Sustained Capacity Building of Local Health Workers in
![Sustained Capacity Building of Local Health Workers in Detecting and Responding to Avian Influenza Sustained Capacity Building of Local Health Workers in Detecting and Responding to Avian Influenza](https://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-1.jpg)
Sustained Capacity Building of Local Health Workers in Detecting and Responding to Avian Influenza and Emerging Infectious Diseases Achievements and Lessons Learned
![Background Vietnam • Areas of virus activity for Avian and Pandemic Influenza (API) • Background Vietnam • Areas of virus activity for Avian and Pandemic Influenza (API) •](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-2.jpg)
Background Vietnam • Areas of virus activity for Avian and Pandemic Influenza (API) • Human infections typically associated with backyard poultry farms • Commitment by Government of the Socialist Republic of Vietnam (GVN) to control Emerging Infectious Diseases (EIDs)
![USAID’s Avian and Pandemic Influenza Initiative • Improve GVN capacity to prevent, detect, and USAID’s Avian and Pandemic Influenza Initiative • Improve GVN capacity to prevent, detect, and](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-3.jpg)
USAID’s Avian and Pandemic Influenza Initiative • Improve GVN capacity to prevent, detect, and respond to API and EIDs • Implemented by Abt Associates • Oct 2008 - Sept 2013 • $11. 7 million budget
![Project Components • Animal Health – reduce risk of virus transmission during poultry raising, Project Components • Animal Health – reduce risk of virus transmission during poultry raising,](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-4.jpg)
Project Components • Animal Health – reduce risk of virus transmission during poultry raising, slaughtering, and selling through improved education and standardized procedures • Human Health – prevent spread of infection by humans before and during an outbreak through early identification and implementation of infection control strategies • Behavior Change Communication (BCC) – increase awareness and improve animal husbandry practices to reduce risk of transmission from animals to people • Policy Advocacy and Coordination – improve GVNs ability to plan for and respond to outbreaks
![Key Capacity Building Instrument: Training Train the Trainers Animal Health Human Health Behavior Change Key Capacity Building Instrument: Training Train the Trainers Animal Health Human Health Behavior Change](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-5.jpg)
Key Capacity Building Instrument: Training Train the Trainers Animal Health Human Health Behavior Change Communicatio n Animal Health for animal health workers (AHWs) Biosecurity for AHWs and agriculture extension workers (AEWs) Train the Trainers Community-Based Surveillance (CBS) Infection Control Train the Trainers Communicators / Facilitators
![Post-Training Assessment Objectives • Determine outcomes and impact of training conducted under project (to Post-Training Assessment Objectives • Determine outcomes and impact of training conducted under project (to](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-6.jpg)
Post-Training Assessment Objectives • Determine outcomes and impact of training conducted under project (to date) • Identify motivators and barriers for application of new skills and knowledge among trainees • Sub-objectives: – 6 months to 1 -year post-training: • Evaluate knowledge and skills of trainees • Evaluate attitude and application of trainees – Evaluate impact of training on local community – Provide lessons learned – Provide recommendations
![Post-Training Assessment Methods • November 2011, undertaken by Asian Management and Development Institute • Post-Training Assessment Methods • November 2011, undertaken by Asian Management and Development Institute •](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-7.jpg)
Post-Training Assessment Methods • November 2011, undertaken by Asian Management and Development Institute • Conducted: – Desk review – Self-administered questionnaire for KAP survey of trainees – In-depth interviews (IDIs) with trainers and key partner agencies – Focus group discussions (FGDs) with trainees and community members – On-the-job observation of trainees • Multi-stage clustering sampling: – 2 districts within each of 5 provinces – Random selection of participants based on participant lists
![Methods cont’d • Sample size: 1, 316 trainees, 220 trainers, and 59 local animal Methods cont’d • Sample size: 1, 316 trainees, 220 trainers, and 59 local animal](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-8.jpg)
Methods cont’d • Sample size: 1, 316 trainees, 220 trainers, and 59 local animal and human health officers • Quantitative data processed using SPSS and Excel; qualitative using Atlas to code transcribed data • Limitations: – Participant lists sometimes required reorganization for IDI/FGD selection – Respondent availability - some participants were selected for more than one activity but could only participate in one – Local accent/dialect posed challenges to transcription – Data largely self-report
![Post-training Assessment Results • Knowledge and attitude 6 months – 1 year post-training – Post-training Assessment Results • Knowledge and attitude 6 months – 1 year post-training –](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-9.jpg)
Post-training Assessment Results • Knowledge and attitude 6 months – 1 year post-training – 75 -100% of respondents answered at least 50% of knowledge questions correctly (50% = pass) – Qualitative data indicated that participants believed their knowledge was increased • Practice – 48% and 53% BCC and AH trainers conducted diffusion training – 100% CBS trainers conducted diffusion training • AHWs – Trained AHWs provided AH services to 20 farmers/month (avg) – 70 -100% applying skills in veterinary and animal husbandry – Observed correct injection procedures, autopsy techniques, and good counseling skills to farmers
![Results cont’d • CBS collaborators – Visited 40 homes/month to collect disease information – Results cont’d • CBS collaborators – Visited 40 homes/month to collect disease information –](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-10.jpg)
Results cont’d • CBS collaborators – Visited 40 homes/month to collect disease information – 83% AH and 97% HH reported suspected events immediately – 42% believed surveillance activities would be smaller post-project • Health workers – 76% and 58% trained health workers at district and commune level reported applying hand washing skills – Observed hand disinfection liquid and proper sharps disposal • Communicators – 73 -95% reported good performance of MC skills (time management, creating atmosphere, encouraging audiences and facilitating learning) – 50 -80% of FGD facilitators performed facilitation skills (encouraged participation, facilitated learning, clearly delivered messages, and managed time)
![Results cont’d • Impact on local community While baseline data was not collected to Results cont’d • Impact on local community While baseline data was not collected to](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-11.jpg)
Results cont’d • Impact on local community While baseline data was not collected to show improvement, data collected through this assessment indicates a high level of performance. This high level of performance can be seen as a proxy for improved knowledge and skill use in the community due to increased capacity of community members.
![Lessons Learned Key barriers for practicing skills/knowledge learned: • Lack of regular incentives (e. Lessons Learned Key barriers for practicing skills/knowledge learned: • Lack of regular incentives (e.](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-12.jpg)
Lessons Learned Key barriers for practicing skills/knowledge learned: • Lack of regular incentives (e. g. salary or allowances) for public AHWs • Shortage of resources, standardized tools, and frameworks for follow-up, coaching, and continued onsite training and learning • High turnover rates of AHWs (i. e. , those trained are not retained)
![Key Take-Away Messages • Effectiveness/sustainability of TOTs enhanced by integration into GVN systems and Key Take-Away Messages • Effectiveness/sustainability of TOTs enhanced by integration into GVN systems and](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-13.jpg)
Key Take-Away Messages • Effectiveness/sustainability of TOTs enhanced by integration into GVN systems and implementation by local counterparts • Trainings including 1) a training needs assessment, 2) development of full training curriculum, 3) TOT, and then 4) training diffusions were most successful • Establishing selection criteria for trainers will improve quality of trainings • Data collection during and after trainings should be systematic, usable, and uniform across components
![Cam On / Thank you For more information : Lara Hensley Technical Coordinator Lara_Hensley@abtassoc. Cam On / Thank you For more information : Lara Hensley Technical Coordinator Lara_Hensley@abtassoc.](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-14.jpg)
Cam On / Thank you For more information : Lara Hensley Technical Coordinator Lara_Hensley@abtassoc. com
![Authors • Nga Le, MD, MPH, Avian Pandemic Influenza Initiative, Abt Associates, Hanoi, Vietnam Authors • Nga Le, MD, MPH, Avian Pandemic Influenza Initiative, Abt Associates, Hanoi, Vietnam](http://slidetodoc.com/presentation_image/35faf0b88951ad2a5079893453f7c0e3/image-15.jpg)
Authors • Nga Le, MD, MPH, Avian Pandemic Influenza Initiative, Abt Associates, Hanoi, Vietnam • Truong Bui, MD, MPH, Avian Pandemic Influenza Initiative, Abt Associates, Hanoi, Vietnam • Lara Hensley, MPH, Abt Associates, Bethesda, MD, USA • Jens Peter Dalsgaard, Ph. D, MBA , Abt Associates, Hanoi, Vietnam • Duc Nguyen, Asian Management and Development Institute, Hanoi, Vietnam • Manh Nguyen, Asian Management and Development Institute, Hanoi, Vietnam
- Slides: 15