Using eLearning to improve and retain knowledge of community health
workers in maternal and neonatal health in Rwanda: A prospective cohort
study
Abstract
Background: In Rwanda, Community Health Workers (CHWs) serve a
crucial function in providing community-based maternal and neonatal
health (CBMNH) services. However, limited access to refresher training
contributes to knowledge gaps among CHWs, affecting their confidence and
ability to execute their roles effectively. This study aimed to evaluate
the impact of eLearning on enhancing and maintaining CHWs’ knowledge of
CBMNH. Methods: This prospective cohort study, conducted from
April-October 2021 in two Rwandan districts, evaluated knowledge
acquisition and retention among 36 Community Health Workers (CHWs)
participating in an eLearning course. Knowledge scores were measured
using a structured questionnaire administered pre-training,
post-training, and at a six-month follow-up. Descriptive analysis and
paired t-tests were used to assess mean score differences, exploring the
effectiveness of this eLearning approach. Results: This study
demonstrated an improvement in Community Health Workers’ (CHWs)
performance scores following eLearning training, with an average rise
from 86.5% to 98.2%. The improvement was sustained at a six-month
follow-up. Statistical significance was found between age category and
CHWs’ pre and post-test performance (p=0.01, p=0.04 respectively), and
between years of experience and pre-test scores (p=0.02), highlighting
demographic influences on training outcomes. Conclusions: The
results of this study suggest that eLearning is an effective method for
enhancing and retaining CHWs’ knowledge of CBMNH. The findings support
the use of eLearning as a valuable strategy for strengthening the
capacity of CHWs in Rwanda and other countries with similar contexts.