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Basic health skills training for community health workers

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The Visayas Primary Health Care services successfully conducted the first basic health skills training (BHST) for community health workers (CHWs) in line with its project, “Building community-based health programs to promote health and prevent disease in urban poor communities in Cebu” supported by the Committee of German Doctors for Developing Countries.

A BHST was held for 15 community health workers (CHWs) in Cordova last July 7, 8, 9, 15, and 16 and another training for Barangay San Roque, Talisay City on July 19, 20, 21, 28 and 29. A total of 9 CHWs from Sawsawan and 15 barangay health workers (BHWs) of San Roque attended the latter.

The five-day training consisted of topics that equipped the CHWs with basic knowledge and skills on how to manage common illnesses using health education, promotion of good health seeking behaviour, and natural and indigenous but scientific methods of healing without the use of Western medicine, and when to refer patients to medical personnel for ailments they cannot manage.

The training provided all participants with hand-outs for all topics which were book bound. The resource persons were the project team and other staff members of the VPHCS. Methods of teaching were powerpoint presentations,videos, lectures, actual demonstration of herbal medicine cooking and dramas where the participants played the roles of patients seeking consultation with CHWs.

The first topic was understanding the local health situation and social determinants of health. Health is a basic human right and the Philippine government has the responsibility to provide health services to the Filipino people, services that are accessible, affordable and responsive to the needs of the people. Moreover, health can be obtained if everyone has enough food, shelter, decent house, adequate means of livelihood, education and social services from the government. Health is a social phenomenon.

As a response to the ill health situation of the Philippines, community-based health programs (CBHPs) have been established in various parts of the country since the Martial Law period in 1970s. CBHPs rely on community participation to address the basic health needs of the people and to work for a decent living and welfare of the residents. Capability building of CHWs on primary health care is the core of CBHPs.

The training emphasized the eight basic health elements of primary health care, namely: (1), education concerning prevailing health problems and the methods of controlling and preventing them, which are done through health skills training of CHWs and health awareness raising among the residents, (2) promotion of food supply and proper nutrition, (3) an adequate supply of safe water and basic sanitation, (4) maternal and child health care, including family planning and reproductive health, (5) immunization against the major infectious diseases, (6) prevention and control of locally endemic diseases, (7) appropriate treatment of common diseases and injuries, and (8) provision of essential drugs.

The project in the three communities shall start to work for the attainment of these eight elements of primary health care with the involvement of CHWs after they undergo the BHST.

The skills transfer started with teaching them how to take vital signs, that is blood pressure, pulse rate, respiratory rate, weight, and temperature. These are easy to learn skills but knowing them will enable them to assess ill health such as hypertension, fast heart rate, difficulty in breathing, underweight, and fever.

The next skills was on control of acute respiratory tract infection, to teach the CHWs how to identify a child with pneumonia by counting the respiratory rate and to manage simple cough and colds at home. Another skill was to identify a child with diarrhea and dehydration, how to administer oral rehydration salts therapy and refer to a refer to a health facility if home management is not sufficient anymore.

Topics of the second day included water therapy, ventusa, herbal medicine, ventusa, and acupressure for common ailments. There are many uses of water such as sponge bath for fever, steam inhalation for colds, cold compress for sprains, and acute toothache, and taking orally increased amount of water in times of fever, diarrhea and cough and colds.

Ventusa is a form of traditional Chinese medicine where glass cups are applied to the skin through vacuum to create localized stimulation of circulation. Acupressure is another form of traditional Chinese medicine using finger and hand massage to relieve body and head aches, insomnia, digestive problems and cough, among others. Common points were taught to the CHWs.

The different types of preparations of herbal medicine and plants that are sources of herbal medicine as well as the ailments that they can alleviate, were taught and demonstrated during the lecture on herbal medicine. The cooking of a plant-based skin ointment and liniment was also demonstrated.

The next topic was environmental sanitation. A video on cleanliness in the homes and surroundings and personal hygiene was shown to the CHWs to complement the lecture.

This was followed by the topic on nutrition which was given through a video. Then, the CHWs were taught how to determine the nutritional status of children less than 71 months old using a chart of weight for age by the National Nutrition Council of the Philippines adapted from the World Health Organization.

The topic of immunization followed. The government’s expanded program on immunization (EPI) was thoroughly explained in order to enable the CHWs to understand and explain to mothers the diseases that are covered in the program and the importance of having their children immunized.

The fourth day of the training concerned about hypertension, tuberculosis and safe motherhood and family planning and methods of birth control.

This was followed by role playing that applied the knowledge that they have learned during the four days of training. The participants played scenes of a CHW checking up children with cough, fever, and diarrhea, malnourished child, adults with cough and headache, symptoms of tuberculosis, and with hypertension. On the last day of the training, the participants had a practicum on giving health education, that is, volunteers stood in front of the other participants and lectured on a health topic printed in a tarpaulin. They would later do this in their communities as health educators.

After the practicum, the participants made plans on how they would apply their knowledge and skills learned. An evaluation was finally conducted to end the five-day training.

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