Improving Interpersonal Communication Skills of Community Health Workers through Video Evaluation
A common challenge
Achieving effective interpersonal communication is a challenge for projects that rely on counseling to promote new practices and change behavior among their beneficiaries. The Manoff Group found a unique approach to addressing this challenge through its work on the PROCOSI Network Technical Assistance Project in Bolivia.
The Manoff Group provided technical assistance (TA) designed to strengthen the interpersonal communication skills of the community health workers (CHWs) on PROCOSI's Community Health Project. Drawing on past international experiences, the TA team recognized the importance of conducting an early evaluation of the CHWs’ mastery of counseling, with a methodology and instruments perfected through evaluations in Nicaragua, Dominican Republic, Peru, and Guatemala. The TA team chose a unique format for the evaluation of this skill: video.
A new technique that results in a wealth of material
The TA team recommended the use of video because video allows for an objective and detailed evaluation of health workers’ acquired interpersonal communication skills, specifically measuring their handling of verbal and non-verbal communication, use of printed materials and job aids, skill with negotiation, and success in obtaining commitments to change behavior.
The evaluation was qualitative in nature and was conducted after the CHWs had completed two or three months of home visits. The plan included recording the CHW’s home visits in their communities as they completed the tasks outlined in the maternal and neonatal health, tuberculosis, and hygiene modules.
Following each recorded visit, the evaluation team interviewed the family and the CHW about the experience, asking about the support materials, particularly their use and value, the frequency and length of home visits, satisfaction with the program in the community, confidence in the CHW, and support provided by community leaders and health personnel. Simultaneously, the evaluation team recorded testimonials of CHW facilitators regarding their ideas about most valuable outcomes from the communication activities. In total, the activity produced 12 hours of video with recordings from 34 home visits.
The edited videos of the home visits were evaluated systematically by three different individuals, including one person from the NGO supervising the particular CHW in the video. The evaluations were standardized using an instrument that ranked performance. The results of the evaluation provided a wealth of detailed information for all aspects of CHW interpersonal communication.
The activity concluded with a workshop with the facilitators of the CHWs, who had many observations regarding the communication steps requiring more reinforcement and those for which the CHWs seem well-trained.
The most important product
These data and the discussions during the workshop about CHW communication skills led facilitators to take corrective actions. They improved the training plans for interpersonal communication, including using final materials and not photocopies, and giving more time to learning how to use the materials and to practicing interpersonal communication and counseling.
They decided to use video cameras to follow the development and improvement of the CHWs in order to promote an exchange with them about their performance and to come to agreement on corrective actions and needed support.
An invaluable tool
The activity was able to improve interpersonal communication based on an analysis of real situations. The facilitators were able to realize the challenges inherent in training and supporting effective interpersonal communication in their CHWs, and they identified specific steps to correct and improve the process. The NGOs also made plans to continue using “Video Documentation” as a teaching tool and to bring the voices of the community to program managers.