Teaching Prenatal Health, Postpartum Care, and Disease Prevention in Rural Haiti: Evaluating a Community Health Worker Training Program

The purpose of this study was to evaluate the efficacy of a volunteer-led community health worker training program in rural Haiti. The course, which was undertaken through collaboration between a U.S.-based medical technology company and an international nonprofit organization, aimed to expand health literacy and promote prevention efforts among the Haitian trainees. The training curriculum focused on prenatal health management, postpartum care, managing childhood illness, family planning, and disease prevention. The authors of the current study conducted a mixed methods evaluation of the course incorporating measures of pre- and post-course knowledge, satisfaction with the course, help-seeking beliefs, and focus group discussions. These data were used to explore relationships between a variety of factors including socioeconomic status, access or barriers to seeking care, help seeking beliefs and their influence on the efficacy of the course. Trainees showed strong, significant improvement in public health knowledge from pre-test to post-test and enthusiastically endorsed the course as valuable and unique. However, a variety of concerns were noted in the measurement of these variables, including variation in literacy and familiarity with testing, observed trends toward social desirability, and challenges with test administration and measurement. Further, the course and its evaluation were conducted almost entirely by short-term, first-time volunteers to Haiti, which appeared to impact the cultural compatibility of these programs. The implications of these findings are discussed in depth, including the characteristics of culturally competent instructors and program models for community health educators in low-resource nations.