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Related Experiment Videos

Determining whether Community Health Workers are 'Deployment Ready' Using Standard Setting.

Celia Taylor1, Basimenye Nhlema2, Emily Wroe2,3,4

  • 1Division of Health Sciences, University of Warwick, GB.

Annals of Global Health
|February 20, 2019
PubMed
Summary

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Establishing a formal assessment standard for Community Health Workers (CHWs) is crucial for ensuring safe practice. This study used the Ebel method to set a passing score for CHW knowledge, finding most trainees met the deployment-ready standard.

Area of Science:

  • Public Health
  • Health Workforce Development
  • Educational Assessment

Background:

  • Community Health Workers (CHWs) are vital for delivering basic health services.
  • No standardized method exists to determine CHW competency post-training.
  • This study addresses the need for a formal standard-setting process for CHW assessments.

Purpose of the Study:

  • To apply the Ebel method for standard setting on a post-training knowledge assessment for CHWs in Neno, Malawi.
  • To establish a reliable benchmark for CHW deployment readiness.

Main Methods:

  • Utilized the Ebel method involving 12 expert participants to define 'just-deployment ready' and 'ideal' CHWs.
  • Participants rated question importance and difficulty, and estimated correct answer proportions for CHWs.

Related Experiment Videos

  • A passing standard was determined using mean scores, adjusted by one standard error of measurement (SEM).
  • Assessed inter-rater reliability using Krippendorf's alpha and analyzed results with classical test theory.

    • Main Results:

    • Low inter-rater agreement was observed for question importance (Krippendorf's alpha=0.064) and difficulty (alpha=0.074).
    • The established passing score was 53.3% after SEM adjustment.
    • 68% of 129 CHW trainees achieved 'clear passes', with 12% categorized as 'clear fails'.

    Conclusions:

    • Setting deployment readiness standards for CHWs is challenging, indicated by poor rater agreement.
    • The current assessment suggests most trained CHWs are deployment-ready.
    • Field validation of the established pass mark is essential to confirm CHW competency.