In Busia county, Kenya, CHWs attend a socially distanced training on COVID-19 sensitization and continuity of essential primary health services.

Living Goods halted all trainings at the outset of the COVID-19 pandemic. Not only had governments banned public gatherings, but we also knew it would be impossible to safely continue our typical multiday indoor trainings with dozens of CHWs and staff enclosed together for extended periods. But trainings are essential for recruiting new CHWs, keeping skills fresh, and driving greater impact by expanding the basket of health services they provide to communities. Knowing that the impacts of the pandemic will remain for some time, we determined that the benefits of training CHWs outweighed the risks of COVID-19 transmission—provided we employ robust disease mitigation strategies that also comply with prevailing national COVID-19 prevention guidelines.

We have developed protocols to guide any in-person training, prioritizing modules that require less contact time but offer maximum impact. All participants are required to wear masks, trainers undergo mandatory testing every 14 days, there are daily supervisor and trainee self-assessments, and all classes start with COVID screening and training. We also use thermoguns to take temperatures on-site, test 10% of CHWs, limit class sizes, and select venues that both have space for social distancing and provide participants with adequate sanitation facilities.

In Uganda, we have prioritized training in our new exemplar district of Oyam; conducting follow-ups for all CHWs introduced to base training, immunization and family planning at the beginning of 2020; for those upgrading from V2 to V3 of the Smart Health app; and any CHWs who had yet to be trained on immunization protocols.

We are also supporting in-person training of government supervisors and CHWs in our new co-financed partnership in Kisumu County, Kenya. But elsewhere in Kenya, we have largely shifted to virtual training of community health supervisors for family planning, immunization, home-based isolation and care, COVID prevention and workflows, who then cascade it in-person to CHWs at the community level. 

We have experienced a number of challenges since resuming in-person trainings, such as delays in receiving COVID test results, the need to cancel or reschedule classes when a trainer tests positive and longer training periods—as a result of the small class sizes.  To mitigate these issues, we have added more lead time between testing and training, put in place service–level agreements with accredited labs, and are working to have additional trainers on reserve in case someone tests positive prior to the start of activities. Safety remains our top priority and we will stop any trainings where there are suspected or positive COVID cases.