Sharing Histories: Test of a Teaching Method for Community Health Workers

Objective: Training of community health workers (CHW) is a growing priority to close the gap between health services and mothers/families in resource poor communities. To address research needs on how to improve effectiveness of CHW training, the investigators tested an innovative CHW teaching methodology called "Sharing Histories" hypothesizing that this would empower and enable CHW to better teach mothers to improve health knowledge and behaviors that contribute to improved child growth.

Method: The study was a cluster-randomized controlled trial: 22 health facility jurisdictions were matched and randomly assigned as experimental or control. Health personnel Tutors and female CHW were trained using either the "Sharing Histories" methodology (experimental) or a standard but still participatory teaching method (control). Training content, materials, and other interventions were held constant between study groups. Impact on maternal knowledge and practices, and child growth and morbidity were measured in representative household surveys at baseline, midterm, and final evaluation, with 600 mothers interviewed - 300 in each study group - at each point in time.

Inclusion criteria

• Adult interviewed must be mother or guardian of a child under two years of age.
• Child from birth (0.1 months-old) to under two years of age (23.9 months-old).

Exclusion criteria

• If a mother selected for interview had more than one child under age two years, only the younger child was considered for the interview and anthropometry measurements.