Collaborative model as a training for increasing village health worker competency about complementary feeding

Background: A Kader refers to a Village Health Worker (VHW), a volunteer, which becomes one of the sources of community reference. Commonly, they sustain a mother's knowledge regarding adequate complementary feeding. However, there are still some VHW who have not possessed a health education background nor been able to be independent.Objectives: This study aimed to analyze the impact of collaborative models on VHW's competence as in knowledge, self-efficacy, attitudes, and counseling skill on the topic of complementary feeding.Materials and Methods: The design of this research is a quasi-experiment control group pretest-postest, with the retrieval of subjects using purposive sampling. Subjects were selected based on the location of the posyandu. The population in this research was VHWs in the Lembang district were 40 VHWs in each group. The treatment group was given training intervention for 1 month with a collaborative model, combining several methods into a series. The main topic was counseling and complementary feeding. The control group was given booklets and leaflets. VHW's competence was measured using questionnaires. This research was conducted in January-April 2020.Results: Statistical test results before the treatment of both groups showed no difference (p>0,05) in each variable. Two months after the intervention, there were significant differensces in the mean score of knowledge (p=0,001), attitude (p=0,001), and VHWs self-efficacy (p=0,000) in both groups. VHW counseling skills (p=0,149) until the first month there was not a significant difference. Unexpectedly, in the second month, the VHW counseling skills could not be observed due to the global COVID-19 pandemic. The mean score of each group increased significantly, but the score of the treatment group was higher than the control group.Conclusions: A collaborative model is effective when compared to only providing booklets and leaflets in increasing VHW's knowledge, attitudes, and self-efficacy but not effective yet for VHW counseling skills.

Empowerment of Village Health Worker to Become Assistance to Mother Groups in Prevention of ISPA in Toddlers by Using Complementary Therapy

ISPA is a respiratory disorder that causes children to tend to be lethargic, fussy, and lack of appetite, thus reducing the child's immunity which affects other health problems. The use of Complementary Therapies can help to reduce the impact of disease incidence, especially ISPA in toddlers at home as an alternative therapy for self-medication for families. It is hoped that the involvement of village health worker in the mother group in the community is directly involved in implementing the program to create and increase the ability to live healthy in a sustainable manner. The method of implementing community service activities is carried out by providing education, training and mentoring to 41 people consisting of village health worker and mother groups. The implementation of activities for the mothers group began with distributing pre-test questionnaires, then continued with providing health education about complementary therapies, herbal therapy simulations and toddler massage training to village health worker and mother groups, the activities were evaluated by providing posttest sheets. The results of the implementation of community service activities after health education and training activities obtained good knowledge about complementary therapies (75.6%) and sufficient knowledge (24.4%), paired t-test results before and after health education and the training obtained p value 0.005. It is hoped that village health worker can become activists and health promoters for mothers in an effort to prevent health problems by using complementary therapies.

HOSENG trial – Effect of the provision of oral self-testing for absent and refusing individuals during a door-to-door HIV testing campaign on testing coverage: protocol of a cluster randomized clinical trial in rural Lesotho

BACKGROUND: HIV testing coverage remains below the targeted 90% despite efforts and resources invested into testing in sub-Saharan Africa. Home-based HIV testing is a key approach endorsed by the World Health Organization, especially to reach individuals who might not seek testing otherwise. Although acceptance of testing during such campaigns is high, coverage remains low due to absent house-hold members. This cluster-randomized trial aims to assess increase in testing coverage using oral HIV self-testing among individuals who are absent or decline testing during home-based HIV testing. METHODS: The HOSENG (HOme-based SElf-testiNG) trial is a cluster-randomized, parallel group, superiority trial in two districts of Lesotho, Southern Africa. Clusters are stratified by district, village size, and village access to the nearest health facility. Cluster eligibility criteria include: village is in catchment area of one of the study facilities, village authority provides consent, and village has a registered, capable and consenting village health worker. In intervention clusters, HIV self-tests are provided for eligible household members who are absent or decline HIV testing in presence of the campaign team. In control clusters, standard of care for absent and refusing individuals applies, i.e. referral to health facility. The primary outcome is HIV testing coverage among individuals ≥12 years of age within 120 days after enrolment. Secondary objectives include HIV testing coverage among other age groups, and uptake of the different testing modalities. Statistical analyses will be conducted and reported in line with CONSORT guidelines. HOSENG trial is linked to VIBRA (Village-Based Refill of ART) trial. Together, they constitute the GET ON (GETting tOwards Ninety) research project. DISCUSSION: The HOSENG trial tests if oral HIVST may be an add-on during door-to-door testing campaigns towards achieving optimal testing coverage. The provision of oral self-test kits, followed up by VHWs, requires little additional human resources, finances and logistics. If cost-effective, this approach will inform home-based HIV testing policies not only in Lesotho, but in similar international settings. TRIAL REGISTRATION: This trial has been registered at clinicaltrials.gov (NCT03598686) on July 25, 2018. More information under www.getonproject.wordpress.com. KEYWORDS: HIV, cluster randomized controlled trial, village health worker, community health worker, community-based, self-testing, HIV testing coverage, Lesotho, Southern Africa, implementation research.