Organization

Before they begin supporting patients, CHWs receive an orientation from the clinical staff at the health center as well as participate in a rigorous training program designed by PIH.

PIH’s current pilot curriculum for CHWs comprises 15 units, with a focus on AIDS and tuberculosis. The training is tailored to be given over seven consecutive or separate days. Each training day consists of 6.5 hours of training, 1 hour for lunch, and two 15-minute breaks.

The number of participants varies according to need; 25 participants or fewer is ideal. All participants are provided with meals and a stipend.

Trainers and facilitators are drawn from the staff at the health centers and should have experience in training or education to ensure that they are knowledgeable about and competent in participatory-based learning and training methods suited to low-literate adult learners.

Regardless of the specific content areas covered, the primary objective of CHW training is consistent: to instill a sense of solidarity and social justice in supporting patients, households and the community. Specific goals include:

• Providing correct information about treatment, prevention, and risk factors for HIV, TB, malaria, and other infectious diseases.

• Defining the roles and responsibilities of CHWs.

• Helping CHWS recognize and reduce stigma and discrimination in their communities.

• Developing CHWs' competence in active casefinding for diseases and social needs.

• Helping CHWs improve their skills related to effective communication and psychosocial support.

• Directing CHWS to additional resources or people at the health center and in the community who can guide or assist their work.

Training principles

Based upon adult learning principles, the CHW training curriculum presented here incorporates a variety of participatory approaches to teaching and learning that build upon the existing knowledge, skills, and experiences of the participants, including:
• Large- and small-group activities and discussions
• Role plays
• Case studies
• Brainstorming
• Panel discussions
• Peer teaching

Continuing education

After the initial program, CHWs participate in ongoing monthly education sessions for one year and beyond, with additional training in areas such as nutrition, malaria, pediatric HIV/AIDS, diarrheal disease, family planning, active casefinding, worms and parasites, chronic disease, first aid, the role of traditional healers, and oral hygiene. Trainings are led by health center staff or other available teachers.

Shadowing a CHW

After completing his/her initial training, the new CHW joins a veteran CHW in conducting patient visits. This provides a practical, hands-on learning experience and helps the new CHW develop a support network of fellow CHWs.