Training and field work experiences of Community Health Workers conducting non-invasive, population-based screening for Cardiovascular Disease (CVD) in four communities in Low and Middle-Income Settings

Background: Effective task-sharing from physicians or nurses to Community Health Workers (CHWs) to conduct population-based screening for persons at risk for cardiovascular disease, has the potential to mitigate the impact CVD on vulnerable populations. CHWs in Bangladesh, Guatemala, Mexico, and South Africa were trained to conduct non-invasive population-based screening for persons at high risk for CVD

Objective (s): To assess the performance of CHWs during training and to describe their training and fieldwork experiences while conducting non-invasive screening for cardiovascular disease (CVD) risk in their communities

Methods: Written tests were used to assess CHWs’ acquisition of content knowledge during training and focus group discussions to capture their training and fieldwork experiences.

Findings: Training was effective at increasing the CHWs’ content knowledge of cardiovascular disease (CVD) and this knowledge was largely retained up to six months after the completion of field work.  Common themes that need to be addressed when designing task sharing with CHWs in chronic diseases were identified, including language, respect, and compensation. The importance of having intimate knowledge of the community receiving services, from the design to implementation phases, is underscored.

Conclusions: Effective training for screening for CVD in community settings should have a strong didactic core that is supplemented with culture-specific adaptations in the delivery of instruction. The incorporation of expert and intimate knowledge of the communities themselves is critical, from the design to implementation phases of training. Challenges such as role definition, defining career paths, and providing adequate remuneration, must be addressed.