EFFECTIVENESS OF AN INDONESIAN MODEL FOR RAPID TRAINING OF GUATEMALANHEALTH-WORKERS IN DIARRHEA CASE-MANAGEMENT

The aim of this study was to assess the effectiveness of a newly devel oped method for rapid tiered training of health workers in improving c ommunity health worker knowledge and case management skills. The inter active ''Kader'' method, developed in West Java, Indonesia, was compar ed with traditional didactic training in a prospective trial with rura l health workers (''Tecnicos'') and village health promoters (''Promot ores'') for the Public Health Department in the state of Alta Verapaz, Guatemala. Twenty-five tecnicos received one day of training concerni ng diarrhea and dehydration. One group was trained using the interacti ve Kader method of Indonesia; the other with didactic methods. A sampl e of these tecnicos then trained 49 randomized promotores utilizing th e same training method with which they were trained. The tecnicos and promotores in each group completed a case-based pre-test and post-test before and after their training sessions. Both tecnicos and promotore s trained using the Kader tiered training approach demonstrated signif icantly greater improvement in their ability to correctly diagnose and recommend treatment for diarrhea of varying type and severity. Non-si gnificant differences favoring the experimental groups were found in t he tecnicos' and promotores' general knowledge regarding diarrhea prev ention practices, signs of dehydration and preparation of oral rehydra tion solution. This pilot study suggests that the Kader method for rap id tiered training of health workers has applicability to the populati ons of other developing nations and can be recommended for large scale implementation and evaluation in the training of public health worker s, village health promoters and families in Guatemala.