LHW Systems Review - Oxford Policy Management

AnnexesAnnex A All variations in curriculum since 2000Table A.1 All variations in curriculum since 2000Change/addition tocurriculumThe Basic Curriculumwas revisedin 2001/02. 86Change mechanism:response from the trainingdivision on what stimulatedthe revisionThe knowledge scores of the3rd Evaluation gave the initialstimulus. The objective was toimprove LHW knowledge andskills.During the trainer training forthe revised curriculum, furtherareas of improvement wereidentified (e.g. on antenatalvisits, micronutrients, MIScase studies, andstrengthening of training incounselling skills).Field experience of LHWPmanagement highlighted theweakness of the MIS, whichresulted in the revision of theMIS section.At the same time, the MMRverification pro forma wasintroduced.Was therepiloting?How and whenwas the changeimplementednationwide?No In 2002/03,throughout thecountry, allLHWs weregiven 15 days’refresher trainingon the revisedLHW manual.Is it integratedinto thesupervision/inspectionmechanisms?YesThe LHS curriculumwas updated in2003/04 with thestrengthening of thesupervision andmonitoring component.Chapters on anatomy/physiology weredeleted as they werenot relevant. Thesubject matter is thesame as the LHWcurriculum, but withmore in-depthcoverage of topics.The LHS manual was revisedbased on the changes in theLHW curriculum. Fieldexperience showed that theLHS course was not aspractical as it needed to be.Initially, it was thought that theLHSs would become LHVs;therefore, their course workincluded basic anatomy andphysiology, etc. This idea waslater dropped and thecurriculum was revised andadapted to the requirementsof the LHS’s role andresponsibilities.Also, more in-depthknowledge was provided tothe LHS.Verification of infant mortalitywas introduced, but this hasyet to be implemented.Updated section of MIS wasincluded.Mechanismsimilar toLHS. Nopiloting wasundertaken,and therefreshertrainingstartedthroughoutthe country in2005.All working LHSsreceived 12 days’refresher trainingfrom 2005onwards.Complete in allprovinces.Yes86Some topics were revised. Most of the changes were in the MIS, on a few indicators on monthly reports. The followingchanges were made in the curriculum: maternal death reporting; break up of child death (into infant death, death of childrenunder five years of age); registered number of pregnant women; number of newborns weighed at birth; break up ofcontraceptives; and the antenatal visit number (4) during pregnancy was mentioned. Other changes included: CBA agechanged from 15–45 years to 15–49 years; introduction of adolescent health topic; exclusive breastfeeding definition changed(six months, instead of four); position and latching at breastfeeding were introduced; instead of children under 3 years old, thechild age range was changed to 0–35 months. Some topics were revised. Topics added were the TB DOTs with strategy andHIV Aids (enhancing the STD section).79