Primary Care International, Oxford, United Kingdom, GB.
Instituto Nacional de Saúde, Marracuene, MZ.
Glob Heart. 2022 Aug 2;17(1):51. doi: 10.5334/gh.1052. eCollection 2022.
Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in the design and implementation of a cascade training of trainers (ToT) intervention to strengthen the prevention and control of cardiovascular disease.
Between October 2018 and March 2020 a multidisciplinary global technical partnership was used to train frontline primary care health professionals from a resource-poor suburban setting in Maputo, Mozambique. Following engagement with local policy makers, clinicians, and academics, core training materials were developed, and a ToT cascade was implemented, supported by an on-site pilot clinic. Knowledge and confidence acquisition by participants and new local trainers were assessed using pre- and post-training surveys, while trainees and trainers completed further evaluation surveys at the end of the program.
Three ToT workshops trained 60 mixed cadre healthcare workers in assessment, diagnosis and management of hypertension, diabetes, and cardiovascular risk; of these, 11 became new local trainers. Mean pre- and post-test scores improved in all three training workshops (53% to 90%, 59% to 78%, and 58% to 74% respectively). New local trainers were highly rated by their trainees and reported increased confidence as trainers (mean Likert scale 3.0/5 pre-training to 4.8/5 post-training).
This global health partnership delivered interprofessional training with good knowledge acquisition and increased self-reported confidence. Intensive local supervision and hands-on training empowered a new cohort of trainers to strengthen the prevention and control of cardiovascular disease and is likely to improve coordination and integration at primary care level as well as support the national scale up of NCD care delivery.
在基层卫生机构，卫生专业人员对非传染性疾病（NCD）的准备不足是莫桑比克卫生系统面临的一个重大挑战。为了解决这一弱点并实现非传染性疾病护理的去中心化，需要对初级保健人员进行培训。我们描述了在设计和实施培训师培训师（ToT）级联培训干预措施以加强心血管疾病预防和控制方面的经验。
2018 年 10 月至 2020 年 3 月，一个多学科全球技术合作伙伴关系用于培训莫桑比克马普托资源匮乏的郊区基层初级保健卫生专业人员。在与当地政策制定者、临床医生和学者接触后，开发了核心培训材料，并实施了 ToT 级联培训，同时在现场试点诊所提供支持。通过培训前后的调查评估参与者和新的本地培训师的知识和信心获取情况，而培训师和培训师在项目结束时完成进一步的评估调查。
三届 ToT 研讨会培训了 60 名混合干部医疗保健工作者，以评估、诊断和管理高血压、糖尿病和心血管风险；其中 11 人成为新的本地培训师。所有三个培训研讨会的平均预测试和后测试分数都有所提高（分别为 53%至 90%、59%至 78%和 58%至 74%）。新的本地培训师受到其学员的高度评价，并报告作为培训师的信心增强（平均李克特量表从培训前的 3.0/5 提高到培训后的 4.8/5）。
这个全球卫生伙伴关系提供了专业间培训，具有良好的知识获取和增加的自我报告信心。密集的本地监督和实践培训使新的一批培训师有能力加强心血管疾病的预防和控制，这可能会改善初级保健层面的协调和整合，并支持国家扩大非传染性疾病护理的提供。
