Effectiveness of refresher training to community health workers and their supervisor and defaulter tracing activity in nyanza province

Purpose: The purpose of this study were to measure the impact of refresher training to community health workers and their supervisor in terms of leadership, facilitation skill, case management and data management and community referral and defaulter tracing activities. Methods: This study was cluster randomized control trial conducted from Aug,2011 to Sep,2012. All 64 sub-location which have been covered by community health workers by May,2011 in 4 district, Nyanza province, Kenya were targeted. We randomly divided into 3 groups with consideration on contamination, control group, group one (refresher training only) and group two (refresher training and defaulter tracing activity). The refresher training was conducted as one day intensive training per month from Jan to July,2012. In addition, referral and defaulter tracing mechanism were developed and launched from April,2012. Results: Compared with control group, CHW's and their health knowledge were significantly improved and household coverage of CHWs was significantly increased. In the household level, their care seeking behavior, first choice of treatment, significantly changed to consultation health facilities or community health workers. Other results on household level are still ongoing to analyze. Conclusions: It is important to provide continuous intensive training to not only community health workers, but also their supervisor in terms of leadership, facilitation skill, case management and data management. Defaulter tracing activity with better knowledge would be facilitated to change household health seeking practices.