Developing an Institute for Workforce Development with Multi-communication, Online Training for Global Health Security among the Public Health Workforce in West Africa Public
Ogunyemi, Kehinde (Fall 2023)
Abstract
Background: eLearning plays a key role in bridging competency gaps among the public health workforce. However, implementation remains a challenge in resource-limited settings. In this study, we assessed the contextual fit and feasibility of a multi-communication, online training (MOT) to guide establishment of an Institute for Workforce Development in West Africa.
Methods: A mixed-methods study was conducted among public health workers in 16 West African countries between Aug 10, 2023, to Oct 10, 2023. Participants were invited through a multisectoral health forum and sub-regionally coordinated efforts to complete an online survey that was created in English, pilot-tested and translated to French and Portuguese. Contextual fit was measured with MOT preference and acceptability, while feasibility was measured with MOT willingness to use and workplace ICT availability using a scoring system developed based on implementation science. Statistical weighting was applied to improve representativeness. In-depth interviews were thematically analysed.
Results: A total of 231 survey responses were collected and seven in-depth interviews conducted. MOT was found to be of “somewhat” contextual fit with population estimates of (preference: 29.61%, 23.96–35.27; acceptability: 95.99%, 93.79–98.18) and “strong” feasibility (willingness to use: 95.56%, 93.78–97.35; workplace ICT availability: 82.09%, 77.50–86.68). Work area was found as a major predictor of MOT contextual fit and feasibility, where probabilities of MOT preference, acceptability, willingness to use, and workplace ICT availability were 42% lower (0.58–0.59), 99% lower (0.01–0.14), 95% lower (0.01–0.40), and 2.57 (1.22–5.40) times higher respectively for public health workers in rural areas compared to those in urban areas. The three leading constraints identified were poor internet connectivity, high internet costs and unreliable electricity, while protected work time, contextual practice-based training and consensual training schedule were identified as the top three recommendations.
Conclusion: The study findings suggest MOT is contextually fit and feasible, but geographic disparities exist. Constraints on limited access to ICT including internet, and unstable electricity, with recommendations for protected work time and better training delivery highlight the need for equity-focused workplace policies and increased investments in social infrastructure to improve the public health workforce capacity for global health security.
Table of Contents
Chapter 1: Introduction 1
Chapter 2: Literature Review 4
2.1 Public Health Workforce Development and Global Health Security 4
2.2 Training Modalities for Public Health Workforce Development 5
2.2.1 Training Delivery Methods 6
2.2.2 Training Design Approaches 7
2.3 Benefits and Limitations of Training Modalities for Public Health Workforce Development 9
2.4 Public Health Workforce Development with Online Training in Africa 12
2.5 Gaps in Public Health Workforce Development with Online Training in Africa 15
2.5.1 Research Gap 16
2.5.2 Policy and Practice Gap 18
2.6 Global and African Region’s Policies for Public Health Workforce Development 19
2.7 Leveraging Multi-communication, Online Training (MOT) for Global Health Learning in West Africa 26
Chapter 3: Description of the Project 28
3.1 Project Overview 28
3.2 Operational Definition of Terms 28
3.3 Conceptual Framework: Theories, and Assumptions 31
Chapter 4: Methods 34
4.1 Study Design 34
4.2 Study Settings 34
4.3 Study Population 36
4.4 Sample Size Estimation 36
4.5 Sampling Technique 37
4.6 Data Collection 38
4.7 Data Analysis 42
4.8 Ethical Considerations 49
Chapter 5: Results 50
5.1 Sociodemographics of Public Health Workers in the Study (Survey Participants and Interviewees) 50
5.2 Multi-communication, Online Training (MOT) Preference Rate among Public Health Workers Overall, and by Factors 53
5.3 Bivariate and Multivariate Analysis, Themes, and Meta-Inferences of MOT Preference 58
5.4 MOT Acceptability Rate among Public Health Workers Overall, and by Factors 62
5.5 Bivariate and Multivariate Analysis, Themes, and Meta-Inferences of MOT Acceptability 67
5.6 MOT Willingness to Use Rate among Public Health Workers Overall, and by Factors 72
5.7 Bivariate and Multivariate Analysis, Themes, and Meta-Inferences of MOT Willingness to Use 77
5.8 Workplace ICT Availability Rate for MOT among Public Health Workers Overall, and by Factors 81
5.9 Bivariate and Multivariate Analysis, Themes, and Meta-Inferences of Workplace ICT Availability for MOT 86
5.10 Contextual fit of MOT among Public Health Workers Overall, and by Country 90
5.11 Feasibility of MOT among Public Health Workers Overall, and by Country 93
5.12 Perceived Constraints for MOT among Public Health Workers 96
5.13 Perceived Enablers for MOT among Public Health Workers 98
5.14 Recommendations of Public Health Workers for MOT 100
Chapter 6: Discussion, Conclusion and Public Health Implications 102
6.1 Discussion 102
6.1.1 Strengths and Limitations 109
6.2 Conclusion 111
6.3 Public Health Implications 112
6.3.1 Research 112
6.3.2 Policy and Practice 113
References 114
Appendices 123
Appendix 1: Survey Instrument (English) 123
Appendix 2: Survey Instrument (French) 132
Appendix 3: Survey Instrument (Portuguese) 141
Appendix 4: In-Depth Interview Guide (English) 150
Appendix 5: In-Depth Interview Guide (French) 152
Appendix 6: West Africa’s Public Health Workforce, Economy, & Global Health Security Index 154
Appendix 7: Balance Assessment of Sample, and Sample Weights Computation 155
Appendix 8: Normality Tests 157
Appendix 9: Braun & Clarke 15-point Thematic Analysis Checklist 158
Appendix 10: Good Reporting of a Mixed-Methods Study (GRAMMS) Checklist 159
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