Use of creative training approaches for community health workers: Experience with the Standard Days Method

Access to primary health services, such as family planning, may be expanded by community health workers (CHWs). The Standard Days Method (SDM) of family planning has been provided in clinic settings worldwide, and provision by community health workers began recently. Training of CHWs, within a variety of public and private organizations, can be formal or non-formal, occur on-the-job as part of routine supervision, or even be self-taught. Because of the varied nature of CHW training, designing a one-size-fits-all generic curriculum was not an option. To achieve some level of standardization, concepts and messages were simplified and tested prior to integration in training programs in India, Madagascar, Guatemala, Rwanda and Mali. Different methodologies for training this level of providers were selected after gathering information on CHW program characteristics, literacy levels, and family planning experience. Approaches developed required only basic reading level and vary from a “how-to” tool kit for adapting sample lesson plans per topic, to ready-to-use pictorial modules, including: (1) wall-posted storyboard modeling of counseling by CHWs and comic books to reinforce learning at home; and (2) songs, pictorial memory aids and simple role plays to learn counseling. These training approaches have been integrated into existing trainings and have been validated. The feasibility and acceptability of the training approaches was assessed through in-depth interviews with trainers and program managers and effectiveness through knowledge checklists administered to CHWs more than 3 months after training. Our experience has shown that flexibility and creativity is necessary when developing CHW materials for various contexts.