In-Service Training of Stakeholders Working for Particularly Vulnerable Tribal Groups (PVTGs) in an Eastern State of
Vikas Bhatia1, Prajna Paramita Giri1, Manish Taywade1
1Department of Community Medicine and Family Medicine, AIIMS Bhubaneswar, Odisha, India.
Background:
Particularly vulnerable tribal groups (PVTGs) are among the most marginalized tribal communities in India. The uptake of government-led health and nutrition programmes by them is low owing to the geographical remoteness of their habitats, communication gaps between service providers and PVTG communities, and distinct cultural beliefs. Under the "Jiban Sampark" ("Connection with Life") project-a collaboration between the Government of Odisha, United Nations Children's Fund (UNICEF), and AIIMS Bhubaneswar-a structured training of trainers (ToT) programme was implemented to build the capacity of stakeholders serving these communities. The objective of this study was to implement and assess the effectiveness of the training programme on the knowledge of stakeholders working for PVTGs in tribal districts of Odisha, an eastern state of India.
Methods:
A single-group pre-post (before-after) interventional study was conducted in 12 tribal districts from April 2019 to January 2020. Six modules were developed and vetted by subject experts for the training of different stakeholders including health officials, officials from Women and Child Development (WCD) departments, Non-Governmental Organization (NGO) personnel, and functionaries of the Odisha Livelihood Mission (OLM) and the Odisha PVTG Empowerment and Livelihood Programme (OPELIP). Three-day residential trainings covered six modules; knowledge was assessed across five domains-childhood malnutrition, adolescent health, antenatal and postnatal care, newborn care and immunization, and communication in service delivery-using a pretested, content-validated 20-item questionnaire administered immediately before and after training to 231 of the 242 participants trained.
Results:
The mean total knowledge score improved significantly after training compared with before training (13.80 ± 3.78 vs 11.55 ± 5.19; paired t-test, P < 0.001). All five domains improved significantly by McNemar's test (all P < 0.0001). The pre-test overall knowledge was lowest among OPELIP staff and health functionaries (8.41 ± 3.03 and 9.16 ± 2.49, respectively). The post-test scores of health functionaries were highest across all domains, and their overall improvement was statistically significant (9.16 ± 2.49 vs 15.48 ± 4.19; P < 0.001). WCD functionaries, who had the highest baseline score, showed a significant decline in total score (14.85 ± 6.37 vs 12.82 ± 3.96; P = 0.023).
Conclusion:
The assessment of pre- and post-test results revealed a significant improvement in the knowledge of stakeholders across most domains and cadres. Hence, an administrative mechanism within the government system is needed to impart training to all stakeholders at regular intervals and to monitor the cascade training of frontline workers (FLWs).
