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01.12.2018 | Research | Ausgabe 1/2018 Open Access

Human Resources for Health 1/2018

The use of low-cost Android tablets to train community health workers in Mukono, Uganda, in the recognition, treatment and prevention of pneumonia in children under five: a pilot randomised controlled trial

Zeitschrift:
Human Resources for Health > Ausgabe 1/2018
Autoren:
James O’Donovan, Kenneth Kabali, Celia Taylor, Margarita Chukhina, Jacqueline C. Kading, Jonathan Fuld, Edward O’Neil
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12960-018-0315-7) contains supplementary material, which is available to authorized users.

Abstract

Background

Since 2012, The World Health Organization and UNICEF have advocated for community health workers (CHWs) to be trained in Integrated Community Case Management (iCCM) of common childhood illnesses, such as pneumonia. Despite the effectiveness of iCCM, CHWs face many barriers to accessing training. This pilot study compares traditional training with using locally made videos loaded onto low-cost Android tablets to train CHWs on the pneumonia component of iCCM.

Methods

We conducted a pilot randomised controlled trial with CHWs in the Mukono District of Uganda. The unit of randomisation was the sub-county level, and the unit of analysis was at the level of the individual CHW. Eligible CHWs had completed basic iCCM training but had not received any refresher training on the pneumonia component of iCCM in the preceding 2 years. CHWs in the control group received training in the recognition, treatment, and prevention of pneumonia as it is currently delivered, through a 1-day, in-person workshop. CHWs allocated to the intervention group received training via locally made educational videos hosted on low-cost Android tablets. The primary outcome was change in knowledge acquisition, assessed through a multiple choice questionnaire before and after training, and a post-training clinical assessment. The secondary outcome was a qualitative evaluation of CHW experiences of using the tablet platform.

Results

In the study, 129 CHWs were enrolled, 66 and 63 in the control and intervention groups respectively. CHWs in both groups demonstrated an improvement in multiple choice question test scores before and after training; however, there was no statistically significant difference in the improvement between groups (t = 1.15, p = 0.254). There was a statistically significant positive correlation (Pearson’s r = 0.26, p = 0.03) linking years of education to improvement in test scores in the control group, which was not present in the intervention group. The majority of CHWs expressed satisfaction with the use of tablets as a training tool; however, some reported technical issues (n = 9).

Conclusion

Tablet-based training is comparable to traditional training in terms of knowledge acquisition. It also proved to be feasible and a satisfactory means of delivering training to CHWs. Further research is required to understand the impacts of scaling such an intervention.

Trial registration

Registered on 23/11/2016 at clinicaltrials.gov (NCT02971449).
Zusatzmaterial
Additional file 1: Consort diagram. (PDF 87 kb)
12960_2018_315_MOESM1_ESM.pdf
Additional file 2: Pre-and post-test knowledge MCQ. (PDF 67 kb)
12960_2018_315_MOESM2_ESM.pdf
Additional file 3: Post training clinical scenarios. (PDF 94 kb)
12960_2018_315_MOESM3_ESM.pdf
Additional file 4: Evaluation questionnaire. (PDF 33 kb)
12960_2018_315_MOESM4_ESM.pdf
Additional file 5: Demographic data. (PDF 57 kb)
12960_2018_315_MOESM5_ESM.pdf
Additional file 6: Univariate analysis and regression analysis. (PDF 107 kb)
12960_2018_315_MOESM6_ESM.pdf
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