Rehabilitation training for community health workers: a five-year study

Abstract

ABSTRACT The purpose of this study is to evaluate the effectiveness of a rehabilitation training program for community health workers in a resource-limited setting over a 5-year period. This is a retrospective cross-sectional study. Participants were home-based palliative care community health workers at St. Gabriel’s Hospital in rural Malawi (2013: n = 20, 2014: n = 20, 2015: n = 20, 2016: n = 60, 2017: n = 60). Data were collected from knowledge tests, skill competency tests, observations of skills in the home setting and surveys of the community health workers. Descriptive and comparison statistical methods were used to analyze the results. Over the 5 years of trainings, attendance was 99%. Participants showed significantly greater knowledge on the post-test than on the pre-test in four of the 5 years of annual training (2013: p < 0.001, 2014: p < 0.001, 2015: p = 0.007, 2016: p < 0.001). 100% of the participants demonstrated competency in all rehabilitation skills in all 5 years of training (20 skills in the first 3 years, 32 skills in the fourth year, and 20 skills in the fifth year). 100% of participants demonstrated the ability to apply some aspect of training in the home setting. The community health workers reported that the rehabilitation skills learned helped the patient, the caregiver, and themselves (> 85% ‘some’ or ‘a lot’). Community health workers participating in the rehabilitation training program in a resource-limited setting over the past 5 years have improved their knowledge, skill competency and the ability to implement what they have learned for patient care in the village.