Seeing, thinking and acting against malaria--a new approach to health worker training in rural Gambia
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Updated: Aug 15, 2026
Protocol for Mosquito Rearing (A. gambiae)
Published on: July 4, 2007
Angela Dawson1, Balla Musa Joof
1School of Indigenous Health Studies, University of Sydney, Australia.
Insights
A pilot malaria training program using computer-based training (CBT) for Community Health Nurses (CHNs) in The Gambia improved confidence but faced resistance. Sustainability and wider e-learning adoption are key for future malaria control efforts.
Area of Science:
- Public Health
- Medical Education
- Information Technology in Healthcare
Background:
- Malaria is a leading cause of child mortality in The Gambia, West Africa, particularly in rural areas.
- Primary healthcare workers manage most malaria cases, highlighting the need for effective training and community engagement.
- The National Malaria Control Programme aims to halve the malaria burden by 2007 through enhanced training and awareness.
Purpose of the Study:
- To pilot a malaria in-service training program for Community Health Nurses (CHNs) using a novel computer-based training (CBT) package.
- To assess the effectiveness of the CBT package in enabling CHNs to facilitate change in malaria control.
- To gather insights into learner experiences and preferences for future e-learning initiatives.
Main Methods:
- A computer-based training (CBT) package was developed and piloted for Community Health Nurses (CHNs).
- Learner feedback was collected through interviews and evaluation forms to assess experience and learning preferences.
- Stakeholder input and a reference group informed the curriculum development.
Main Results:
- The CBT package was positively received, with learners reporting increased confidence despite a desire for more computer instruction.
- Resistance to developing IT skills in CHNs emerged from some health professionals, linked to perceived roles and confidence.
- Modifications to the CBT package, including activities and language, were necessary based on feedback.
Conclusions:
- The pilot demonstrated potential for e-learning in The Gambia, with opportunities to expand to pre-service training and other health professionals.
- Addressing sustainability and resource implications is crucial for the long-term success of e-learning initiatives.
- Further investigation is planned to assess the viability of adapting the CBT module for allied health and community extension workers.
Context:
In the Gambia, West Africa, Malaria is a major cause of death among children in rural areas. It has been estimated that in one division in the country malaria accounts for 40% of all deaths in children aged between one and 4 years. Most malaria cases are managed at home assisted by primary healthcare workers. The strategic plan of Gambia's National Malaria Control Programme includes improved training and supervision of all health care providers, at all levels, and increased community awareness in order to reduce the malaria burden by 50% before 2007.
Issue:
A malaria in-service training program for Community Health Nurses (CHNs) working at village level was piloted in 2004. The program includes a computer-based training (CBT) package, the first of its kind for health professionals in Gambia. The education program is part of a larger initiative, funded by the Gates Malaria Partnership, that aims to increase community involvement in malaria control. The objective of the course is to enable CHNs to facilitate the change process. The curriculum was informed by a reference group and stakeholder input. Interviews and evaluation forms were used to gather information about learner experience and learning preferences.
Analysis:
The CBT package was well received. Learners reported wanting more computer instruction, but felt they had gained confidence. There was resistance from other health professionals regarding the development of information technology skills in CHNs. This related to the perceived role and status of CHNs, as well as confidence in their ability. Some modifications of the CBT package were necessary, including the reworking of some activities and language.
Lessons Learned:
There are issues related to sustainability and resource implications that need to be addressed. Opportunities exist to expand e-learning in the Gambia for pre-service CHNs and other professionals. An investigation into the viability of reproducing this module as a generic planning tool for allied health workers and other extension workers at community level will be undertaken.
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