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Developing Capacities of Community Health Workers in Sexual and Reproductive, Maternal, Newborn, Child, and Adolescent Health: A Mapping and Review of Training Resources

Abstract / Summary: 
ABSTRACT Background: Given country demands for support in the training of community health workers (CHWs) to accelerate progress towards reaching the Millennium Development Goals in sexual and reproductive health and maternal, newborn, child, and adolescent health (SR/MNCAH), the United Nations Health Agencies conducted a synthesis of existing training resource packages for CHWs in different components of SR/MNCAH to identify gaps and opportunities and inform efforts to harmonize approaches to developing the capacity of CHWs.   Methods: A mapping of training resource packages for CHWs was undertaken with documents retrieved online and from key informants. Materials were classified by health themes and analysed using agreed parameters. Ways forward were informed by a subsequent expert consultation.   Results: We identified 31 relevant packages. They covered different components of the SR/MNCAH continuum in varying breadth (integrated packages) and depth (focused packages), including family planning, antenatal and childbirth care (mainly postpartum haemorrhage), newborn care, and childhood care, and HIV. There is no or limited coverage of interventions related to safe abortion, adolescent health, and gender-based violence. There is no training package addressing the range of evidence-based interventions that can be delivered by CHWs as per World Health Organization guidance. Gaps include weakness in the assessment of competencies of trainees, in supportive supervision, and in impact assessment of packages. Many packages represent individual programme efforts rather than national programme materials, which could reflect weak integration into national health systems.   Conclusions: There is a wealth of training packages on SR/MNCAH for CHWs which reflects interest in strengthening the capacity of CHWs. This offers an opportunity for governments and partners to mount a synergistic response to address the gaps and ensure an evidence-based comprehensive package of interventions to be delivered by CHWs. Packages with defined competencies and methods for assessing competencies and supervision are considered best practices but remain a gap.        
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TABLE 1. Training resource packages on sexual and reproductive health and maternal, newborn, child, and adolescent health.  These were identified from October to December 2012 (n=31) and are classified by ‘integrated’, ‘focused’ (family planning, childbirth care, newborn, infancy and childhood care, HIV, gender-based violence), and date of publication, starting with the most recent.
- Community Health Worker Trainer's Manual. Millennium Villages Project, 2011/2013 Update.
- Training manual for volunteers on maternal and newborn health care. Society for Family Health Revised edition, 2012.
- Timed and Targeted Counselling. World Vision International, 2010.
- Guide for Training Community Health Workers/Volunteers to Provide Maternal and Newborn Health Messages. USAID, POPPHI, BASICS, 2009.
- Training manual for cluster representatives and health volunteers, Module 1 and Module 3. WHO, 2009
- Community-Based Health Planning and Services (CHPS), Community Health Volunteers Training Manual. The Population Council, Ministry of Health/ Ghana Health Service, 2009.
- Linking Communities with the Health System: the Kenya Essential Package for Health at Level 1. MOH Kenya, 2007.
- CHW Certificate Program - Facilitator's Guide (selected modules). National Department of Health, Papua New Guinea, 2006.
- Reproductive Health Manual for Trainers of CHWs. CEDPA (Centre for Development and Population Activities), India, 2003.
- Health Surveillance Assistants Training Curriculum, MoH Malawi, 2006.
- Health Extension Worker Program of Training Packages Ethiopia. Ministry of Health Federal Democratic Republic of Ethiopia, The Earth Institute at Columbia University Centre for National Health Development in Ethiopia, 2003/2004.
Family planning
- Population, Health and Environment (PHE) Community-based Distribution and Peer Education System: A Guide for Training PHE Community-based Distributors. Balanced Project (Coastal Resources Center, PATH Foundation Philippines, Conservation International), 2012.
- Training for community-based delivery of injectable contraceptives. FHI360, Child Fund Zambia, 2009 (2011 update).
- Postpartum Family Planning for Community Health Workers. Jhpiego, ACCESS-FP / USAID, 2010.
- Community Health Worker Postpartum Family Planning - Training Package for CHW Trainers. USAID, 2008.
- Offering CycleBeads: a Toolkit for Training Community Health Workers. Institute for Reproductive Health, Georgetown University, 2008.
Childbirth care
- Prevention of Postpartum Haemorrhage at Home Birth ­ A Program Implementation Guide. Access Program / Jhpiego. 2009.
- Prevention of postpartum haemorrhage at home birth ­ Facilitator’s guide and reference manual. MOH, Population Nepal, 2005.
Newborn, infancy, childhood care
- Caring for the newborn at home, a training course for community health workers. WHO, UNICEF, 2012.
- Care for child development: improving the care of young children. WHO, UNICEF, 2012.
- The Community Infant and Young Child Feeding Counselling Package: Facilitator Guide. UNICEF, URC/CHS, 2012.
- Caring for the sick child in the community. WHO, UNICEF, 2011.
- Manual de agente comunitario de salud: Atencion integrada a las enfermedades prevalentes de la infancia (AIEPI) [IMCI]. PAHO, 2010.
- Community IMCI. MOH Cambodia, 2008.
- Infant young child feeding counselling: An integrated course. WHO, UNICEF, 2006.
- How to Train Community Health Workers in Home-Based Newborn Care. The SEARCH Team, 2006.
- Guide for Training Community Health Workers in WASH-HIV Integration. C-CHANGE (FHI360, Kenya MoPH and Sanitation), 2011.
- Accompagnateur Training Guide. Partners in Health, 2008.
- HIV Prevention Treatment Care and Support- A Training Package for Community Volunteers. WHO, IFRC, Safaids, 2006.
- Community Home-Based Care for People and Communities Affected by HIV: Training Course and Handbook for Community Health Workers. Pathfinder International, 2006.
Gender-based violence
- Rethinking Domestic Violence: A Training Process for Community Activists. Raising Voices, 2004.


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Tran NT, Portela A, de Bernis L, Beek K

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