NEW SUPPORT TO EXPAND VAPAR COMMUNITY HEALTH WORKER (CHW) TRAINING

January 2023

At the onset of the COVID-19 pandemic, we codesigned a VAPAR training intervention with the district health system. The intervention was for Community Health Workers (CHWs) to build core competencies in community mobilisation through training in rapid PAR methods. CHWs are integral links between the health system and community in low-and-middle-income-country (LMIC) settings. Yet, they are poorly supported and lack skills to connect with communities they serve. To date, we have trained 60 CHWs across the rural sub-district. A pre/post evaluation has shown positive impacts: widening core competencies and supporting CHW’s functionality and agency for local decision-making. There is demand from health officials to further scale the training.

On this basis, we have been awarded funding from the UKRI-GCRF/Newton/ODA scheme at the University of Aberdeen to: (a) scale through a ‘Training-of-Trainers (ToT)’ approach with CHWs, health systems and community actors across the sub-district (population 600,000) and (b) evaluate with Department of Health to explore effectiveness and leverage support for further uptake. Training will be facilitated by CHWs already trained by VAPAR, applying a ‘Training of Trainers (ToT)’ model. This approach is proposed to further enhance skills and capacity of CHWs engaged with VAPAR to date. CHWs who underwent VAPAR training in 2021-22 will facilitate the scale-up. They will recruit new CHWs from each local area for training, with guidance and support from the sub-district management team.

Applying a PAR framework, the training will support and enable CHWs to convene community stakeholders, raise priority health concerns, understand concerns from different perspectives, and facilitate action in communities, health systems and public services. The training will be followed by an evaluation to assess learning and skills developed both for trainers and recipients. In-depth interviews with key stakeholders including CHWs, community stakeholders, and senior health officials will be performed to detect impacts on functionality in devolved decision-making, community mobilisation, learning and skills development, in terms of costs and benefits, and to explore future uptake. This will further enable us to leverage support to implement and evaluate participatory approaches in decentralised health systems in low-and-middle-income countries (LMICs).

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The sub-district is a rural rapidly transitioning environment with widespread poverty – the project seeks to strengthen human resource capacity to improve health among vulnerable communities. The project will expand CHWs competencies in community mobilisation: in rapid evidence generation on burden and determinants of disease, human experience of burden, and on feasible local action to respond to this burden. The intervention thus supports the Department of Health in its mandate to engage with and respond to community needs and address exclusion from health systems. The training also supports data-driven decision-making through facilitating utilisation of evidence in public sector planning and management. The project, moreover, enables the team to document and share best practice with the sub-district, as well as with higher levels of the health system. Further development, testing and dissemination of the intervention will also support us to leverage funding to implement and evaluate in decentralised health systems across low-and-middle-income countries.