Development, Implementation, and Evaluation of a Training Module for Community Health Workers in Rwanda: A Special Studies Project Open Access

Abstract

Abstract

Development, Implementation, and Evaluation of a Training Module for Community Health Workers in Rwanda: A Special Studies Project

By Johannah Ohlin

Background: Diarrhea remains the second leading cause of death in children under five years old, with the global estimate of deaths between 0.538-1.031 million. In Rwanda, diseases related to environmental health are among the major causes of morbidity and mortality in children under 5 years. Interventions targeting water may effectively reduce diarrheal diseases. This project was part of a larger study to assess the sustainability of installing membrane-filtered water kiosks in health centers that could be used by the community. Community level behavior change regarding drinking water practices is critical to the success of the project. This project aims to engage with community health workers (CHWs) to promote safe drinking water source selection and storage practices. CHWs currently lack training in behavior change strategies specific to drinking water messages.

Purpose: The immediate purpose was to develop a standardized training module that provided community health workers with training on behavior change strategies around safe drinking water practices. The overarching goal was to strengthen community health worker capacity in behavior change strategies in order to motivate community adoption of safe drinking water source selection, transport, and storage behaviors.

Methods: The module's content was based on key-informant interviews, observations, and existing training curriculums. The module was field tested, evaluated, revised, and then submitted to research partners for further revisions and translation.

Results: CHWs do not receive systematic training that applies behavior change communication to drinking water source selection and storage. The training module utilizes components of interpersonal communication, such as listening, empathizing, and affirming to motivate adoption of safe drinking water practices. Role-play activities are an effective teaching strategy for the adult learners.

Discussion: CHWs are well positioned to facilitate behavior change around safe water practices. CHWs currently emphasize health and disease as motivators when providing drinking water messages to community members, however using other behavior change strategies, such as interpersonal communication, may be more effective to motivate behavior change around drinking water source selection and storage.

Table of Contents

Table of Contents

INTRODUCTION..........................................................4

LITERATURE REVIEW.................................................12

METHODS.................................................................30

RESULTS...................................................................38

DISCUSSION.............................................................46

RECOMMENDATIONS..................................................53

CONCLUSION............................................................57

APPENDIX A..............................................................59

APPENDIX B..............................................................60

APPENDIX C..............................................................62

APPENDIX D..............................................................64

APPENDIX E..............................................................65

REFERENCES.............................................................90

List of Tables

Table 1.....................................................................40

Table 2.....................................................................42

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Rwanda Community Health Worker Behavior Change
Committee Chair / Thesis Advisor	Dreibelbis, Robert, University of Oklahoma
Committee Members	Moe, Christine L, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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