Introduction
Community health extension workers (CHEWs) have become a critical component in the frontline amid the quest to enhance access to healthcare to the rural and underserved areas. In these cases, these professionals serve as the bridge between the official medical systems and the most vulnerable populations that have a risk of remaining underserved. But beyond every successful CHEW is a path that has been filled with intense training, training skills and learning.
This article examines the entire experience that defines a Community health extension worker and this includes educational credentials as well as clinical training to the community integration and professional growth. We consider the process of training and its effects to show exactly what is required to shape these valuable agents of change in maternal and child health services.
Educational Pathways: Where it Begins
Entry Requirements
Careers in becoming a CHEW begin with a beginner pretence of service and standard educational background. The general training institutions require:
- These should be Secondary school education with relevant science subjects
- Low credits in disciplines such as English, Biology, Chemistry and Mathematics
- Valid passes in school admission tests or tests or interviews
These requirements are needed so that new students have strong academic background and are challenged to enroll into studying the process of being a service provider in the field of public health.
Accredited Training Institutions
Colleges of health-science and technology provide CHEW training programs, and those training programs are governed by national or regional health education boards. Among such companies that stand out in this undertaking is the Interlink College of Health Technology in Nigeria. Differently, such schools present well-organized programs that correspond to national objectives of healthcare.
The CHEW Curriculum: Core Subjects and Clinical Modules
Theoretical Instruction
The CHEW fundamental education involves an inclusive curriculum that combines the basis science and community health. The important theoretical modules are:
- Physiology and Anatomy
- Epidemiology and the health of communities
- Food science and nutrition
- Family planning
- Community interaction and health education
- Occupational health and environment
The subjects have been organized in such a way that they provide students with medical background as well as public health awareness.
Maternal and Child Health Focus
With many mothers and children dying in the underserved areas, CHEWs are given special training in this field. In the curriculum, there is:
- Antenatal, intrapartum and postnatal care
- Danger signs recognition in pregnancy
- Immunization and neonatal control
- Control of diseases during delivery
- Simple obstetric emergencies and referrals processes
Such training develops effective CHEWs in the prevention of complications and even saving lives in critical times.
Hands On Experience: From Classrooms to Clinics
Clinical Rotations
As a supplement to original classroom learning, CHEW students endure lengthy clinical rotations in:
- Standardised healthcare centers
- General hospitals
- Maternity homes
- Immunization centers
Such placements introduce the students to actual cases and enable them to get their knowledge applied in different healthcare settings. They are taught on how to perform physical checks, vaccinations, antenatal services, and how to go about ordinary health disorders.
Simulation Based Learning
Most schools have adopted simulation labs where students can exercise the important skills in a managed setting. This usually comprise:
- Mannequin safe delivery practice
- Injections and wound dressing
- Patient communications and patient counselling vignettes
The simulations create confidence and also equip the students with the ability to work entirely in the field.
Community Immersion: Learning in the Field
Community Diagnosis Projects
Community immersion is one of the most peculiar features of CHEW training. The students must take part in community diagnosis projects, in which they:
- Surveying native health problems
- Examine environmental and social influencing factors on health
- Designing and implementation of health educational campaigns
- Communicate with families and local leaders
Such a practice imparts the cultural competence and interventions customization to communities.
House to House Campaigns
Students are also subjected to door to door visits during training as they carry out a public health outreach. They authorize them in other to:
- Enlighten families with matters of sanitation and disease prevention
- Refer children sick or high risk mothers to clinics
- Register pregnant women
through the work with actual populations, students start to acquire knowledge of how grassroots health measures are made.
The Path to Certification and Development
Licensing and Graduation
After completing coursework, clinical experience, and community projects with high integrity, the students will take a comprehensive qualifying examination curated by the regulation institution. In this exam, the following test is made:
- Practical skills
- Ethical making of decision
- Applied knowledge
Graduates obtain a licence as a professional and thereby certified as CHEWs.
Postings to Rural Areas
Most CHEWs are posted to rural or in-accessible regions mostly during a government program or NGO collaboration. Their duties may include;
- Active Antenatal and Immunization clinics
- Carrying out health education at schools or marketing and meetings.
- Keeping track on the growth of children
- Liaising with local birth attendants
- Referral to upper-level facilities of complicated cases
It is in these postings where training becomes Community impact that can be measured.
Continuous Training: Keeping CHEWs Updated
In service Training and Workshops
The healthcare is also dynamic and therefore CHEWs are supposed to keep themselves updated every now and then in terms of workshops and refresher courses. Subjects usually are:
- New vaccines protocols
- Family planning technologies
- New emerging and re-emerging infectious disease
- Digital Health monitoring tools
- Mental health in maternal care
Such meetings are regularly held by governments and non-governmental organizations that need to maintain their competence and relevance.
Use of Digital Learning Platforms
In the recent years, there have appeared such phenomena as mobile applications and e-learning platforms that help people conduct continuous education. These tools are mainly used to provide:
- Quizzes and online modules
- Video education of the processes
- Ministries of health real time updates
- Peer Forum discussion
This would be particularly advantageous when CHEWs are in remote locations where there are no easy access to centers of training.
Challenges in CHEW Training and Development
Resource Constraints
Although they are so vital, many CHEW training programmes are facing:
- Poor class rooms and insufficient of teaching aids.
- Clinical training shortage of medical equipment
- delay in provision of stipends during internship programmes
These limitations are core issues that should be dealt with to sustain quality education.
Social and Professional Recognition
CHEWs have to work in hard situations and with little recognition. Their skills might be misconceived resulting in poor teamwork with other healthcare providers or loss of trust in patients. The demand to upgrade their status in health systems is growing.
Gender Barriers
Since most CHEWs are women, they might experience some challenges that are unique to them including:
- Discipline and family responsibilities balancing with field work responsibilities
- Gender-based violence in the home visits
- The issue of limited decision-making capacity with healthcare teams
To empower female CHEWs, there is need to have several modules on self-protection, gender equity and leadership in training institutions.
The Impact of CHEWs on Maternal and Child Health
Increasing Service Coverage
Researches demonstrate that the communities sustained by CHEWs record increased percentages in:
- Immunization covering
- Pregnant women care attendance
- Expert birth deliveries
- Practices on exclusive breastfeeding
The situation leads to lowering maternal and infant mortality directly.
Building Trust and Behavior Change
The CHEWs mostly work in the community where they are serving, and this enables them:
- Establishing long lasting relationships
- Learn of local beliefs and practices on health
- Provide appropriate cultural education
They are there in a consistent fashion, so again this is boosting a sense of trust which is important in terms of prolonged behaviour modification.
Case Study: Interlink College of Health Technology
Excellence in CHEW Training
Interlink College of Health Technology has carved for itself a reputation of producing competent as well as well rounded CHEWs. Their programme adds:
- Good academic curriculum
- The good simulation labs
- Supervised clinical postings
- Internships that are community based
Graduates are also doing very well in national certification exams and are in great demand in government run health programs in rural areas as well as in NGO run health programs in rural areas.
Student Testimonials
One student shared:
“The training was very tough but very fulfilling. In the classroom as it is in the rural communities where I was on an internship, I learnt not only skills, but I also became an eminent human being and not afraid. Today I work in one of the distant villages and observe how I can contribute to changes every day.”
Conclusion
The process of training to contribution of a community health extension worker is a process of transformation, service and dedication. CHEWs are the tools of change in the campaign against maternal and child deaths due to the fact that they are educated in a methodical manner that builds their clinical and community skills.
Their special place between healthcare and community makes them irreplaceable when working towards the achievement of universal health coverage. The only thing we must do is to continue investing in their education, support systems, and recognition and we will make sure that CHEWs will continue to be a pillar of rural health systems for many generations to come.
