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TargetingHealthWorkersforCaseManagementTrainingatalllevels
MalariaConsortiumoffersanalternativetothecascademodeloftraining
Dr.Mwiche,theProvincialCommunicableDiseaseControlSpecialist,facilitatescasemanagementtraininginKateteDistrict,ZambiainJune2009.
Providingprompt,effectivetreatmentformalariaremainsanunmetgoalforhealthcentresacrossZambia.TheZambianMinistryofHealthhascalledattentiontothehumanresourcecrisisinthehealthsystem,whichunderminesitscapacitytoprovideeventhemostbasichealthcareservicestoitspeople.
Thehealthsystemhassufferedfurtherdeteriorationsduetohighstaffattritionratesattributedtothemigrationofhealthprofessions,alongwithHIV/AIDSrelateddeaths.TheextentofthecrisisissuchthatmanyRuralHealthCentreshavenostafforarestaffedbyuntrainedpersonnel,andnewcentreshavebeenopenedwithoutadditionalstafftorunthem.Thephotototherightshowstwocasualdailyemployeeswhoaretheonlystaffmembersattheirclinic.
Inresponse,MalariaConsortiumhasdesignedacasemanagementtrainingthattargetsalllevelsofstaff,toensurethatanystaffmemberhandlingmalariacasesknowsthecorrectprotocols.[Themostimportantprinciplesofmalariacasemanagementareearlyandaccuratediagnosis,promptandeffectivetreatment,adherencetotreatment,follow‐upandgoodnursing.]MalariaConsortiumhasinvitedDoctors,ClinicalOfficers,RegisteredandEnrolledNurses,EnvironmentalHealthTechnicians,LaboratoryStaff,andCasualDailyEmployeesaswellasManagersofDistrictHealthUnitsandHospitals.
Afterthetrainingsbyqualifiedhealthprofessionals,follow‐upsessionstakeplaceatthree,sixandtwelvemonthintervals.
ThetrainingmanualusedduringtheseworkshopswaswrittenbytheCaseManagementTechnicalWorkingGroup,ateamofexpertsincludingMalariaConsortium–International,andinZambia,MalariaConsortiumCountryOffice,NationalMalariaControlCentre,ProvincialClinicalCareandCommunicableDiseaseControlSpecialists,andotherhealthpractitioners.ThetrainingfocusesonaccuratecasedetectionanduseofRapidDiagnosticTests,treatment,careforpregnantwomen,havingconfidenceinrapiddiagnostic
TheseCasualDailyEmployeesrodeover150kilometrestoattendtheCaseManagementTraininginChama.Althoughtheyhavehadnoformalmedicaltraining,theyaretheonlystaffintheirhealthcentre,responsibleforallthehealthcareneedsoftheircatchementarea.
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testresults,andhowtotrackdatasothattheentiresystemcanrunsmoothly.
In2009,trainingwascarriedoutinfiveDistricts;twoinEasternProvince,andthreeinSouthernProvince,reachingover462healthfacilityworkersandapproximately100healthcentresincludingtworemoteDistricts,ChamaandItezhi‐Tezhi.
CentraltrainingcancostuptoUSD$1,000perpersonwhenitisheldatahotel.MalariaConsortiumhasdesignedamorecost‐effectivemodelwhichreachesmorehealthworkers,andmakesuseofthecentreswheretheymeetpatients.TrainerscamefromtherespectiveProvincialHealthOffices,allowingforeasyfollow‐up.Smallergroupsmeanthands‐ontrainingforparticipants,withalowteachertostudentratio.Thismodelallowedparticipantstogainpracticewithavailableequipment,makingoptimaluseoftheirtime.
Thetrainingprovidesbasicoperationalinformationandessentialskillsneededbyallhealthworkersinvolvedinmalariacasemanagement.Itsobjectiveistoraisecapacityofhealthstaffatalllevelsintermsoftheirabilitytoperformlife‐savinginterventions,transferringknowledgeintothemindsofthepeoplewhotakecareofpatientseveryday.
AttheendofaMalariaConsortiumtraininginJune2009,YoanaMbewe,acasualdailyemployeesaid,‘Thankyou.Weshouldcontinueinthisspirittoconsideruscasualdailyemployeestofindproblemswhenqualifiedstaffarenotthere.Butthistraininghastaughtusalotofthingssothatwhenweareatthe[health]centreweareabletodothework.’(TranslatedfromNyanja.)
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www.malariaconsortium.org
MalariaConsortiumZambiaPlot37L/2Middleway,Kabulonga,Lusaka,Zambia T+260211262715
HealthworkersataCaseManagementTraininginChama,inEasternProvince.
