'First of all, I need training': a qualitative study evaluating the Fiji community health worker training program.
Community health worker
Qualitative study
Republic of Fiji
Training program
Journal
BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676
Informations de publication
Date de publication:
26 Jun 2024
26 Jun 2024
Historique:
received:
28
02
2024
accepted:
17
06
2024
medline:
27
6
2024
pubmed:
27
6
2024
entrez:
26
6
2024
Statut:
epublish
Résumé
Fiji faces a growing burden of diseases and a significant emigration of health workers, heightening the role of community health workers (CHWs) in healthcare delivery. Effective training is crucial for CHWs to enhance their capacity and service quality. This study evaluates CHW training in Fiji, aiming to identify areas for improvement. A qualitative study was conducted, encompassing a review of national policies on CHW training, six focus group discussions, and interviews with CHWs and their supervisors across Fijian subdivisions. This study was collaboratively designed with Fiji's Ministry of Health and Medical Services (MOHMS). Data was transcribed, coded, and thematically analysed using the Community Health Workers Assessment and Improvement Matrix (CHW-AIM). While CHW training policies in Fiji are well-established, discrepancies exist between the policy and its implementation. Challenges include inconsistent training for new recruits, limited resources, and variability in training content and frequency of training across divisions, especially concerning noncommunicable disease (NCD) training. To enhance the CHW training program in Fiji, a restructuring and standardisation of both pre-service and in-service training is necessary, tailored to the needs of each division. Investment in ongoing capacity building, alongside the development and revision of training guidelines, particularly for managing NCD complications in the community, is crucial. Implementing these changes will enable CHWs in Fiji to be better equipped for providing essential community-based care.
Sections du résumé
BACKGROUND
BACKGROUND
Fiji faces a growing burden of diseases and a significant emigration of health workers, heightening the role of community health workers (CHWs) in healthcare delivery. Effective training is crucial for CHWs to enhance their capacity and service quality. This study evaluates CHW training in Fiji, aiming to identify areas for improvement.
METHODS
METHODS
A qualitative study was conducted, encompassing a review of national policies on CHW training, six focus group discussions, and interviews with CHWs and their supervisors across Fijian subdivisions. This study was collaboratively designed with Fiji's Ministry of Health and Medical Services (MOHMS). Data was transcribed, coded, and thematically analysed using the Community Health Workers Assessment and Improvement Matrix (CHW-AIM).
FINDINGS
RESULTS
While CHW training policies in Fiji are well-established, discrepancies exist between the policy and its implementation. Challenges include inconsistent training for new recruits, limited resources, and variability in training content and frequency of training across divisions, especially concerning noncommunicable disease (NCD) training.
INTERPRETATION
CONCLUSIONS
To enhance the CHW training program in Fiji, a restructuring and standardisation of both pre-service and in-service training is necessary, tailored to the needs of each division. Investment in ongoing capacity building, alongside the development and revision of training guidelines, particularly for managing NCD complications in the community, is crucial. Implementing these changes will enable CHWs in Fiji to be better equipped for providing essential community-based care.
Identifiants
pubmed: 38926808
doi: 10.1186/s12875-024-02480-8
pii: 10.1186/s12875-024-02480-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
228Informations de copyright
© 2024. The Author(s).
Références
Kim R, Costello A, Campbell-Lendrum D. Climate change and health in Pacific island states. Bull World Health Organ. 2015;93(12):819.
doi: 10.2471/BLT.15.166199
pubmed: 26668431
pmcid: 4669736
Ministry of Health and Medical Services, Fiji. Annual Report 2015. Parliament of Fiji. Parliamentary Paper No 79, August 2016.
Yoon CG, Latianara A, Irava W, Lee E, Park K. Working conditions and perception on incentives of Fiji community health workers: findings from a survey with a convenience sample in 2016. J Glob Health Sci. 2019;1(1). https://doi.org/10.35500/jghs.2019.1.e8 .
World Health Organization. Health workforce requirements for universal health coverage and the Sustainable Development Goals. In: Background paper No. 1 to the Global Strategy on Human Resources for Health. 2016.
Ministry of Health and Medical Services, Fiji. Strategic plan 2020-2025. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.health.gov.fj/wp-content/uploads/2020/05/Strategic-Plan-2020-2025-1.pdf .
Morgan J. Country in Focus: turning the tide of diabetes in Fiji. Lancet Diabetes Endocrinol. 2015;3(1):15–6.
doi: 10.1016/S2213-8587(14)70240-2
pubmed: 25466524
South Pacific Community. Strengthening Human Resources for Health Management and Planning in the Pacific Island Countries. Directors of Clinical Services Meetings. In: Public Health Division. 2022. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://phd.spc.int/sites/default/files/p-related-files/2022-08/DCS2.1%20Human%20resources%20for%20Health%20WHO_0.pdf .
Wiseman V, Lagarde M, Batura N, Lin S, Irava W, Roberts G. Measuring inequalities in the distribution of the Fiji Health Workforce. Int J Equity Health. 2017;16(1):115.
doi: 10.1186/s12939-017-0575-1
pubmed: 28666460
pmcid: 5493125
Negin J, Roberts G, Lingam D. The evolution of primary health care in Fiji: past, present and future. Pac Health Dialog. 2010;16(2):13–23.
pubmed: 21714331
Ministry of Health and medical Services Fiji Islands. Community health worker policy. 2015.
Minstry of Health and Medical Service, Fiji. World Health Organisation’s Package of Essential Non-Communicable (PEN) disease interventions evaluation workshop. 2023.
Australian Government, Department of Foreign Affairs and Trade. Fiji country brief. https://www.dfat.gov.au/geo/fiji/fiji-country-brief . Australia 2023.
World Population Review. Fiji Population 2023 2023 [Available from: https://worldpopulationreview.com/countries/fiji-population .
Fiji Bureau of Statistics. Fiji Multiple Indicator Cluster Survey 2021, Survey Findings Report. Suva: Fiji Bureau of Statistics; 2022.
World Health Organization, Regional Office for the Western P. The Fiji Islands health system review. Manila: WHO Regional Office for the Western Pacific; 2011. p. 2011.
Community Health Impact Coalition, Community Health Worker Assessment and Improvement Matrix (CHW AIM). Updated program functionality matrix for optimizing community health programs. 2018.
Dedeilia A, Papapanou M, Papadopoulos AN, Karela N-R, Androutsou A, Mitsopoulou D, et al. Health worker education during the COVID-19 pandemic: global disruption, responses and lessons for the future—a systematic review and meta-analysis. Hum Resour Health. 2023;21(1):13.
doi: 10.1186/s12960-023-00799-4
pubmed: 36829158
pmcid: 9951171
Abdel-All M, Thrift AG, Riddell M, Thankappan KRT, Mini GK, Chow CK, et al. Evaluation of a training program of hypertension for accredited social health activists (ASHA) in rural India. BMC Health Serv Res. 2018;18(1):320.
doi: 10.1186/s12913-018-3140-8
pubmed: 29720161
pmcid: 5932780
Abdel-All M, Putica B, Praveen D, Abimbola S, Joshi R. Effectiveness of community health worker training programmes for cardiovascular disease management in low-income and middle-income countries: a systematic review. BMJ Open. 2017;7(11):e015529.
doi: 10.1136/bmjopen-2016-015529
pubmed: 29101131
pmcid: 5695434
Tesema AG, Peiris D, Abimbola S, Ajisegiri WS, Narasimhan P, Mulugeta A, et al. Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery. PLOS Global Public Health. 2022;2(11):e0001160.
doi: 10.1371/journal.pgph.0001160
pubmed: 36962619
pmcid: 10021836
Henderson LN, Tulloch J. Incentives for retaining and motivating health workers in Pacific and Asian countries. Human resources for health. 2008;6:1-20.
Morrell S, Lin S, Tukana I, Linhart C, Taylor R, Vatucawaqa P, Magliano DJ, Zimmet P. Diabetes incidence and projections from prevalence surveys in Fiji. Population health metrics. 2016;14:1-8.
Scott K, Beckham SW, Gross M, Pariyo G, Rao KD, Cometto G, et al. What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers. 2018;16(1):39.
Vaughan K, Kok MC, Witter S, Dieleman M. Costs and cost-effectiveness of community health workers: evidence from a literature review. Human resources for health. 2015;13(1):71.
doi: 10.1186/s12960-015-0070-y
pubmed: 26329455
pmcid: 4557864
Braun R, Catalani C, Wimbush J, Israelski D. Community Health Workers and Mobile Technology: A Systematic Review of the Literature. PLOS ONE. 2013;8(6):e65772.
Li L, Lin C, Pham LQ, Nguyen DB, Le TA. Networking community health workers for service integration: role of social media. AIDS Care. 2022;35(7):1030–6.