Assessing the knowledge and skills of community health workers in a high mortality region of northern Ghana

Objectives: To measure the knowledge and competence of community health workers (CHWs) in performing their duties. Methods: This is a cross sectional survey study of about 150 CHWs (aged ≥19) working in 4 districts (2 intervention and 2 control) of Northern Ghana. All 4 districts have Community Health Planning Service (CHPS) compounds which provide health services at the community level. Knowledge and skills of CHWs were ascertained at the CHPS level on specific functions including postnatal and infant care, antenatal care, growth monitoring, safe delivery, postnatal care, kangaroo mother care, and education on neonatal health and survival. Univariate and multivariate analysis are carried out to compare knowledge and skills in intervention district vs control districts. Results: Community health workers (CHWs) have adequate knowledge and skills in the performance of most of their duties, but nearly all CHWs said they required urgent training in some areas (e.g. safe delivery, neonatal health and survival). More than half also have plans of going for further education at the midwifery school or other higher health training institutions. Independent factors like education and experience were significantly associated with better knowledge and skills. Conclusion: Regular assessment of the knowledge and skills of CHWs enables us to identify specific areas that require attention to build capacity of CHWs to efficiently and effectively deliver health care services at community level.