Dissemination of Pamene Palibe Dokotala to Health Surveillance Assistants in Chikwawa District by Scotland Chikwawa Health Initiative

The Scotland Chikwawa Health Initiative is a three year programme funded by the Scottish Executive International Development Fund which aims to achieve measurable reductions in major causes of disease and death in four villages within the Chikwawa District of Malawi alongside improving the hospital environment for the good of both staff and patients. The initiative has developed a holistic approach to health improvements through the provision of infrastructure at both health facilities and within communities, combined with training of government personnel and community volunteers in line with the Ministry of Health Essential Health Package (EHP).

Environmental health is integral to the achievement of the Millennium Development Goals, and within this programme Scotland Chikwawa Health Initiative touches upon achieving 6 of these goals either directly or indirectly. Working with environmental health professionals at community level in Malawi are health surveillance assistants who play an integral role and are often in charge for a catchment of 1000 – 2000 population for a wide range of activities including medical (e.g. mother and child health, safe motherhood) and environmental (e.g. water and sanitation, food safety, community hygiene) health. Their current ability to conduct their duties is hindered not only by the wide ranging nature of their role, but also by the limited training and capacity of the individuals involved. At most HSA’s have received a secondary school certificate and a further 12 weeks of training on their roles and responsibilities. Combined with poor salaries, there is often little enthusiasm or job satisfaction for these individuals. HSA’s also have a role to work with voluntary committees at community level who are often lacking training, direction and in many cases are no longer functioning.

It is evident that gaps still exist in the knowledge of HSA’s, and the reference materials available to them particularly at community level. As such, the publishing of Pamene Palibe Dokotalawas timely for the District wide programme to build capacity with the 400 HSA’s in Chikwawa District, and 40 nurses/medical officers.


Practical implementation
In order to maximise the efficacy and use of the publication, an orientation programme was developed by Scotland Chikwawa Health Initiative with the Chikwawa Health Office who were to be the leaders in the orientation. This began with a planning meeting whereby the system of training, logistics and areas of concern were discussed for dissemination of Pamene Palibe Dokotala. Subsequently, a scheme was developed whereby each health centre (n = 12) was used as a focal point for training to allow HSA’s from throughout the district to be easily targeted. All HSA’s affiliated with the health centre were gathered for a two day training course on the content and use of the book.
Outcomes

• 400 HSA’s and 40 nurses/medical officers received a copy of Pamene Palibe Dokotalathroughout Chikwawa District
• 440 individuals received training and orientation on the content and appropriate use of the text.
• Pre and post test results indicated an increase in knowledge by 15 – 30% in participants.
• Overall feedback from HSA’s has indicated the book is a useful tool in the field and has particularly assisted with information for community based education related to common diseases and family planning. It has also been useful in diagnosis and assistance with STI’s.

Link: http://www.strath.ac.uk/malawi/projects/chikwawa/

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