Sunday, November 16, 2014

Addressing the needs of ASHAs and other CHWs in India

Currently healthcare education (even in India) is moving from a traditional curriculum to one that is based on assessing and developing 'competencies,' where the application of 'knowledge' in 'real professional' endeavors take center stage. More here
If you go through the above link you shall also find a predominant emphasis on formative assessment than on summative.
We have tried to incorporate all these attributes in our own CHW engagement program with Mission Arogya and a few Indian Medical Colleges who are interested in supporting CHWs as a vital link between individual patients in the community and hospital based health-professionals. This is aimed at facilitating 'information' transfer between 'individual patients' (in the form of 'de-identified individual patient data' aka 'particular' evidence) and 'health-professionals' (in the form of health professional outputs to patients expressed as evidence based knowledge) with resulting feedback learning loops.

All this narrative data automatically gets collected and tagged in the searchable web-repository as 'practice based evidence.'

We believe that IT enabled ability to store all this 'interactive' and 'reflective' data generated by patients with the help of CHWs and processed further by health-professionals can serve as a valuable tool to develop transparency (thus providing real time working needs assessment) and accountability (thus providing a formative assessment tool for all the workers).
Both the needs assessment as well as learning competency assessment can be done for every participant through a thematic analysis of the narrative data that is generated in participatory conversations (such as here : scroll down after link opens) as well as in uploaded patient data (such as here : enter first three numbers of the pin code of locality--currently most data are from two pilot locations 736 and 462). The learning-portfolios of the CHWs uploading patient data can be traced (and currently manually analyzed) through the website audit trails.
As always language is currently the strongest barrier and perhaps next generation mobile based IVR interfaces (with voice to text conversion and translation) for the entire process described above can make things easier?

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