Evaluation of a community health worker train-the-trainer program for kerosene poisoning prevention in Ghana

Introduction: Estimated childhood mortality rates from unintentional poisoning in Sub-Saharan Africa are over double the global average. Barriers to healthcare highlight the importance of poisoning prevention in the region. A prior needs assessment identified kerosene poisoning as a significant public health risk in Accra, Ghana. To address this concern, we trained 76 community health workers to conduct interactive health talks with mothers of young children using picture-based flip-charts to promote kerosene poisoning prevention in the home. This study was designed to evaluate and improve the program. Methods: We used structured interviews to collect qualitative data about health workers' experiences giving the health talks on kerosene poisoning prevention. The evaluation was performed six months after an initial training workshop to determine the number of mothers reached, barriers to implementation, and any questions or concerns about the key messages that may have been raised. Results: 23 health workers were interviewed. Each had given an average of four talks monthly reaching an estimated 1,690 mothers. Images depicting risky situations were easily identified by mothers. However, recommendations about safe storage and what to do in case of poisoning consistently raised concerns. Mothers also asked about first-aid for poisoning with medications, soap, and parazone (a household bleach). Conclusions: The program should be expanded to include discussion of other common household poisons. Modifications should include feedback from mothers about specific recommendations that they will perceive as being feasible and achievable. Future research assessing the impact of the program on preventive behaviors is also planned.