Community Health Workers and Assessed Digital CPD: A Trial in Malawi and Rwanda

Abstract

Community health workers are asked to deliver more programmes each year with little assessed training. This paper reports a randomised encouragement trial of an AFU short, credit-bearing CPD sequence on maternal danger signs and referral documentation. Workers who completed assessed modules improved referral form completeness. Knowledge scores rose, but the operational gain was documentation quality, which supervisors could audit. Devices shared at health-post level outperformed a model that assumed each worker had a personal smartphone. Durham University should offer public-health CPD that ministries can recognise, with identity-checked assessment and a downloadable evidence pack for the district office. Digital is justified here because the worker cannot leave the catchment. It is not justified if the course cannot be finished offline.