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Research Officer Abel Muiambo and Communications Specialist Nilda de Lima Santos from Malaria Consortium Mozambique find out about the training of community health workers in Inhambane Province and interview Luisa, one of the first trainers.

Community health programmes have been running for over 30 years in Mozambique with government support. In 2009, revitalisation of the programme was begun by the Ministry of Health and partners. Since 2010, Malaria Consortium has been working with the provincial health team in Inhambane province providing training to newly recruited community health workers (or Agente Polivalente Elementares (APEs) as they are known in Mozambique) for health promotion, diagnosis and treatment of childhood diseases.

Recruiting literate adult members of the community and training them to become APEs who are able to diagnose sick children correctly and dispense medicines is a challenging task in a country where half of the adult population cannot read or write. Malaria Consortium has played an instrumental role in developing the national training curriculum for APEs to ensure that the training was accessible to low-literacy APEs and effective by applying specific adult learning methods.

The APE training courses run for four months and cover health prevention and the treatment of common childhood illnesses, with alternating modules and practical sessions that take place either in a health centre or in the community.

Educating adults differs from educating children because of their accumulated practical knowledge and life experience. Thus adult training techniques and curricula must be problem-based, practical and collaborative rather than didactic, and based primarily on practical learning (learning by doing). Adult training techniques also put more emphasis on the equality between the teacher and learner to ensure APEs can learn effectively.

These techniques were new to most of the district-level trainers, who are medical officers in charge of a health centre and not necessarily skilled trainers.

Luisa is a Preventive Medicine Technician and works in a health centre in Jangamo, a rural district in Inhambane Province. She was one of the first trainers of APEs in the area.

Luisa felt there has been an increase in knowledge sharing around health promotion in the community during and following the training for APEs and that this was helping to build an invaluable bank of knowledge on the healthcare issues and concerns faced by communities in Jangamo.

“During the training, the APEs sought to understand what the community already knows about malaria and other common diseases before adding new information on prevention and health promotion,” she said. “This meant they were building on their own knowledge.”

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