Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package

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dc.contributor.authorSodhi, Sumeet
dc.contributor.authorBanda, Hastings
dc.contributor.authorKathyola, Damson
dc.contributor.authorJoshua, Martias
dc.contributor.authorRichardson, Faye
dc.contributor.authorMah, Emmay
dc.contributor.authorMacGregor, Hayley
dc.contributor.authorKanike, Emmanuel
dc.contributor.authorThompson, Sandy
dc.contributor.authorFairall, Lara
dc.contributor.authorBateman, Eric
dc.contributor.authorZwarenstein, Merrick
dc.contributor.authorSchull, Michael J
dc.date.accessioned2016-06-28T10:30:41Z
dc.date.available2016-06-28T10:30:41Z
dc.date.issued2014-05-12
dc.date.updated2016-05-20T18:08:35Z
dc.description.abstractBackground: The government of Malawi is committed to the broad rollout of antiretroviral treatment in Malawi in the public health sector; however one of the primary challenges has been the shortage of trained health care workers. The Practical Approach to Lung Health Plus HIV/AIDS in Malawi (PALM PLUS) package is an innovative guideline and training intervention that supports primary care middle-cadre health care workers to provide front-line integrated primary care. The purpose of this paper is to describe the lessons learned in implementing the PALM PLUS package. Methods: A clinical tool, based on algorithm- and symptom-based guidelines was adapted to the Malawian context. An accompanying training program based on educational outreach principles was developed and a cascade training approach was used for implementation of the PALM PLUS package in 30 health centres, targeting clinical officers, medical assistants, and nurses. Lessons learned were identified during program implementation through engagement with collaborating partners and program participants and review of program evaluation findings. Results: Key lessons learned for successful program implementation of the PALM PLUS package include the importance of building networks for peer-based support, ensuring adequate training capacity, making linkages with continuing professional development accreditation and providing modest in-service training budgets. The main limiting factors to implementation were turnover of staff and desire for financial training allowances. Conclusions: The PALM PLUS approach is a potential model for supporting mid-level health care workers to provide front-line integrated primary care in low and middle income countries, and may be useful for future task-shifting initiatives.en_ZA
dc.identifier.apacitationSodhi, S., Banda, H., Kathyola, D., Joshua, M., Richardson, F., Mah, E., ... Schull, M. J. (2014). Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/20149en_ZA
dc.identifier.chicagocitationSodhi, Sumeet, Hastings Banda, Damson Kathyola, Martias Joshua, Faye Richardson, Emmay Mah, Hayley MacGregor, et al "Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package." <i>BMC Health Services Research</i> (2014) http://hdl.handle.net/11427/20149en_ZA
dc.identifier.citationSodhi, S., Banda, H., Kathyola, D., Joshua, M., Richardson, F., Mah, E., ... & Bateman, E. (2014). Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package. BMC health services research, 14(Suppl 1), S8.en_ZA
dc.identifier.issn1472-6963en_ZA
dc.identifier.ris TY - Journal Article AU - Sodhi, Sumeet AU - Banda, Hastings AU - Kathyola, Damson AU - Joshua, Martias AU - Richardson, Faye AU - Mah, Emmay AU - MacGregor, Hayley AU - Kanike, Emmanuel AU - Thompson, Sandy AU - Fairall, Lara AU - Bateman, Eric AU - Zwarenstein, Merrick AU - Schull, Michael J AB - Background: The government of Malawi is committed to the broad rollout of antiretroviral treatment in Malawi in the public health sector; however one of the primary challenges has been the shortage of trained health care workers. The Practical Approach to Lung Health Plus HIV/AIDS in Malawi (PALM PLUS) package is an innovative guideline and training intervention that supports primary care middle-cadre health care workers to provide front-line integrated primary care. The purpose of this paper is to describe the lessons learned in implementing the PALM PLUS package. Methods: A clinical tool, based on algorithm- and symptom-based guidelines was adapted to the Malawian context. An accompanying training program based on educational outreach principles was developed and a cascade training approach was used for implementation of the PALM PLUS package in 30 health centres, targeting clinical officers, medical assistants, and nurses. Lessons learned were identified during program implementation through engagement with collaborating partners and program participants and review of program evaluation findings. Results: Key lessons learned for successful program implementation of the PALM PLUS package include the importance of building networks for peer-based support, ensuring adequate training capacity, making linkages with continuing professional development accreditation and providing modest in-service training budgets. The main limiting factors to implementation were turnover of staff and desire for financial training allowances. Conclusions: The PALM PLUS approach is a potential model for supporting mid-level health care workers to provide front-line integrated primary care in low and middle income countries, and may be useful for future task-shifting initiatives. DA - 2014-05-12 DB - OpenUCT DO - 10.1186/1472-6963-14-S1-S8 DP - University of Cape Town J1 - BMC Health Services Research KW - training KW - educational outreach KW - task-shifting KW - continuing professional development KW - anti-retroviral treatment KW - integrated primary care LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 SM - 1472-6963 T1 - Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package TI - Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package UR - http://hdl.handle.net/11427/20149 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/1472-6963-14-S1-S8
dc.identifier.urihttp://hdl.handle.net/11427/20149
dc.identifier.vancouvercitationSodhi S, Banda H, Kathyola D, Joshua M, Richardson F, Mah E, et al. Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package. BMC Health Services Research. 2014; http://hdl.handle.net/11427/20149.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderSodhi et al; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceBMC Health Services Researchen_ZA
dc.source.urihttp://bmchealthservres.biomedcentral.com/
dc.subjecttraining
dc.subjecteducational outreach
dc.subjecttask-shifting
dc.subjectcontinuing professional development
dc.subjectanti-retroviral treatment
dc.subjectintegrated primary care
dc.titleSupporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS packageen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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