Training CBD workers for family planning and health interventions.

Training of community-based development (CBD) workers in family planning addresses some problems faced by CBD workers: isolation and problematic supervision solo public contact roles tather than helper roles assumed by clinic workers time constraints and local resistance. Combining primary health care with family planning forces the worker to set priorities in accordance with project goals. Training of workers must be careful continous and competency-based not credentials oriented bridging the gap from program goals to worker execution of the goals by job description and analysis task analysis concrete task description grouping of objectives developing a teaching plan and evaluation based on competency. Low levels of literacy may necessitate keeping theory to a minimum and preclude ongoing written protocols. Worker attitudes must be consistent with program philosophies. Selection of the trainers themselves can be complicated; the best trainers seem to be selected community workers. In any case training should continue to be skills-oriented and based on real execution. The minimum time necessary to prepare family planning workers is 5 days; there is a trend for longer periods especially as extra duties are added. Rate is an important consideration as well since it is difficult to speed up learning to fit time constraints. Decentralization or regionalization of training increases possibilities for practical components and is more personal although it stretches resources. Phasing training by adding skills as older ones are mastered and applied is a promising approach as is related continuing education. Materials should be simple and demonstrative. Training evaluation should cover input process evaluation attainment of competencies and outcome measures. All training programs should be designed to generate feedback since program evaluation data is still scarce.