SWAT’s Evaluation of Evaluating Trainings

By Hannah Braun

The first regional representative training occurred in early August at the Peace Corps Kumasi sub-office. One of the many topics in the two full days of training was the importance of monitoring and evaluation.  SWAT leading by example decided to evaluate if any and how much knowledge was gained at the training. A pre and post malaria knowledge survey was given to all in attendance of the training.  8 individuals responded out of 13 to the baseline survey the day before the training began and the post survey had 9 responders out of 13 one month after the training. We chose to do the post survey one month after the training for a sufficient amount of time to pass for information not to be just regurgitated from the training, but actually absorbed. The survey consisted of approximately 50 in-depth malaria questions (Refer to Appendix A).  The questions were mainly derived from significant teaching points in the training.  The survey was designed for easy comparison of results; therefore, most questions were in multiple-choice format. Few questions were also short answer and choosing multiple answers from a list.

The general results of the survey show an average increase in knowledge to be 18% after the training.  The pre-test has people answering correctly about 64% of the time and 83% for the post-test. The small increase could be due to the small sample size and heavy weighing of one correct answer.  Also the short answer questions were graded on a pass or fail basis. Some replies did not have all the information required for the correct answer so it was deemed incorrect.  Although the strict grading may have kept our percent increase small we will continue to grade this way for future surveys in order to keep the data significant.  In addition some questions were pretty easy (indicated by answers with 0% change, people answered correctly in both tests).  Future surveys should have harder questions; therefore, the pre-tests would have a lower percent correct.

SWAT believes that surveys are key to improving our trainings.  Without any monitoring how could we tell if all of our work had an impact? How could we justify asking for Peace Corps to fund our trainings?  All future trainings will have pre and post surveys ready for all in attendance.  We hope to have the next survey for our January training to have an average of 95% correct answering. SWAT wants their representatives to be extremely knowledgeable in order for them to act as a malaria resource in their respective regions.  A 95% understanding rate post training is a high expectation, but SWAT does have high prospects. SWAT aims to conclude every training with greater knowledge retention than the previous. One change that can be made to ensure the improvement from the previous training would be to have our key points to every topic highlighted on a single slide at the end of each presentation.  The key points would be directly related to the questions being asked in our survey.  Last training we went over the entire survey as a presentation and told them the right answers, but we believe that is not the most effective way for disseminating information.  The connection between our questions and the presentations need to be more cohesive.

APPENDIX A

SWAT Regional Representative Training, August 2012

Results of Pre-training and Post-training Malaria Knowledge Survey

The differences in percentage correct (pre vs. post test) are given below. A 0% indicates no change. A positive value indicates an increase in knowledge and a negative value indicates a decrease in knowledge.

1) Which species of mosquito transmits malaria?

Anopheles  (0%)

2) What is the peak time of day malaria transmitting mosquitoes are most likely to bite?

12Am to 3AM  (+50%)

3) Which of the following are anopheles mosquitoes most likely to breed in?

Clean rain barrel  (0%)

4) Weeding around the compound helps prevent malaria significantly.

False  (+12%)

5) Where do anopheles mosquitoes go after they take a human blood meal?

Walls to rest  (0%)

6) What is the flight radius of an anopheles mosquito?

80km  (+64%)

7) What is the life span of the female anopheles mosquito?

1 month  (+5%)

8) When the parasite enters into your bloodstream, where does it go first?

Liver  (+12%)

9) When the parasite enters the liver, what does it do first?

Replicates into 1,000s of parasites  (+26%)

10) What makes P. vivax and Ovale unique?  

Primary cause of chronic or recurrent malaria because it lays dormant in the liver  (+15%)

11) Fever is your body’s response to what?

Unrecognized pathogen  (+18%)

12) How long after a bite do symptoms show?

1-4 weeks  (-18%)

13)When the plasmodium enters and replicates in the human body, what causes the malarial symptoms?

Parasites attacking and bursting RBCs  (0%)

14) What is the physiological difference between uncomplicated and severe malaria?

More blood cells being destroyed  (+64%)

15) How often do LLINs need to be retreated?

Never  (+62%)

16) How many times can you wash a LLIN?

20  (+28%)

17) When you receive a new LLIN what should you do before you can sleep under it?

Air it out in a shady place  (+25%)

18) Princess style hanging involves how many points of contact?

1  (+25%)

19) What kind of soap should be used to clean LLINs?

Mild soap such as Key and Geisha soap   (+25%)

20) Nets should be thrown away when they are torn.

False  (0%)

21) Why should a person with malaria sleep under a LLIN?

To prevent further transmission of malaria to family and community members  (+12%)

22) According to the National Malaria Control Program, what does universal bed net coverage mean?

One net per two people  (+14%)

23) If a child under 5 has suspected malaria when should they go to the clinic?

Immediately  (-11%)

24) If an adult has suspected malaria when should they go to the clinic?

Within 24 hours  (+87%)

25) What is currently the recommended treatment for malaria in Ghana?

ACT  (0%)

26) What does ACT stand for?

Artemenisin based Combination Therapy  (+14%)

27) Mono-therapies are detrimental to the malaria eradication cause in which way?

The parasite is more likely to develop resistance to a mono-therapy than a combination based therapy.   In addition, their availability at pharmacies allows people affected by illness to self treat for malaria without a test to verify their illness.  (+3%)

28) Patients should stop taking medicine when they feel better.

False  (0%)

29) What is the best way to test for malaria at rural CHPS?

Rapid Diagnostic Test  (25%)

30) When should a pregnant woman go to the health facility to receive her first dose of SP?

When she feels the baby kicking  (+42%)

31) How much does SP cost at a health facility in Ghana?

Free  (+26%)

32) Which of the following are symptoms for uncomplicated malaria?

Fever, chills, body pains  (0%)

33) Which of the following are symptoms for severe malaria?

Very high fever, dark urine, and convulsions  (-8%)

34) Pale eyes, lips and palms indicate what?  

Anemia  (0%)

35) Anemia is defined as:

Reduction of RBCs that carry nutrients and oxygen to the body  (+1%)

36) If not treated early, uncomplicated malaria can turn into what?

Severe malaria  (+12%)

37) What are the negative impacts of malaria on the family?

Emotional issues, financial loss, education and work is affected adversely  (+15%)

38) What groups are the most at risk for malaria?

Children under 5, pregnant women, PLHIV, foreigners  (0%)

39) What complications arise from malaria during pregnancy?

Miscarriage, spontaneous abortion, stillbirth, low birth weight, death of pregnant women  (+19%)

40) Which of the following long-term effects can be caused by malaria?

Brain damage, epilepsy and poor educational performance (results not included in overall score)

41) IRS acts as a mosquito repellant for the room?

False  (+3%)

42) According to Anglo-Gold how often should IRS be applied in the household?

Every six months  (-19%)

43) Neem cream combines which ingredients?

Neem leaves, water, oil or shea butter, Key soap  (+54%)

44) What’s preventing a malaria vaccine from being distributed worldwide?

The parasite has 5,000 genes and a multiphase lifecycle. Producing a vaccine in large quantities is difficult. No human vaccine against a parasitic disease is approved for use.  The limited financial return anticipated from a market that is primarily in Africa and other developing regions holds little attraction for the private commercial sector.  (+56%)

45) Which new knowledge on malaria did the third round of the AP study in the Northern region of Ghana reveal?

IRS might not be effective due to mosquito changing habits based on human habits  (+37%)

46) What are the stages of country’s malaria status?

Control: high contribution to global deaths; Control: low contribution to global deaths; Pre-Elimination, Elimination, Prevention of Reintroduction; Malaria free  (+22%)

47) What is Ghana’s malaria status?

Control: high contribution to global deaths  (+22%)

 

If you have additional questions on the survey or want to request additional information please contact Hannah Braun at hannahjbraun@gmail.com.

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