Adaptation. Sustainability. eLearning.

By Cristina Lussiana, Senior Program Manager, Digital Health & Monitoring and Janet Patry, Training Facilitator, PSI

In a world of social distancing, ensuring training and capacity building for healthcare providers and beneficiaries is a challenge. Before COVID-19, PSI used to conduct in-person trainings and capacity building activities in nearly all of the 50+ countries where we work to improve health providers’ skills in delivering health services in addition to beneficiaries’ awareness of, and access to, health services and products.

PSI is committed to continuing this work during the coronavirus pandemic, and we have quickly adapted our training and capacity building activities to fit the current circumstances. This has allowed us to deliver remote training and capacity building content using digital channels and tools that best fit many of PSI’s target audiences.

Over the past ten years, PSI has built and fostered the Digital Health journey for our archetypal consumer, Sara, ensuring that she can access care when, where and how she needs it for herself and her family. This past year, PSI’s Digital Health and Monitoring department has worked with country and program teams to adapt current training curricula and learning journeys to a remote approach and in-person awareness campaigns to digital marketing campaigns.

Taking into consideration the limited access to mobile devices and internet connectivity that low- to middle-income countries (LMICs) have, PSI has adapted training curricula, learning journeys and the content of our awareness campaigns to fit the devices and connectivity our target audience can access. For example, the use of Interactive Voice Response (IVR) overcomes a lack of access to internet connectivity and still offers access to content, which our target audience receives through basic handsets. WhatsApp- and Facebook Messenger-based chatbots offer an easy way to reach thousands of health providers and beneficiaries without creating an additional economic burden by relying on channels that they already use. For audiences with internet access through laptops or tablets, PSI offers online training curricula on Moodle, or other similar platforms, on COVID-19-related topics as well as other health areas like malaria, sexual and reproductive health and tuberculosis.

PSI’s continuously evolving Digital Strategy has enabled us to pursue and succeed in applying eLearning approaches over the past decade. Below are some examples of that success.

 

 

In Angola, PSI partnered with the local digital innovation company Appy People LDA to create a Moodle-based eLearning platform, named ‘Kassai: The Stream of Knowledge.’ It started by targeting 200 health providers at the facility and community level with malaria case management training, and now plans to scale up to thousands of public sector healthcare workers. The interactive courses are tailored for providers’ needs and digital literacy skills, and feature videos, case studies, quizzes and pre- and post-training evaluation checklists to assess knowledge and progress. In partnership with a local telecom provider, the platform will eventually offer nationwide free URL access. To improve experience and engagement, Kassai deploys gamification, blended learning, user forums, chats and additional job aids for download. Courses in sexual and reproductive health and family planning will be developed next; new features will be available by the end of 2020. Kassai will also integrate with PSI’s Health Network Quality Improvement System (HNQIS) quality assurance system, used in Angola since November 2019. Through the Health for All project, USAID and the US President’s Malaria Initiative are supporting Kassai’s development while the Angolan Ministry of Health supervises its content development and deployment in the national healthcare system.

 

A screenshot from the “Malaria in Children” course in the Kassai eLearning platform created by PSI Angola and the Angola Ministry of Health. This photo portrays question 7 in the course’s quiz, asking the user to interpret the result of the malaria rapid diagnostic test portrayed in the photo.

For health providers in Niger, PSI is working to launch online training curricula to use the HNQIS app, which supports Quality Assurance Officers (QAOs) in assessing and improving providers’ skills and knowledge in health service provision. PSI wants to ensure that QAOs can successfully use HNQIS to assess clinical skills and improve the quality of their engagement with providers to influence behavior change, leading to improved quality of care and more efficient and scalable supportive supervision. The HNQIS e-learning course teaches QAOs how to plan their supervision visits to facilities, assess facility performance in service provision, improve facility knowledge and skills and monitor facility performance over time. Through the launch of the online platform, PSI drives sustained adoption of eLearning modalities, initially for QAOs using HNQIS but in the long-term for a wider audience including system administrators, data users and providers.

In Kenya, Population Services Kenya (PSK) and PSI have prototyped a WhatsApp-based chatbot to train 58 health providers in the Tunza Social Franchise network on Awareness and Personal Protective Equipment (PPE) for COVID-19. With this successful pilot complete, we now plan to scale it up to 400 providers by October 2020 and include other COVID-19-preparedness and response topics. The goal of the WhatsApp-based chatbot is to help participants acquire knowledge and skills to deepen their understanding of COVID-19, and to facilitate eLearning experiences across project partners and implementers by using a channel providers and beneficiaries are already familiar with. Additional modules to be included in the WhatsApp-based chat are: identifying symptoms and preparing clients for triaging; client awareness and messaging on helping clients and communities to stay infection free; hygiene control and proper handwashing; information on Social Distancing; and dispelling myths and reinforcing facts.

PSI Mozambique, alongside communications and marketing leads at sister organizations and the Ministry of Health (MoH), has developed a series of online videos and self-evaluation surveys to train health providers on COVID-19. The team’s diverse perspectives supported partners to lean on each other’s strengths in achieving a common goal: equipping health workers to fold COVID-19 protection and prevention measures into existing health outreach and service provision. The videos cover seven modules, defined by the MoH, covering COVID-19 transmission, symptoms and prevention. Partners share videos across low-bandwidth digital platforms, such as WhatsApp, with a corresponding link to a knowledge survey to capture health workers’ understanding of COVID-19 per videos viewed.

 

These successes are not achieved in isolation. PSI recognizes the need for building strategic partnerships across the public, private, non-profit and educational sectors, and to develop and deploy effective eLearning approaches at scale.

We recognize and seek out experts in the Digital Health space; PSI currently partners with key players like Viamo, one of the global leaders in IVR, Appy Saude to support customization of the Moodle platform in Angola and Amref to adopt online COVID-19 training curricula for health providers approved by the Ministry of Health in Kenya. PSI is always open to exploring new partnerships to deliver tailored online content to our target audiences, increasingly at scale.

PSI is confident that our joint investments in eLearning will pay off in the long-term because each effort adds tailored learning approaches for our target audiences, that can be complemented by in-person trainings when we physically visit Sara and the health providers who serve her. We welcome you to get in touch if you would like to explore what we can do together.

For more information about this initiative, please reach out to Cristina Lussiana at clussiana@psi.org or Janet Patry at jpatry@psi.org.

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