Training is widely considered to contribute to the ‘can do’ and ‘will do’ capacities of health workers. Having appropriately skilled health workers is recognised as critical to assuring quality health services. This study examined the relevance of in-service training (IST) provided to maternal health workers (MHW) in rural Vietnam. A mixed method approach was used involving a survey of 240 health workers providing maternal health services and managers and 43 in-depth interviews of health workers and managers from 5 health districts across two provinces in Vietnam. Although two thirds of participants reported accessing IST within the previous 12 months, only 53.3% attended maternal health training. Factors related to the self-reported ability to perform Essential Obstetric Care (EOC) include: Being trained on EOC; Work experience; and Qualifications of MHWs. Participants reported that the IST was irrelevant to their actual needs, while managers reported frustration that IST programs were scheduled haphazardly, dependent on budget availability. In conclusion, in-service training programs should be designed taking into account the needs of the workforce and managers in terms of content, mode of delivery, scheduling and follow-up. Poorly planned and inappropriately delivered training may contribute to a perceived inability to provide EOC.
Abdel-AllM., PuticaB., PraveenD., AbimbolaS., & JoshiR. (2017). Effectiveness of community health worker training programmes for cardiovascular disease management in low-income and middle-income countries: A systematic review. BMJ Open, 7, e015529. https://doi.org/10.1136/bmjopen-2016-015529
2.
BazeleyP. (2007). Qualitative data analysis with Nvivo. Sage Publications.
3.
CharmazK. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Sage Publications.
4.
CriglerL.H.K., FurthR., & BjerregaardD. (2011). Community health worker assessment and improvement matrix (CHW AIM): A toolkit for improving community health worker programs and services USAID health care improvement project. http://www.who.int/workforcealliance/knowledge/toolkit/50.pdf
5.
DielemanM., ToonenJ., ToureH., & MartineauT. (2006). The match between motivation and performance management of health sector workers in Mali. Human Resources for Health, 4(2). https://doi.org/10.1186/1478-4491-1184-1182
6.
FieldA. (2009). Discovering statistics using SPSS: And sex and drugs and rock ‘n’ roll(3rd ed.). Sage Publications.
7.
GilmoreB., & McAuliffeE. (2013). Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: A systematic review. BMC Public Health, 13(847). https://doi.org/10.1186/1471-2458-1113-1847
8.
Global Health Workforce Alliance. (2008). Scaling up, saving lives: Taskforce scaling up education and training for health workers. https://www.who.int/publications/m/item/scaling-up-saving-lives-2008-report
9.
GuptaM., TripathyJ.P., JamirL., SarwaA., SinhaS., & BhagC. (2017). Improving quality of home-based postnatal care by microteaching of multipurpose workers in rural and urban slum areas of Chandigarh, India: A pilot study. Advances in Medical Education and Practice, 8, 1–8.
10.
HorwoodC., ButlerL., BarkerP., PhakathiS., HaskinsL., GrantM., & RollinsN. (2017). A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: A cluster randomised controlled trial in South Africa. Human Resources for Health, 15(39). https://doi.org/10.1186/s12960-12017-10210-12967
11.
KokM.C., DielemanM., TaegtmeyerM., BroerseJ.E.W., KaneS.S., OrmelH., TijmM.M., & de KoningK.A.M. (2015). Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review. Health Policy Plan, 30(9), 1207–1227. https://doi.org/1210.1093/heapol/czu1126.
12.
KongnyuyE.J., HofmanJ.J., & Van den BroekN. (2009). Ensuring effective essential obstetric care in resource poor settings. BJOG: An International Journal of Obstetrics and Gynaecology, 116, 41–47. https://doi.org/10.1111/j.1471-0528.2009.02332.x
13.
KuuleY., DobsonA.E., WoldeyohannesD., ZolfoM., NajjembaR., EdwinB.M.R., HavenN., VerdonckK., OwitiP., & WilkinsonE. (2017). Community health volunteers in primary healthcare in rural Uganda: Factors influencing performance. Frontiers in Public Health, 5(62). https://doi.org/10.3389/fpubh.2017.00062
14.
McLeanK.E., KaiserB.N., HagamanA.K., WagenaarB.H., TherosmeT.P., & KohrtB.A. (2015). Task sharing in rural Haiti: Qualitative assessment of a brief, structured training with and without apprenticeship supervision for community health workers. Intervention, 13, 135–135.
15.
MusokeD., SsemugaboC., NdejjoR., AtusingwizeE., MukamaT., & GibsonL. (2019). Strengthening the community health worker programme for health improvement through enhancing training, supervision and motivation in Wakiso district, Uganda. BMC Research Notes, 12(1), 812. https://doi.org/810.1186/s13104-13019-14851-13106
16.
NguyenT.H.T., WilsonA., & McDonaldF. (2015). Motivation or demotivation of health workers providing maternal health services in rural areas in Vietnam: Findings from a mixed-methods study. Human Resource for Health, 13(91). https://doi.org/10.1186/s12960-12015-10092-12965
17.
O’DonovanJ., O’DonovanC., KuhnI., SachsS.E., & WintersN. (2018). Ongoing training of community health workers in low-income and middle-income countries: A systematic scoping review of the literature. BMJ Open, 8, e021467. https://doi.org/021410.021136/bmjopen-022017-021467
18.
OliverM., GenietsA., WintersN., RegaI., & MbaeS.M. (2015). What do community health workers have to say about their work, and how can this inform improved programme design? A case study with CHWs within Kenya. Global Health Action, 8, 27168.
19.
PattonM.Q. (2002). Qualitative research and evaluation methods. Sage Publications.
20.
Plano ClarkV.L., & CreswellJ.W. (2008). The mixed methods readers. Sage Publications.
21.
Puchalski RitchieL.M., SchullM.J., MartiniukA.L., BarnsleyJ., ArenovichT., van LettowM., ChanA.K., MillsE.J., MakwakwaA., & ZwarensteinM. (2015). A knowledge translation intervention to improve tuberculosis care and outcomes in Malawi: A pragmatic cluster randomized controlled trial. Implementation Science, 10, 38.
22.
Puchalski RitchieL.M., Van LettowM., BarnsleyJ., ChanA.K., SchullM.J., MartiniukA.L.C., MakwakwaA., & ZwarensteinM. (2016). Lay health workers experience of a tailored knowledge translation intervention to improve job skills and knowledge: A qualitative study in Zomba district Malawi. BMC Medical Education, 16, 54.
23.
OtchereS.A., & BinhH.T. (2007). Strengthening emergency obstetric care in Thanh Hoa and Quang Tri provinces in Vietnam. International Journal of Gynecology and Obstetrics, 99, 165–172. https://doi.org/110.1016/j.ijgo.2007.1007.1005
24.
Sana SheikhR.N.Q., KhowajaA.R., SalamR., VidlerM., SawchuckD., & von DadelszenP. & the CLIP Working Group. (2016). Health care provider knowledge and routine management of pre-eclampsia in Pakistan. Reproductive Health, 13(Suppl. 2), 104. https://doi.org/10.1186/s12978-12016-10215-z
25.
SérgioC. L., AntónioJ. C., & Brunod. S. (2014). Community health workers: To train or to restrain? A longitudinal survey to assess the impact of training community health workers in the Bolama Region, Guinea-Bissau. Human Resources for Health. https://doi.org/10.1186/1478-4491-1112-1188
26.
StellenbergE., Van ZylM., & EygelaarJ. (2015). Knowledge of community care workers about key family practices in a rural community in South Africa. African Journal of Primary Health Care & Family Medicine, 7, 892.
27.
TranN.T., PortelaA., De BernisL., & BeekK. (2014). Developing capacities of community health workers in sexual and reproductive, maternal, newborn, child, and adolescent health: A mapping and review of training resources. PLoS ONE, 9(4), e94948. https://doi.org/94910.91371/journal.pone.0094948
28.
United Nations. (2013). The millennium development goals report. http://www.un.org/millenniumgoals/pdf/report-2013/mdg-report-2013-english.pdf
29.
United Nations. (2014). The millennium development goals report. http://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf
30.
VallièresF., McAuliffeE., Van BavelB., WallP.J., & TryeA. (2016). There’s no app for that: Assessing the impact of mhealth on the supervision, motivation, engagement, and satisfaction of community health workers in Sierra Leone. Annals of Global Health, 82, 936–949.
31.
Vietnamese Ministry of Health. (2001). Quyết định về việc ban hành quy định nhiệm vụ kỹ thuật trong lĩnh vực chăm sóc sức khỏe sinh sản tại các cơ sở y tế (Decision 385/2001/QD-BYT: Technical Assignment in Reproductive Health).
32.
Vietnamese Ministry of Health. (2005). Quyết định của Bộ trưởng Bộ Y tế số 23/2005/QĐ-BYT ngày 30 tháng 5 năm 2005 về việc ban hành quy định phân tuyến kỹ thuật và danh mục kỹ thuật trong khám chữa bệnh (Decision 23/2005/QD-BYT: Technical assignment in examination and treatment).
33.
Vietnamese Ministry of Health. (2009). Hướng dẫn quốc gia về các dịch vụ chăm sóc sức khỏe sinh sản (Ban hành kèm theo Quyết định số 4620/QĐ-BYT) (National Guideline on Reproductive Health services. Issued with the Decision 4620/QĐ-BYT on 25/11/2009).
34.
WanduruP., TetuiM., TuhebweD., EdiauM., OkugaM., NalwaddaC., Ekirapa-KirachoE., WaiswaP., & RutebemberwaE. (2016). The performance of community health workers in the management of multiple childhood infectious diseases in Lira, northern Uganda—A mixed methods cross-sectional study. Global Health Action, 9, 33194.
35.
World Health Organization. (2009). Monitoring emergency obstetric care: A Handbook. http://www.who.int/reproductivehealth/publications/monitoring/9789241547734/en/
36.
World Health Organization. (2010). Increasing access to health workers in remote and rural areas through improved retention Global policy recommendations. WHO Press. http://www.who.int/hrh/retention/guidelines/en/
37.
World Health Organization. (2018). Essential obstetric care: Factsheet. www.who.int/features/factfiles/maternal_health/en/
