Journal Article

EXPERIENCE OF THE NEEP PROJECT IN GUATEMALA AND EL SALVADOR

Choi, Sunhea, Portillo, Carmen, Velasquez, Carmen, Valle, Michele Monroy

2017

Overview

Severe Acute Malnutrition has a low prevalence among under 5 population in Central America; Guatemala has 0.7% and El Salvador 2%. Important nutrition-health politics have been implemented in the past years. Guatemala, the growth child survey system implemented in 2009 is capable of screening, assessing and treat, in the community, moderate acute malnourished children reducing inpatient treatment needs. El Salvador's Health System improved overall health access decreasing stunting rate 13 percental points. In this scenario, SAM treatment has dropped its importance, building skills in health personnel is out of sight; but for those that work with the poorest population is a necessity missed by the in-service and pre-service trainers. The aim of the project was to identify if the Malnutrition eLearning course could cover this training gap among health professionals and improve the quality of treatment of SAM children. Nutrition Embedding Evaluation Program (NEEP), PATH supported a Malnutrition eLearning course evaluation in Guatemala, El Salvador, Ghana and online from overall world. We will describe Central America's results. Using a mixed methods, evaluation was conducted for existing users and for new users and trainers. Online Malnutrition eLearning course is in English, contents include 3 units about screening, assessing, managing malnutrition Phase 1 Participants were former users in Guatemala students and professionals. Online questionnaires, interviews and Focus groups were conducted. Phase 2 new users We enrolled 143 participants from 6 institutions: Rafael Landivar University, Nutrition Degree in Guatemala and Quetzaltenango; Juan Pablo II Hospital (paediatricians); Guatemal's Health Ministry Nutritionist; University Evangelica de El Salvador (nutritionist); Hospital Nacional Zacamil (paediatricians). In June 2015 pre-test, questionnaires, focus groups, medical records (one year before) and hospital observations. eLearning was done in September to comply with the programme contents, post intervention evaluation was in October. 21 trainers were selected from institutional survey for a workshop where they made an action plan to implement the course. A post-6-months test was conducted to verify knowledge gain in longer term. 6 and 12 months' interviews, focus groups and questionnaires were conducted for individuals and for the hospital's medical records and observations. We had 47 participants, pre-test scores average percentage was 16.83 and post-test were 28.62. Despite the significant change, scores were low, but all the sample reported Language barrier as main reason they were not able to answer properly. Participants that reported skills gain compare course contents to national SAM managing guidelines while eLearning. Implementing the course with credit gains was more successful than the ones that didn't, learning in English resulted a double burden. For Guatemala, course represented the technical background, that few had, for implementing the national SAM treating guidelines. At the 6 and 12 months' follow-up participants reported they use course contents in their daily work, particularly the assessment and 10 steps. We generated two needs in SAM control: a tool to support science and technical background in managing SAM children available online for all health workers, and the need of Malnutrition eLearning course in Spanish.

• Publisher: S. Karger AG
• Subject: CAI / Children / Childrens health / Colleges & universities / Computer assisted instruction / Distance learning / Embedding / Guidelines / Health / Internet / Malnutrition / Medical personnel / Medical records / Nutrition / Online instruction / Pediatrics / Polls & surveys / Screening / Skills / Training / Workers