeted at CHWs.
• Not competence based or assessed.
• Assessment is by pre-/post-testing only.
Prevention of indoor air pollution
Newborn stimulation and play
• Limited guidance on selecting training
participants and eligibility criteria.
in spite of the title that highlights
newborn care
• Outlines key steps in preparing for the
course (incl. involving policymakers,
supervisors, selection of CHWs,
equipment checklist, etc...)
• Strong emphasis on communication skills
and processes of behavior change with
detailed role-play scripts
• Realistic job aids using pictures
vs. drawings
• Recommends extra visits for: small
babies, babies referred to health facility
• Emphasis on practice e.g. handwashing,
weighing babies, etc.
• Holistic considerations: CHWs must
be considered part of the health work
force whether they are employed by the
government or supported by NGOs.
Must be linked to higher levels of health
services that support their training,
and help maintain performance through
regular follow-up, periodic skills
reinforcement, and continuous flow of
medicines and supplies.
4. Strengths
and limitations
Limitations/
Weaknesses
• Technical contents: limited coverage on
HIV, support for WLHIV; does not address
safer sex, harmful effects of alcohol and
smoking, domestic violence. Addresses
FP only in postpartum care. Does not
address blues/depression.
• Mentions importance of health system
support, regular supervision, supply
chain, but does not go into detail about
examples to implement it.
Note: the Package of Interventions for FP,
SAC, MCH recommends under ‘infancy and
childhood care’: promotion and support for
child stimulation and play. This training
material targets a wide audience and is not
specifically tailored for CHWs
Recommendations: further simplify job
aids, define roles and functions of CHWs
in counselling and supporting child
development at household level. When,
how often, integrated with what other
interventions, etc.?
of follow-up actions unclear.
--
• Curriculum specific to the CHW role
and includes components on working
in the community in addition to
technical content.
• Curriculum planners have addressed the
acceptance of CHWs by the community
through strategic planning of modules.
• Detailed training guide suitable for
varying levels of facilitator experience.
• Competence based and assessed.
• Clear guidance for follow up,
supervisor involvement, evaluation and
assessment given.
---
21
HIV
1. Identification
of the tool
1. Identification
of the
tool
1.
Identification
01
02
03
04
Tool name,
year, author
Guide for Training Community Health Workers in WASH-HIV Integration. C-CHANGE
(FHI360, Kenya MoPH and Sanitation), 2011
Accompagnateur Training Guide, Partners in Health, 2008.
HIV Prevention Treatment Care and Support- A Training Package for Community Volunteers
WHO, IFRC, Safaids, 2006
Community Home-Based Care for People and Communities Affected by HIV: Training
Course and Handbook for Community Health Workers, Pathfinder International, 2006
Link /Source
Trainers guide:
http://www.c-hubonline.org/sites/default/files/resources/main/Kenya%20WASH-HIV%20
Integration%20Trainers%20Guide.pdf
http://model.pih.org/accompagnateurs_curriculum
https://www.plhivpreventionresources.org/index.cfm?action=main.abstract&id=1318
http://www.pathfinder.org/publications-tools/publication-series/Community-HomeBased-Care-for-People-and-Communities-Affected-by-HIV-AIDS-Training-Course-andHandbook-for-Community-Health-Workers.html
This training curriculum has two over-arching goals:
The goals and objectives of this training are to:
1) To help accompagnateurs- community health workers trained and employed to provide
1) Increase knowledge of participants surrounding HIV prevention, treatment, care,
The goal of this course is to add skilled Community Health Workers to the forces that are
fighting the HIV epidemic. These CHWs will complement facility-based HIV services by
providing and training caregivers to provide care and support to People Living with HIV,
reducing stigma, and mobilising the community to prevent future HIV infections.
By the end of training on Core Units, participants should be able to carry out the
key activities*
of the tool
Counselling cards:
http://www.c-hubonline.org/sites/default/files/resources/main/WASH-HIV%20Integration%20
Counselling%20Cards%20for%20Community%20Health%20Workers_0.pdf
Purpose
This training guide is intended for use by any organization that works at a community level
to help people adopt healthier behaviours related to water, sanitation, and hygiene in the
context of HIV.
New or improved practices will result in significantly fewer cases of diarrhoea (and
therefore less illness and fewer deaths), especially among people living with HIV and
their families.
After participating in the workshop, CHWs should be able to use the knowledge and skills
acquired to carry out the following activities:
medical and psychosocial support for their neighbours- develop confidence in active
casefinding for diseases and social needs
2) To instil a sense of solidarity and social justice in supporting patients, households and
the community.
By the end of this training, participants are expected to be able to carry out key tasks*.
and support
2) Address attitudes of participants surrounding HIV prevention, treatment, care, and
support interventions
3) Equip participants with problem solving skills for addressing community specific issues
related to community-based HIV management
4) Promote the transfer of skills from participants to clients and their family members
regarding important information, skills and practical knowledge required for
community-based HIV management.
1) Describe the local WASH and HIV situation
2) Define their role and responsibilities as an outreach worker
3) Describe the four key WASH practices and the small doable actions that households can
take to move toward the ideal practice
4) Negotiate with households to choose a WASH small doable action to adopt using
effective communication and negotiation skills
5) Use appropriate monitoring tools to record their progress (p7).
General overview
This document is a compilation of several training documents that were produced by the
USAID/Hygiene Improvement Project that were then adapted into a Kenya-specific Trainer’s
Guide (pii). It should be used to train local community health, home-based care or other
outreach workers to carry out activities at the community level to reduce diarrhoea in the
context of HIV (p7).
The Trainer’s Guide is accompanied by counselling cards and guidance is given on the
use of suggested or existing tools to monitor the progress of CHWs and track changes in
WASH practices in the community (p4).
The training course is divided into the following 8 Modules:
1) Introduction: why WASH matters and key practices for preventing diarrhoea
2) Communication and negotiation: interpersonal communication for improved practices
2. Purpose,
description and
scope of the tool
and the role of the CHW
3) Making water safe to drink
4) Hand washing with soap
5) Handling faeces
6) Faeces management at household level
7) Caring for HIV+ women with menses
8) Action planning with multiple WASH needs (ppvi-vii).
Accompagnateurs have played a central role in the community-based health care programs
of Partners in Health (PIH) since PIH began working in Haiti 20 years ago. Serving as a link
between the clinic and the community, they provide medicine, education, and psychosocial
support to people living with tuberculosis, HIV/AIDS, and other illnesses. They are
often selected by patients themselves and are people who are respectful and empathetic,
can maintain confidentiality, and can understand what it means to stand in solidarity with
those who are suffering.
Accompagnateurs receive an orientation from PIH clinical staff before they begin
supporting patients and they also attend the seven day, 15-unit intensive training program
described in this Facilitator’s Manual (Facilitator’s Manual pxv).
The following units are covered in this training curriculum:
Unit 1) Introduction to Accompagnateur Training,
Unit 2) Introduction to Partners In Health,
Unit 3) What is HIV/AIDS?,
Unit 4) HIV/AIDS: Prevention and Transmission,
Unit 5) Treatment of HIV/AIDS
Unit 6) Side Effects of Antiretroviral Medicine,
Unit 7) Women and HIV/AIDS,
Unit 8) STIs,
Unit 9) Stigma and Discrimination
Unit 10) Psychosocial Support and Effective Communication
Unit 11) Tuberculosis,
Unit 12) Tuberculosis Treatment and Side Effects,
Unit 13) Roles and Responsibilities of Accompagnateurs
Unit 14) Challenges Faced by Accompagnateurs
Unit 15) Summary and Evaluation
The training is supported by the following resources:
The goal of this training package will be to provide participants with the relevant
knowledge, attitude, problem solving and skills transfer capabilities required to assist
and support community-based HIV prevention, treatment, care and support. This
document represents a collaborative effort between the International Federation of Red
Cross and Red Crescent Societies, WHO and Southern Africa HIV/AIDS Information
Dissemination Service.
This curriculum aims to provide CHWs with the knowledge and skills necessary to provide
Community Home-Based-Care for people living with HIV in their communities.
It includes a Trainer’s Guide for the trainers and a Handbook for the participants.
The Trainer’s Guide is divided into 13 core units, a practicum, and 5 advanced units that
contain additional information that CHWs might find useful after they have covered the core
areas (Trainer’s Guide pxiv).
The training package consists of eight generic training modules which have been designed
for global use to train and empower community-based volunteers with the skills and
knowledge to support the roll out of comprehensive programmes on HIV/AIDS (Facilitator’s
Guide p4).
Unit 1) Introduction to the training
These eight generic modules are as follows:
Unit 4) Our Bodies and Safer Sex
The units are as follows:
Unit 2) Facts about HIV and People Living with HIV
Unit 3) Community Home-Based-Care: The Basics
1) Basic facts on HIV and AIDS
Unit 5) Talking with Others: Communication Skills
2) Treatment literacy
Unit 6) The Community Health Workers’ Role in Community Mobilisation and
3) Treatment preparedness
HIV Prevention
4) Adherence
Unit 7) Promoting Positive Living and Emotional Wellbeing
5) Community-based counselling
Unit 8) Nutrition
6) Nutrition
Unit 9) Basic Nursing Care
7) Palliative care: symptom management and end-of-life care
Unit 10) Managing and Treating AIDS-Related Conditions
8) Caring for carers
Unit 11) Teaching Others and Transferring Skills
The package provides the following tools:
Unit 12) Taking Care of Yourself
• Facilitator’s Guide
• Introduction to the training manual
• Participant’s Handbook
• Evaluation Tools Manual
• Flipchart
• Information pamphlets for each module.
• Facilitator’s Manual
Unit 13) Record Keeping
Unit 14) CHBC Practicum
Advanced Unit 15) Expanded Role of the Community Health Worker
Advanced Unit 16) Introduction to Family Planning
Advanced Unit 17) PMTCT of HIV
Advanced Unit 18) Antiretroviral Therapy
Advanced Unit 19) CHBC for Groups Needing Special Attention (Trainer’s Guide ppvi-ix).
The Handbook contains the content areas covered in each unit. Participants will use
their Handbooks throughout the training and as reference after the training when they
are working in the communities. The Handbook can also be used as a visual aid in some
instances when transferring skills to the client or caregiver (Trainer’s Guide pxv).
• Participant’s Handbook to be used throughout the training and as a reference for
accompagnateurs when working with patients and community members
• Visual Aids (PowerPoint)
• Visual Aid Notes
Target
audience: trainees
Existing CHWs.
Accompagnateurs.
Community Based Volunteers (CBVs) are the target trainee audience of this training. CBVs
are described as community members who provide home-based care and support to
People Living with HIV and AIDS.
CBVs do not require any previous experience in community-based HIV management. This
training content has been designed to suit the lowest level of education within training
audiences. Facilitators are expected to adapt content to match the particular skills and
knowledge levels of the training audience, and meet the requirements of the working
environment of participants (Facilitator’s Guide p5).
The target trainee audience for this training is Community Health Workers.
It is advised that CHWs be selected:
• By the community, with the help of Community-Based Organisations (CBOs) and/or
Faith-Based Organisations (FBOs).
• That both women and men be chosen, as well as PLWHIV.
• That favouritism and patronage be avoided.
• That while selection criteria should be community driven but should include basic level
literacy (enough so they can fill out basic record keeping forms), interest in serving their
community, and ability to devote time to CHBC activities (Trainer’s Guide pxiii).
22
HIV
1. Identification
of the tool
01
02
03
04
Tool name,
year, author
Guide for Training Community Health Workers in WASH-HIV Integration. C-CHANGE
(FHI360, Kenya MoPH and Sanitation), 2011
Accompagnateur Training Guide, Partners in Health, 2008.
HIV Prevention Treatment Care and Support- A Training Package for Community Volunteers
WHO, IFRC, Safaids, 2006
Community Home-Based Care for People and Communities Affected by HIV: Training
Course and Handbook for Community Health Workers, Pathfinder International, 2006
Target
audience: trainers
The Trainer’s Guide has been written purposefully in a «recipe» style, so that someone
whose primary duties are not related to training will be able to implement the workshop.
Not stated.
The training package has been designed for facilitators who may not have extensive
experience in training specific to comprehensive HIV management. However, facilitators are
expected to have the following minimum of skills:
The Trainer’s Guide recommends that where possible, trainers (or at least one of the
trainers) should be facility-based providers. In cases where there are multiple trainers, it is
suggested that the inclusion of a CBO/NGO trainer with skills in community-based services
or community mobilisation can significantly enrich the training (Trainer’s Guide ppxiii-xiv).
Experienced trainers may find the training directions too detailed and should treat
them accordingly.
• Prior experience in conducting training programs
• A working knowledge of training methodologies
Also, experienced trainers can «upgrade» the training methodologies based on their level
of comfort with training and the content (p6).
• The ability to read and write English to a secondary education level
• A health background which provides the capacity to understand the concepts within
If facilitators do not have a health background, they should be supported through
contacts and resources in the community that can assist with specific, technical aspects
of training (Facilitator’s Guide p6)
Training
methodology,
including clinical
practice and
assessment of
competencies acquired
The workshop methodology is based on adult learning principles. Each session is
structured to follow an experiential learning cycle.
The techniques used to facilitate this training:
1) Uses structured learning activities: presentations, group discussions, demonstration,
role plays, practical exercises, etc.;
2) Engages participants through active involvement in exercises and small groups;
3) Enables participants to experience the same activities they will carry out in their
communities (pp7-8).
The training is modular in design and as such can be used in full, modified as necessary
to fit context and circumstances, or particular sessions integrated into alternate trainings or
presentations (p4).
Guidance on deciding training session relevance and whether to incorporate WASH
activities into existing programming is given (p3).
Assessment is based on pre- and post-testing self-assessment at the beginning and end of
the training workshop.
This curriculum uses training methods that are participatory, active and engaging. Short
lectures and presentations are incorporated into this manual but are not the primary
technique for sharing information with participants. Rather, various techniques are used
that build upon the existing experiences, knowledge and skills of the participants. These
methods include:
The training methodology of this training package has been designed to support adult
learning. These include:
The nature of this training program is intended to be participatory and based on adult
learning principles. The methodologies used throughout this training include:
• Mini-lectures
• Lectures
• Group discussions
• Discussions: Large and small group
• Activities
• Group work
• Small group activities
• Games
• Demonstrations and return demonstrations
• Large group activities
• Demonstrations
• Role plays (coached, spontaneous, rotating trio)
• Large and small group discussions
• Role-plays (Facilitator’s Guide p14).
• Case studies
• Pair share
Following the completion of each module, participants will have the opportunity to
be evaluated on that topic area. The criteria for evaluation for each module involves a
combination of two types of assessment:
• Brainstorming
• Role-play
• Demonstration
• Case study
• Facilitator presentation
• Brainstorm
• Reflection journey
• Panel discussion
• Picture story
1) Post-Test Knowledge
2) Demonstration of Core Skills
• Pre- and post-tests
2. Purpose,
description and
scope of the tool
Other health
subjects covered
WASH, diarrhoea in the context of HIV.
Duration of
training course
A full training is three days, but any module can be used by itself or integrated into another
training or presentation. Raising awareness can be done in a 1-2 hour session (p4).
• Observation and assessment during classroom, home-based, and community practicums
• Use of skills checklists
• Practicums
• Participant feedback
• Participant course evaluation (Trainer’s Guide pxxiv).
Assessment is conducted through participatory evaluation through daily evaluation sheets
HIV and TB focus
STIs
• Constructive feedback (Trainer’s Guide ppxx-xxiv).
In order to pass evaluation for any individual module, participants must achieve a minimum
of 50% pass on the post-test and a minimum level of performance to enter practice in core
skill assessment (a list of required core skills is provided in each module of the training).
• Review
HIV
• Games
Evaluation and assessment methods include:
• Peer teach
Aspect of the
continuum of
SRMNCAH
care covered
• Question and answer
Guidance is given to adapt the curriculum to the varying experience and literacy levels of
CHW participants (Trainer’s Guide p xvi).
HIV
HIV
Community Home-Based Care; Basic nursing care; CHW self-care; Teaching others and
transferring skills; Record keeping; Nutrition; Community mobilisation; Communication
skills; Positive living.
7 day intensive training course with on-going monthly education sessions for a year.
The training course is modular and as such, it is not necessary to undertake the training as
a single block. A phased approach may be used. The approximate length of time required
for each module is stated as the following:
• Core Units 1-13 and the Classroom Practicum: 14 Days.
• Home-Based Practicum 2 Days.
• Community-Based Practicum 2 Days.
Introductory session: 3 hours
• Advanced Units 15-19: 6 Days.
• Module 1: 10.5 hours
This curriculum is also designed to be flexible and in a way that units can be put together
for a shorter course, a training series, depending on the time and funding available, and on
the key issues being addressed in a particular setting (Trainer’s Guide pxvi).
• Module 2: 10.5 hours
• Module 3: 11 hours
• Module 4: 12.5 hours
• Module 5: 12.5 hours
• Module 6: 12.5 hours
• Module 7: 18 hours
• Module 8: 8.5 hours
Follow-up training
and supervision
(if planned)
Should an organisation decide to sponsor WASH training for CHWs, program managers
are directed to be responsible for several tasks before, during, and after the training (p2).
1) Deciding whether to incorporate WASH activities into your program (at the strategic
level) (p3)
2) Preparing for the training (become familiar with training guide and WASH/HIV conditions
in CHW target communities, prepare logistics, decide which sessions trainers should
cover, modify the training) (p4)
3) Supporting CHW training (welcome participants and tell them that they have the
organisation’s approval and support. Explain how their new tasks will help meet
organisational goals and objectives. Monitor progress of the workshop (p5)
4) Supporting CHWs in the field (help CHWs put new skills/knowledge into practice as
soon as possible. Provide supportive supervisions. Assist CHWs with monitoring
forms. Conduct debriefing sessions (p5)
5) Brief trainers (p6).
Training course
evaluated,
and key results
This trainer’s Guide was drawn from two guides developed for Ethiopia and Uganda.
The compilation was developed based on feedback from the community of practice.
The document was revised and rewritten based on pilot testing with 30 District Public
Health Officers (pii).
After the 15-unit intensive training, accompagnateurs participate in on-going monthly
education sessions for a year, receiving additional training in nutrition, malaria, paediatric
HIV/AIDS, clean water and diarrheal disease, family planning, active case finding, parasites,
chronic disease, vaccinations, reproductive health, and oral hygiene.
Suggestion is given for facilitators to schedule on-site visits with individual training
participants (or provide supervisors with information on assessing core skills) periodically
following training to ensure retention of skills and knowledge over time (Facilitator’s
Guide p24).
It is suggested in the Trainer’s Guide that trainers double as supervisors of CHWs as they
are in the best position to reinforce transferred skills and strengthen ties between CHBC
and facility-based services.
The final drafts of these modules were tested at the community level by training 22
community based volunteers actively involved in implementing programmes on HIV/AIDS
at community level (p4).
The curriculum was pre-tested in Tanzania and Mozambique, and underwent an internal
and external peer review.
Between completion of the 15-unit intensive training and their first monthly education
session, newly trained accompagnateurs participate in peer coaching, during which
they join another accompagnateur in conducting patient visits. This provides a practical,
hands-on learning experience a, helps accompagnateurs within a particular region to
develop a support network of fellow accompagnateurs, and enables new accompagnateurs
to internalise the concepts and issues discussed during their training and gain confidence
in conducting their own patient visits (Facilitator’s Guide pxvi).
This curriculum is currently being pilot tested with partners in Haiti, Lesotho, Malawi
and Rwanda.
It is advised that ongoing supervision and support is needed to help the CHW overcome
challenges, to ensure that PLWHIV are getting good quality services, and to facilitate
learning between trainings (Trainer’s Guide pxiv).
23
HIV
1. Identification
of the tool
3. Sustainability
01
02
03
04
Tool name,
year, author
Guide for Training Community Health Workers in WASH-HIV Integration. C-CHANGE
(FHI360, Kenya MoPH and Sanitation), 2011
Accompagnateur Training Guide, Partners in Health, 2008.
HIV Prevention Treatment Care and Support- A Training Package for Community Volunteers
WHO, IFRC, Safaids, 2006
Community Home-Based Care for People and Communities Affected by HIV: Training
Course and Handbook for Community Health Workers, Pathfinder International, 2006
Integration of
curriculum into
national health
system for
implementation
at scale
Unknown.
Unknown.
Unknown.
Much of the content of this tool has been incorporated into different versions of Tanzania’s
national CHBC training tool.
Countries where
curriculum has
been implemented
and number
Kenya.
Haiti, Lesotho, Malawi and Rwanda.
Workshops have been organised in Tanzania, Malawi, Cameroon and Burkina Faso.
Tanzania, Uganda, Ethiopia and India.
Estimated cost
of training
course (USD)
Unknown.
Unknown.
Unknown.
Unknown.
Strengths
• Clearly defines roles and responsibilities of target trainees.
• Comprehensive package of training resources provided (Facilitator’s Manual,
• Provides a comprehensive package of training resources (Facilitator’s Guide, Introduction
• Training Guide provides instructions on CHW selection and motivation.
• Contains strategies for working with communities together with technical components.
Participant’s Handbook, Visual Aids (PowerPoint), Visual Aid Notes).
• Tools and resources for use on the job provided.
• Provides clear guidance on follow-up training.
• Clear guidance for supervision by peer-coaching given.
to the training manual, Participant’s Handbook, Evaluation Tools Manual, Flipchart for
Client Education, and information pamphlets for each module).
• Provides tools/resources for use on the job.
• Generic training package with guidance on adaptation to participant needs and the
working environment of participants.
• Assessment includes demonstration of core skills.
• Clear guidance on follow-up by trainers and/or supervisors given, including on-going
evaluation of participants n the field to ensure retention of skills and knowledge
over time.
• Includes instructions for arranging on-site training within real-life community settings
where possible.
• Provides resources and tools (see Participant’s Handbook) for participants to use in their
• Slightly out of date with regard to ART and breastfeeding while using ARVs, but these
• Includes strategies to transfer new knowledge and skills to the workplace through action
planning and learner-focused objectives.
• Provides trainees with counselling cards for use on the job (available at http://www.chubonline.org/sites/default/files/resources/main/WASH-HIV%20Integration%20
Counselling%20Cards%20for%20Community%20Health%20Workers_0.pdf).
• Provides clear guidance to supervisors on ensuring this training is congruent with their
organisational context and other activities.
• Provides guidance on integrating new skills and activities into existing roles and tools.
4. Strengths
and limitations
Limitations/ Weaknesses
• Assessment is through pre- and post-testing and self-assessment only.
• Target trainee audience is accompagnateur not CHWs (overlap with CHW?)
• Target trainee audience is Community Based Volunteers not specifically CHWs (though
• Not competence based or assessed.
• Target trainer audience not stated.
there may be overlap). This generic training resource provides the possibility of
adaptation for CHW training.
• Tool requires updating.
• Not competence based or assessed.
• Evaluation through daily evaluation sheets only (participatory evaluation).
daily work.
• Includes general CHW skill-building together with technical components.
• Well illustrated- appropriate for low literacy
• Guidance given on integrating this training course and participants into existing health
system structures.
• Curriculum includes home-based and community practicums.
• Evaluation and assessment includes observation and assessment during practicums.
dated items only affect a few modules.
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Gender-based violence
01
1. Identification of
the tool
Tool name, year, author
Rethinking Domestic Violence: A Training Process for Community Activists (Raising Voices, 2004)
Link /Source
http://www.raisingvoices.org/women/domestic_violence.php
Purpose
This training process is a tool for strengthening the capacity of a wide range of community members to prevent domestic violence- not specifically targeted
at CHWs.
It will help participants think about, discuss and take action to prevent domestic violence. It is a practical tool for trainers and activists who want to begin a
process of change in their community (p5).
General overview
This training tool includes programming materials, films, and articles for trainers and activists who want to begin a process of change in their community by
helping community members learn about and prevent domestic violence (p5).
The training process contained in this document was developed by Raising Voices in collaboration with the Centre for Domestic Violence Prevention in
Kampala, Uganda.
It is organised into the following six parts:
1) Introduction: overview and description of ideas behind this work, and tips on facilitating the process
2) Becoming aware of gender and rights
3) Deepening understanding of domestic violence
4) Developing skills to prevent domestic violence
5) Taking action to prevent domestic violence
6) Appendices: including monitoring and evaluation tools, additional information for facilitating the process, handouts and learning tools (p6).
Target audience: trainees
This tool is designed for use with a range of stakeholders. Reference is made to ‘health care workers’ amongst these, but not specifically to CHWs.
Potential participants include anyone «interested in helping community members learn about and prevent domestic violence» (p5).
These may include:
• a trainer working with an NGO
• an activist who wants to help people talk about and take action against domestic violence
• a police officer, community leader, health care worker, teacher, religious leader or a professional who wants to help their colleagues, clients or fellow
community members to better understand domestic violence
2. Purpose, description
and scope of the tool
• a member of a group of women, men or youth interested in promoting women’s rights
• anyone who is interested in women’s right to safety who wants to work with others to prevent domestic violence (p5).
Target audience: trainers
Trainers and activists (p5)- no further details stated.
Training methodology, including clinical practice and
assessment of competencies acquired
The sessions described in this Training process are based on a participatory method of learning (p12).
Aspect of the continuum of SRMNCAH care covered
Cross-cutting: Domestic violence.
Assessment and competence not stated.
Other health subjects covered
Duration of training course
The sessions in the tool can be used as:
• independent activities during any training process
• part of regular capacity building of a selected group of people, for example, weekly or monthly sessions with staff or community groups.
• four separate workshops held over 9 to 18 months with follow up support to participants in between the workshops
• a resource for adaptation to fit your needs and objectives (p5).
Follow-up training and supervision (if planned)
Tools for follow-up provided in appendices (Action Plan & Guidelines- which include tracking outcomes/indicators, conducting monitoring and completing
Phase Reports (Appendix p10).
Training course evaluated, and key results
Evaluation Report released October 2005 (available at http://www.raisingvoices.org/files/RVProgramToolsEvaluation.pdf) as combined evaluation of this training
curriculum and document Mobilising Communities to Prevent Domestic Violence: A Resource Guide for Organisations in East and Southern Africa.
Combined key findings for both documents are as follows:
• Organisations have very high confidence in Raising Voices and the Program Tools. They frequently recommend Raising Voices and share the Tools
with partners.
• The publications are used to develop and implement violence prevention programs in communities and regions around the world.
• The majority of respondents also regularly use the Tools for reference and capacity building. In addition, organisations reported that the Tools have positively
impacted the quality of their violence prevention programs.
• Respondents commented on the high quality of the publications, their clarity, usefulness and the ability to easily adapt the resources.
• Respondents found the Resource Guide comprehensive and the Training Process valuable for implementing training.
3. Sustainability
Integration of curriculum into national health system
for implementation at scale
Unknown.
Countries where curriculum has been implemented
and number
321 trainings have been held utilising this training curriculum, resulting in 9462 participants trained.
Estimated cost of training course (USD)
Unknown.
Strengths
• Comprehensive set of training resources provided.
Although originally intended for use in East and Southern Africa, approximately 2,500 Program Tools (combined result for this curriculum and Mobilising
Communities to Prevent Domestic Violence: A Resource Guide for Organisations in East and Southern Africa) have been disseminated by request in
65 countries.
• Action plan and guidance including tracking outcomes/indicators, conducting monitoring and completing Phase Reports provided for follow-up.
4. Strengths
and limitations
Limitations/ Weaknesses
• Not specifically designed for CHWs. Broad target trainee audience.
• No eligibility criteria for trainees listed.
• No eligibility criteria for trainers listed.
• Not competence based or assessed.
• No guidance on assessment included.
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