Mobile Phones and the Uses of Learning in a Training Intervention for Kenyan Community Health Workers

Mobile phones help move training programmes out of the classroom and into community settings where CHWs live and work. This chapter examines what happens to ‘learning’ when training becomes ‘mobile’. To explore this, an analysis of a three-year intervention to train 90 Kenyan CHWs is drawn from science and technology studies (STS). It is argued that when a mobile learning application is deployed in an informal urban settlement and an isolated rural village, its movement makes it available for many more uses than is originally envisioned. These varied uses subject the CHWs to multiple definitions of what it means to learn and conflicting visions of how learning leads to social change. The chapter ends with a discussion of how power circulates through global health policies, mobile devices, CHWs, and the material conditions of extreme poverty to generate controversies over what knowledge matters most for health worker training programmes, and for the broader aims of international development.

Approaches to Community Health Worker Training and Supervision

Training and supervision are core to the development of an effective CHW programme and have been recognized as so for many years. Their development and framing are important to understand from a historical perspective as this has ultimately helped to shape current approaches in the field. However, current CHWs face many related challenges, including determining their key benefits, whom they serve, and the mechanisms by which these benefits occur. This chapter directly addresses these issues by highlighting some of the key opportunities that could play a role in helping overcome some of these challenges, such as the role of mobile technologies. It is a starting point for developing the foundations for beginning to understand the complexities of this fragmented, contested, and important field of study and practice.

Methods of Evaluation of Community Health Worker Training

This chapter considers the theory and practice of the evaluation of CHW training. It aims to provide guidance on how to conduct evaluations, focusing on evaluations seeking a quantitative measure of effectiveness. The authors highlight the usefulness of ‘thinking through’ how the training is expected to work by developing a logic model. They then show how the model can be used to help design an appropriate evaluation. In addition, potential study designs and ‘end points’ or outcomes to be measured are discussed. However, the authors emphasize, that these elements need to be considered concurrently, because the appropriateness of the study design depends, in part, on the primary outcome measure for the evaluation. The chapter concludes by describing the benefits of mixed methods research and a number of other considerations when designing, implementing, and writing up the important task of evaluating CHW training.