Improving Access to Healthcare in Rural Zambia

Training New Volunteers

Over the past three months we have begun to train 15 brand new Community Health Workers. Nurses from the villages around the three Rural Health Centres had been involved in identifying suitable volunteers.

Their first residential training week was held at the start of November in Livingstone with 15 participants travelling from outlying villages to participate in the training. On Call Africa's volunteer doctors led the training, alongside the nurses from the local rural health centres.

Training Curriculum

The training workshops comprised full day sessions on three areas of clinical concern

• Serious illness
• Respiratory disease
• Gastrointestinal disease

The resources and methods used during each day have been previously trailed and tested in our context. Manuals and training materials were printed for the individual participants. The CHW training sessions used a variety of approaches: including group lectures, discussion groups, visual aids and videos.

Initial assessment of progress was made through face-to-face techniques including workplace based assessment and multi-choice tests. This first training week provided the opportunity to collect some baseline data on CHW knowledge and rate of progress in acquiring knowledge and skills.

Next Steps

During the next three months we will assess how many of those commencing training should continue through to the second residential training week. The new CHWS will be supported in assisting patients in their communities, with the support of the nurses from the RHCs and On Call Africa’s team of volunteers and gradually given increased responsibilities. Their second residential training week is booked for the end of March 2019: Sessions will comprise: musculoskeletal problems; malaria; and nutrition. This will be followed by further residential training weeks in June 2019 and October 2019.

When someone’s unwell we try to help them get better. But once their health improves we want them to stay well. So our plans for the next two years include a project called ‘Mashale Kabotu’ – ‘Stay Well’ in the Tonga language.

Mashale Kabotu (Stay Well) aims to improve access to healthcare in two districts (Zimba and Kazungula) in Zambia’s Southern Province. The project is based on three central pillars:

1. Treating –qualified international volunteer doctors provide primary health care services in rural communities alongside local nurses from Rural Health Centres (RHCs);

2. Teaching – qualified doctors facilitate health education in rural communities in conjunction with local health authorities to allow people to take control over their own health outcomes;

3. Training – delivery of a specially developed and locally customised training programme for Community Health Workers, with the goal of supporting them to be an effective first point of contact for their communities’ health needs fully embedded within the support structure of nurses from local RHCs.

These three activities are integrated and will be delivered in parallel. Community Health Workers will shadow qualified doctors during patient consultations and will be trained to deliver community health messages. Underpinning the model is the principle of supporting and strengthening existing rural health systems and the staff at Rural and District level, building effectiveness and resilience. This requires that we support local workers, including nurses and Community Health Workers. It's all summed up in our 'theory of change' (which you can see in the chart below)

The ultimate aim of Mashale Kabotu is that people living in rural communities in southern Zambia wil lead happier, healthier lives.

• OCA_Theory_of_Change.pdf (PDF)