Training village workers for family planning and health interventions.

This paper discusses the principles of training Community-Based Distribution (CBD) workers in family planning and health interventions with emphasis on a competency-based training system. Training is viewed as a continuum an ongoing process which lasts throughout the professional lives of the health workers. A competency-based training program is organized around specific functions or competencies. It requires a knowledge of the beginning level of the student (e.g. literacy and general background) defining functions into specific tasks subtasks and steps and frequent and thorough assessment to determine if students have mastered the tasks. Curriculum development is accomplished in a systematic way. High priority problems are first identified. The tasks which make up the intervention are then determined through job analysis (observing and writing down tasks done by existing practitioners performing the intervention) and task analysis (analyzing the difficulty and complexity of each task). Then comes the decision to determine exactly what the trainees are to learn. The need to stress exactly what should be learned is essential to any training program as demonstrated in several projects (e.g. Peru PROSMIP Program Sudan Community Based Health and Family Planning Project). Other key points to remember are: 1) use active learning methods and diminish the passive ones 2) the addition of health interventions directly increases training time 4) basic village health workers even those who are literate take 1 to 3 days to feel comfortable in the program and have a basic understanding of the program 5) make sure each worker can perform the tasks at the required standard before he is allowed to do it in the community and 6) continuing training is essential. Recommended research areas are briefly discussed.