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Determining whether community health workers are “deployment ready” using standard setting
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Taylor, Celia A., Nhlema, B., Wroe, E., Aron, M., Makungwa, H. and Dunbar, E. L. (2018) Determining whether community health workers are “deployment ready” using standard setting. Annals of Global Health, 84 (4). pp. 630-639. doi:10.29024/aogh.2369 ISSN 2214-9996.
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Official URL: https://doi.org/10.29024/aogh.2369
Abstract
Background: Community Health Workers (CHWs) provide basic health screening and advice to members of their own communities. Although CHWs are trained, no CHW programmes have used a formal method to identify the level of achievement on post-training assessments that distinguishes “safe” from “unsafe”.
Objectives: The aim of this study was to use Ebel method of standard setting for a post-training written knowledge assessment for CHWs in Neno, Malawi.
Methods: 12 participants agreed the definitions of a “just-deployment ready” and an “ideal” CHW. Participants rated the importance and difficulty of each question on a three-point scale and also indicated the proportion of “just-deployment ready” CHWs expected to answer each of the nine question types correctly. Mean scores were used to determine the passing standard, which was reduced by one standard error of measurement (SEM) as this was the first time any passing standard had been employed.
The level of agreement across participants’ ratings of importance and difficulty was calculated using Krippendorf’s alpha. The assessment results from the first cohort of CHW trainees were analysed using classical test theory.
Findings: There was poor agreement between participants on item ratings of both importance and difficulty (Krippendorf’s alphas of 0.064 and 0.074 respectively). The pass mark applied to the assessment, following adjustment using the SEM, was 53.3%. Based on this pass mark, 68% of 129 CHW trainees were ‘clear passes’, 11% ‘borderline passes’, 9% ‘borderline fails’ and 12% ‘clear fails’.
Conclusions: Determining whether a CHW is deployment-ready is an important, but difficult exercise, as evidenced by a lack of agreement regarding question importance and difficulty. Future exercises should allow more time for training, discussion and modification of ratings. Based on the assessment, most CHWs trained could be considered deployment-ready, but following-up their performance in the field will be vital to validate the pass mark set.
Item Type: | Journal Article | |||||||||
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Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine | |||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Community health aides -- Training of -- Evaluation | |||||||||
Journal or Publication Title: | Annals of Global Health | |||||||||
Publisher: | Elsevier BV | |||||||||
ISSN: | 2214-9996 | |||||||||
Official Date: | 4 January 2018 | |||||||||
Dates: |
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Volume: | 84 | |||||||||
Number: | 4 | |||||||||
Page Range: | pp. 630-639 | |||||||||
DOI: | 10.29024/aogh.2369 | |||||||||
Status: | Peer Reviewed | |||||||||
Publication Status: | Published | |||||||||
Access rights to Published version: | Restricted or Subscription Access | |||||||||
Date of first compliant deposit: | 15 February 2018 | |||||||||
Date of first compliant Open Access: | 15 February 2018 | |||||||||
RIOXX Funder/Project Grant: |
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