239306 Evaluation of a community health worker train-the-trainer program for kerosene poisoning prevention in Ghana

Monday, October 31, 2011: 9:10 AM

Samara Soghoian, MD , Department of Emergency Medicine, New York University, New York, NY
Lauren Schwartz, MPH , NYC Poison Control Center, New York, NY
Cesar Nyadedzor , Ghana Poison Control Center, Accra, Ghana
Rishi Vohra, Medical Student , School of Medicine, New York University, New York, NY
Phyllis Caces, Medical Student , School of Medicine, New York University, New York, NY
Edith Clarke, MD , Ministry of Health, Accra, Ghana
Lewis R. Goldfrank, MD , Department of Emergency Medicine, NYU School of Medicine, New York, NY
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.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Program planning
Social and behavioral sciences

Learning Objectives:
1. Describe the roles and functions of Ghana Health Services community health workers in Accra, Ghana; 2. Explain the utility of qualitative evaluation measures for continuous program improvement and redesign; 3. Identify challenges to program implementation and barriers to traditional poison prevention strategies in Ghana.

Keywords: Child Health Promotion, Injury Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I designed, oversee, and was directly involved in the evaluation process of the poisoning prevention program that is the subject of the abstract
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.