Researching the Gap

Researching the Gap Between the Existing and Potential Community Health Worker Education and Training in the Refugee Context: An Intersectoral Approach

By F. Beryl Pilkington & Isabella Mbai

Executive Summary

The problem addressed through this research is the scarcity of health human resources to meet community health needs in the protracted refugee situation in Dadaab. This project was conducted by academic research partners from York University (Pilkington) and the University of Toronto (Abuelaish) in Canada, and Moi University in Kenya (Mbai), with the assistance of four community researchers (CRs) from Dadaab. The goal of the research was to produce new knowledge to inform the creation of an education model for building health care capacity in marginalized communities in Kenya (and ultimately, Somalia, the country of origin for most of the refugees) by utilizing the cross-sector experience and expertise of Canadian and Kenyan universities and nongovernmental organizations (NGOs). Accomplishing this goal involved determining the education needs of a potential new cadre of community health professionals, and assessing the potential to develop a university level program to meet these education needs. The project was conducted between July 2014 and July 2016. Research activities included 1) pre- and post-fieldwork workshops attended by academic researchers and representatives from stakeholder groups, and 2) fieldwork consisting of focus group discussions with community health workers (CHWs), prospective students in the envisioned university program, and health staff from NGOs and the Ministry of Health (MOH) who train and supervise CHWs.

The research findings indicate that community health professionals in resource poor communities such as Dadaab need education and training that provides a solid foundation in theory along with a practical focus. Given the scope and complexity of the knowledge and skills needed, higher education is desirable. Moreover, in order to meet the particular health needs in communities such as Dadaab, educational programs must be structured in ways that 1) meet the needs of learners, 2) improve the quality of care and health services, and 3) are realistic given constraints around technology, resources and security. Also, the curriculum needs to be tailored to suit the cultural context. In addition, academic institutions need to consult with agencies delivering training and health services in order to determine how to construct the most appropriate and effective education programs.

The knowledge produced though this research informed the development of a new Bachelor of Science (BSc) degree in Community Health Education (CHE), which is scheduled to launch in September 2016. (For information for prospective students, see: ) The program adds to the degree offerings in the School of Nursing, College of Health Sciences at Moi University, Eldoret, Kenya.

Outputs from the project include two reports on the pre- and post-fieldwork workshops, a book chapter, and two policy briefs. One policy brief addresses community health worker education and training in a protracted refugee context, while the other is about building an education model for building health care capacity in a protracted refugee situation.

The full report can be downloaded HERE.

IDRC Policy Brief

An Education Model for Building Health Care Capacity in Protracted Refugee Contexts 

By F. Beryl Pilkington, Isabella Mbai, Judith Mangeni, & Izzeldin Abuelaish

The refugee population in Africa continues to grow as more and more people destabilized by wars and conflicts within their own countries are forced to flee to neighboring countries. The Dadaab refugee camp located in Garissa County, Kenya is one of the oldest and largest camps in Africa hosting around 326,600 refugees mainly of Somali origin. Given that the population is much larger than intended for these camps, access to social services, education and health is a huge challenge. Humanitarian nongovernmental organizations (NGOs) provide basic health care services with the aid of the refugee community health workers (CHWs); however, these workers receive only brief training. Meanwhile, the refugees face numerous health related challenges including outbreaks of communicable diseases which are preventable. Reliance on humanitarian NGOs for health care is protracted displacement situations like Dadaab is not sustainable. There is a need to equip refugees to play a greater role in meeting the primary health care needs of their communities. A qualitative study was conducted to collect the views of the main stakeholders including NGOs involved in training CHWs, the Ministry of Health (MOH), CHWs, and prospective candidates for training in community health regarding the education needs for health workers in Dadaab. Findings clearly indicated overwhelming support for the development of a health-related degree, with most of the prospective students and CHWs expressing interest in taking the degree. The knowledge obtained was used for the development of a BSc degree in Community Health Education that is ready for implementation. This policy brief highlights the importance of developing education models aimed at addressing health and higher education equity issues in protracted refugee situations.

Download complete brief HERE