Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
January 2011
[Type text]
Page 1
Table of contents
Contents
Page
Foreword
Introduction
Course description
15
16
16
completion
Student record keeping and coordination
18
Certification
19
Program cost
20
20
22
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Contributors
FMOH technical staff
Workshop participants from Oromiya, Amhara, SNNPR, Tigray, Diredawa and Harari Regions
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FOREWORD
Through our flagship Health Extension Program, we have been able to train and deploy more than
33,000 Health Extension Workers in an innovative effort to provide universal access to essential
health services and create healthier communities throughout the country. Beyond the deployment of
existing human resources, Federal Ministry of Health (FMOH)and Regional Health Bureaus (RHB)
have also been working towards improving the knowledge and skill of HEWs who already working at
community level.
This guidance is intended to serve as a tool for the Blended Learning Program for Level IV Health
Extension Practitioners management and its implementation at different levels that are involved in
the process of pilot and scale up of blended learning education.
The Ministry believes that these implementation guidelines will be useful in coordinating and
delivering blended education to improve knowledge and skill of HEWs at their work place.
Federal Ministry of Health would like to acknowledge UNICEF Ethiopia and The OU for technical
support in writing of this Implementation Guidance for Level IV Blended learning upgrading
program for Health Extension workers in Ethiopia.
Page 4
Introduction
In order to operate effectively, health systems must carry out a number of basic functions.
The World Health Organization (WHO) has categorized these functions into six essential
building blocks. One of these is to have a health workforce that is responsive, efficient, and
effective and treats everyone equally to achieve the best health outcomes possible, given
available resources and circumstances.
The Health Extension Program (HEP) is an innovative community-based program. It aims to
support the creation of a healthy environment and healthy living through community (Kebele)
based essential health services, as well as targeting and working with individual households.
The philosophy of the HEP is that the right knowledge and skills are transferred to
households so they can take responsibility for establishing and maintaining their own health.
The program promotes health awareness and the proactive management of family health, and
it aims to improve access to effective community health services.
More than 33,000 Health Extension Workers (HEWs) have already been trained and
deployed across Ethiopia since 2005. They are playing an important role in delivering a wide
range of community-based health promotion and disease prevention services.
The Federal Ministry of Health (FMOH) now plans to update and improve the skills and
knowledge of the Level-III HEWs to achieve certification at Level-IV, so they are better able
to provide community level services that will be efficient and meet the needs of individuals
and families at household level.
Since 2008, FMOH have been developing occupational standard and curriculum for level IV
health extension services and subsequently preparing learning materials to realize the
upgrading program. To initiate the upgrading program the following preparatory phase
documents have developed to help the implementation process:
i. Occupational mapping and career structure
ii. Ethiopian occupational standard (EOS)
iii. Model curriculum
iv. 13 learning modules
Draft by Mohammed Hussein Abaseko
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v. Implementation guideline
vi. Blended learning tutor guide
vii. Practical learning guide and logbook
The FMOH is providing a model of education and training that includes a blended learning
component, which will enable trainees to remain working in their communities while they
learn from specially designed self-study materials, with the support of their blended learning
tutor.
The UNICEF Ethiopia, in partnership with The Open University UK (OU) and AMREF, is
supporting the development of an innovative program of print-based blended learning
resources to teach the theoretical components of the Level-IV Health Extension curriculum.
The learning resources will help prepare students for short periods of skills-based training in
local Health Centres, Health Colleges or Hospitals. Theoretical and practical learning are
blended coherently into the curriculum design from the outset. Students must demonstrate
their achievement of learning outcomes for the theory components and the theoretical basis
for the practical sessions by completing self-assessments and tutor-marked assignments.
Demonstration of practical competencies is evaluated by Practical Training Mentors during
and after the practical sessions, using conventional face-to-face methodologies appropriate to
the context.
The purpose of this Implementation Guidance is to set out the aims of the pilot program, the
key features of the blended learning resources and the roles and responsibilities of all of the
stakeholders in ensuring the success of the program.
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Intake,
orientation and assessment occur in a face-to-face setting. Blended models offer limited face-toface contact to provide additional support services, including educational counseling and student
support meeting for the student.
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The Federal Ministries of Health and Education have approved the following Level-IV blended
learning curriculum. There are 13 theoretical modules divided into 225 study sessions, each of 2
hours duration. The student should have to complete at least 3 study sessions per week. Modules
are of different length. Each module will have between one to four Study Support Meetings with
the Blended learning Tutor, depending on the length of the module (see draft schedule on p.20),
and an average of four practical skill training days that follows completion of the theoretical
module.
Federal Ministry of Health advises the training institutions to follow and align to the
principles and policy of TVET training modality and evaluation system.
Page 8
5. Course description
Course
code
Course name
ANC
Labour and Delivery Care
Number of
study sessions
22
11
Allocated hours
Theory Practical Total
44
40
84
160
182
22
PNC
09
18
16
34
IMNCI
16
32
40
72
20
40
32
72
Communicable Disease
42
84
40
124
23
46
40
86
Immunization
10
20
16
36
Nutrition
12
24
24
48
Family Planning
12
24
24
48
13
26
16
42
Non-communicable diseases,
emergency care and mental
health
Health management, ethics and
research
Total
19
38
40
78
16
32
24
56
225
450
Health
512
962
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Mobilize necessary resources for the pilot and for scaling up program
Revise the list of drugs and medical equipment for Health Posts based on the new
skills of the Level-IV Health Extension Practitioners
Support and avail logistic supplies to the RHBs and Practical Training Health
facilities
Provide training for assigned Blended Learning Tutors and Supervisors regionally
Appointing Practical Training Mentors and identifying suitable health institutions for
the practical training
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Distribute learning materials and guides to blended learning and practical centers
Appointing Practical Training Mentors and identifying suitable health institutions for
the practical training
Distribute learning materials and guides to blended learning and practical centers
6.3
One or more Health Science Teaching Colleges in each region will serve as an affiliated
Regional Blended Learning Centre. The college will have the responsibility for
coordinating and monitoring academic issues, including theoretical learning and practical
training, student registration, providing orientation, keeping regional student records,
preparing the examination for each Module, serving as the examination centre, providing
and marking the exams, and finally will award a diploma for each student who
successfully completes the Level-IV upgrading program. They are also responsible for
carrying out the blended learning briefings of Practical Mentors and for student
orientation, as well as being responsible for training of newly recruited tutors and
distribution of learning materials and guides to students and tutors. There will be at least
2 Blended Learning coordinator/Supervisors per Region from the affiliated Health
Science College that will be assigned to coordinate the overall program implementation.
Blended learning coordinators will have the responsibility preparing TMA in the future.
6.4
Practical Learning Centers are District Hospitals or Health Centers that have been
identified and have enough case load and responsibility for conducting clinical practice,
arranging Study Support Meetings and keeping student records for the practical sessions.
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6.5
6.6
District Health Offices are responsible for facilitating a good learning environment for
their students in their respective woreda. They will have an overview of the pilot and
ensure the study calendar / schedule of student learning is managed, together with the
responsibility for implementation of the practical skills training and examination dates
6.7
Development Partners
UNICEF, The Open University, AMREF, WHO and others have been involved in
developing the pilot program. They will continue to work in partnership together with the
Federal Ministry of Health towards successful implementation of the Level IV Health
Extension Program pilot to the best of their ability and as funding allows. RHB will sort
out all options and opportunities to have additional budget support as health system
support (HSS).
6.8
The Blended Learning Tutors have a pivotal role to play in the successful implementation
of the pilot program. One tutor will assist the maximum of 10-15 students per one batch.
Their responsibilities include the following: (Refer to Blended Learning Tutor Guide for
detail)
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Maintaining regular contact with learners for the duration of their studies
Providing information about additional resources for learners who want to pursue a
particular interest in greater depth
Distributing assignments for learner assessment and clarifying assignment tasks and
options to learners
Learning and advising about administrative procedures and deadlines that affect
learners.
6.9
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Attend an initial meeting with the blended learning centers supervisor and the
students to help you all to begin to establish a relationship, to reflect on each
students current ability and needs, and to work with them to establish a smooth
learning environment
Student responsibility
Individual HEWs must agree to adhere to the terms set out below, in order to participate in
the Level IV Blended Learning Pilot Program.
Page 14
Undertake self-supported study for at least 3 study sessions per week (each of about 2
hours) on the Blended Learning curriculum Modules.
After graduation
HEWs who successfully complete their Level-IV education in the Blended Learning Program
each have to provide a minimum of three years public service to compensate the investment
spent in their training.
Learning Tutor for assistance through email and phone at any reasonable time. The Blended
Learning Tutor can support students this way on a one-to-one basis, as well as through the
group Study Support Meetings.
overview of individual students in their group and will check the progress for each student
and give appropriate advice and guidance.
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ii.
iii.
Practical evaluation of clinical skills by several Practical Learning Mentors on the basis
of repeated real life experience in different clinical situations (and linked to each of the
theory Modules): this will count towards 60% of the final grade.
The grading system should have to follow the TVET policy and principles in the region.
The other options for theoretical assessments are
Student have to pass all the tutor marked assignment (TMA)
A candidate must pass all the Module based examinations before being allowed to sit
for COC qualifying examination.
A candidate failing tone or two Modules (subjects) will repeat the subjects.
A candidate who fails three or more modules shall not be allowed to continue on the
program.
Practical Assessment
Successful completion (signed off by the Practical Training Mentor) of all practical procedures
related to each Module is also required. Clinical training is a pre-requisite for completing level IV
certification in Health extension practitioners upgrading course. Logbooks used as an interactive
vehicle between students and clinical mentors to assist both student learning and health facility
teaching. It is expected that after completing practical training the students would be able to submit
their log-book to the Blended Learning Supervisors. 100% of the required practical procedure has to
be fulfilled by each student
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10.
Each student profile, including her academic results, will be organized and kept at the Regional
Blended Learning Centers. Student tutor-marked (TMA) assessment results will be collected
immediately from Blended Learning Tutors after completion of each Module; the results will be
processed and organized at these Centers. Regional Blended Learning Centers will also be
responsible for sending electronically organized regional student profiles via e-mail to the
Federal Coordinator within 10 days after 4 consecutive Modules examination.
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Federal Blended
Learning Coordination
office (FMOH)
Regional Blended
Learning Taskforce
Regional Blended
Learning Center
BL Supervisor
Student
Practical Training
Mentors
Blended
Learning Tutor
Regional COC
11.
Certification
Page 19
12.
Program Cost
The Federal Ministry of Health will cover the cost of designing the occupational map,
development of Occupational Standards, development of curriculum and writing of learning
modules, as well as the cost of printing of the learning materials. The remaining program
implementation cost should be covered by Regional government (RHB). \
11.
Using appropriate monitoring and evaluation activities to ensure the attainment of the desired
objectives of the blended learning program during implementation is essential.
The following major program activities are going to be monitored and evaluated throughout the
pilot implementation period. Those indicators will assess the input, process and the output of the
overall pilot program:
i. Program operational structure and coordination
Federal level
Regional level
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The following list of indicators will be used as a way of tracking activities and accomplishments of
the blended learning program.
Category
Indicator
Input
Budget availability,
adequacy, timely
Curriculum
Ethiopian
Occupational
Standards
Implementation guide
Blended Learning modules
BL Tutor guide
Process
(performed
on Organization by level
schedule)
Student Self study
Study Support Meetings
Practical training
Modular exam
Output
Ratio of student passed for
theory
Ratio
of
students
well
performed practical
Ratio of students passed COC
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Session
Theory
rd
22
Feb 3 wk Apr 4th wk 2011
11
May 2nd wkJun 1st wk
PNC
9
IMNCI
16
Modular examination for the
above 4 modules
Mark and publish result
Health education
20
Communicable
42
diseases
Hygiene and
23
environ. health
Immunization
10
Modular Exam
Mark and publish result
Nutrition
12
Family Planning
12
AYRH
13
Non-Comm.Diseases
19
Health Management
16
Modular exam
(Final)
Mark and publish result
Graduation
SSM
3 times
2 times
TMA
2
1
1time
2 times
1
2
Practical
May 1st week
Jun 2nd wk-Jul
1st wk
July 4th week
Sep 2nd week
1 times
4 times
2
4
Oct 4th wk
Feb 2nd week
2 time
1 time
May 1st wk
2 times
1 times
1 times
2 times
1 time
1
1
1
2
1
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