However, there is a lack of evidence linking these health care worker trainings to improved health outcomes.
Both CHW and health worker trainings were no more than a week in duration, and CHW supervision was by health workers from nearby health facilities rather than UNEST project staff.
One important limitation of this study is that external factors, such as health worker trainings, human resource shifts and the influx of AIDS drugs, particularly in the post-intervention period, likely impeded the study's ability to detect a significant impact of the CD4 nurse intervention.
Following STF health worker trainings that enabled Option B+ roll out to 82%% of health facilities in our catchment area by year 1 end, quarterly ART uptake among HIV-infected pregnant women presenting to ANC increased significantly to 66%% (n/N = 1,057/1,600) by Y1 Q4 (p < 0.001) and 96%% (n/N = 2,046/2,121) by Y3 Q4 (p < 0.001), compared to the pre-B+ baseline (Fig. 5).
All trainings were residential, except for one in Malindi (K) where district managers opted for a non-residential option to reduce costs, thus allowing the district to double the number of health workers trained.
Indeed, according to poll worker and activist interviews with Truthout, supplemented by written complaints, poll workers in some trainings were told by county election officials to just hand out provisional ballots to people showing up in the wrong precinct, knowing full well that those votes wouldn't be counted under state policies.
Details of the community based health workers' programs and trainings are given in Table 1.
Bringing health workers for centralized trainings tend to disrupt service delivery in health facilities and this could have serious consequences for vulnerable and underserved populations [ 6].
Recently, there has been a renewal of concerns raised about the lack of evidence linking the resources invested in health care worker in-service trainings to improved health outcomes [ 7- 10].
Karin Kallander Keep training healthcare workers: We deliver monthly refresher trainings that focus on key health topics or new product launches, with topics timed strategically.
