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ARTICLES
Year : 2015  |  Volume : 13  |  Issue : 2  |  Page : 135-155

Task sharing in rural Haiti: qualitative assessment of a brief, structured training with and without apprenticeship supervision for community health workers


1 MPH, is a doctoral student in the Department of Anthropology at Yale University
2 doctoral student in the Department of Anthropology at Emory University
3 MPH, is a doctoral student in the Department of Global Health, School of Human Evolution and Social Change, at Arizona State University
4 MPH, is a doctoral student in the Department of Epidemiology, School of Public Health, at the University of Washington
5 BA, is a psychological practitioner. She is a member of the Mental Health and Psychosocial Support Team at Zanmi Lasante/Partners in Health in Haiti’s Central Plateau
6 MD, PhD is a psychiatrist and anthropologist. He is Assistant Professor of Psychiatry, Global Health, and Cultural Anthropology at the Duke Global Health Institute and the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine

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Source of Support: None, Conflict of Interest: None


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Despite growing support for supervision after task sharing trainings in humanitarian settings, there is limited research on the experience of trainees in apprenticeship and other supervision approaches. Studying apprenticeships from trainees' perspectives is crucial to refine supervision and enhance motivation for service implementation. The authors implemented a multi-stage, transcultural adaptation for a pilot, task sharing training in Haiti entailing three phases: 1) literature review and qualitative research to adapt a mental health and psychosocial support training; 2) implementation and qualitative process evaluation of a brief, structured group training; and 3) implementation and qualitative evaluation of an apprenticeship training, including a two year follow-up of trainees. Structured group training revealed limited knowledge acquisition, low motivation, time and resource constraints on mastery and limited incorporation of skills into practice. Adding an apprenticeship component was associated with subjective clinical competency, increased of confidence regarding utilising skills and career advancement. Qualitative findings support the added value of apprenticeship according to trainees.


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