2. Prepared by:Thandi Mndzebele –MOH (RHM Program Manager) Thabile Methula –WVS (Health and HIV Coordinator) SWAZILAND 2012-2014

3. 1)RHM (Rural Health Motivators) Background in Swaziland 2)TTC background in Swaziland 3)Adaptation process 4)The materials adopted 5)Trainings by MOH

4. 6) Training done by World Vision Swaziland 7) Challenges of implementing TTC 8) Feedback

5. Def: Rural Health Motivator is a community health volunteer, elected by the community through the community leadership. RHM Program has been in place since 1976 RHMs are trained for 12 weeks on various health topics which includes TTC They further have in-service trainings after the initial 12 weeks training from Government and other partners

6. Report to the Ministry of for activities implemented and health data collected at community level RHMs receive a stipend of SZL 350 per month ($ 35) from the Government of Swaziland Currently the total number of RHMs is 5320 in all the four regions of the country (Hhohho,Lubombo, Shiselweni and Manzini) covering 55 Tinkhundlas (Constituencies) and about 360 chiefdoms

7. Health education Community Mobilisation e.g Child Health Days, PMTCT campaigns, water & sanitation activities Defaulter tracing Growth monitoring of under fives Link the community to the health system Initiate income generating projects Home based care Provide first aid treatment and refer

8. The TTC was introduced to the country by WV-Swaziland WV-S made a presentation to the Senior Management of the Ministry of Health MoH gave the green light and a Community Health programme was tasked with adaptation of the TTC The TTC forms part of the 12 weeks long training curriculum for CHWs known as RHMs in Swaziland

9. The process to review the curriculum took about two months to have final copies ready for trainings. HOW? A Consultant was engaged Technical team was assembled Review of current materials and the generic ttC Consultation and dialogues with relevant stakeholders Drafts and pretesting Final draft materials developed

10. Training of Trainers 2 weeks long WV TTC experts conducted trainings Training of CHWs (RHMs) 2 weeks of training for literate RHMs Non-literate (trained for 1week) Training of Lead CHWs One week training

11. While the MOH trained RHMs on TTC in the Lubombo Region through funding by the World Bank, WVS collaborated with the MOH by providing training to RHMs through their Area Development Programs (ADPs) Each ADP is targeting to train at least 50 RHMs over a period of 2 yrs (25 each year) Currently WVS, has trained over 380 RHMs in the other 3 regions excluding Lubombo since 2013-2015 Number of RHMs trained by WVS still to increase as more ADPs still to train on TTC

12. Training module and duration same as done by the MOH MOH involved in some of the trainings conducted by WVS

13. TRAINER TRAINEE Ordinary CHWLead CHW Facilitators ManualParticipants manualCHWs Participants manual Participants manual10 x Story booksSupervision manual 10 x Story books1 x household handbookReference material booklet 1 x household handbook Teaching aid posters  1 x A4 visit message guide  1 x A4 food poster Data collecting book Teaching aid posters  5 x A1 foot steps  1 x A4 visit message guide  1 x A4 food poster Summary book Materials for practicals  Stationery Stationery

14. At the end of training each CHW was given: A certificate of attendance 5 x Household Handbook 1 x data collecting register 10 x story books A branded carry bag A brand umbrella

15. Major challenge was expensiveness of producing materials Duration of training was long (2 weeks) Training needed more Trainers per session Challenges of having attached Trainers This proved difficult to have them from their emplyers whenever needed. Lack of concentration and commitment from participants during training due to two weeks of absence from their homes

16. TTC training methodology highly appreciated by both Trainers and Trainees TTC proved to be unique and highly effective as it is more involving TTC provided CHWs with a guide on how to record when conducting a home visit Methodology provided enough time for practice by participants

17. Trainees learning materials are user friendly either in local language and or pictoral. Local language for literate CHWs Pictures mostly for non-literate CHWs TTC had The Government support and is very comprehensive.