Evaluating the impact of training tools on health workers during the introduction of Pneumococcal Conjugate Vaccine: A mixed method study

Abstract Introduction: The Pneumococcal Conjugate Vaccine (PCV) was launched phase wise in India in 2017 and was expanded nationwide in 2021, during the peak of the COVID-19 pandemic. The pandemic restrictions resulted in the hybrid trainings (physical and virtual) for the health workforce. A number of training tools were developed for the health workers to include pre-recorded sessions from immunization experts, presentations and ministry approved Frequently Asked Questions (FAQs), along with the animated videos. As the hybrid model of training was deployed for the first time in the state of Nagaland, the present study aims to evaluate the impact of the training tools used for PCV introduction in Nagaland. Methods: Mixed-method study was conducted in two districts from Nagaland selected using random sampling. In-depth interviews and Focussed Group Discussions (FGDs) were conducted with medical officers, Auxiliary Nurse Midwife (ANMs) and Accredited social Health activist (ASHAs), to gather their experience with the training tools. Quantitative data was collected through a survey among 36 ANMs and ASHAs to evaluate the impact of training tools. Based on Kirkpatrick’s model, qualitative data was thematically analysed using NVIVO 14 software, and quantitative data was analysed using SPSS software v.21. Result: Findings highlight that 29% of the respondents had received training through virtual sessions and 5% via hybrid mode. The majority (66%) of the trainings were in person. Most health workers, particularly the ANMs, found the training materials to be informative and comprehensible. Majority of the respondents preferred in-person training. The finding also revealed the challenges of online trainings included lack of focus, network instability, limited interactions with trainers and clarification of doubts real-time. Furthermore, the videos were highly appreciated for its precise content and comprehensiveness by the respondents (69%). Most of them (87%) found the videos as a pivotal tool for skill-based learning and community sensitization. Conclusion: The study revealed that the field workers still prefer face-to-face trainings. The benefits of online trainings were also highlighted. The training tools had significant positive impacts on health workers' performance and its effectiveness on community and creating awareness among the communities. The study further makes key program-based recommendations to improve trainings in future. This included sessions with visual aids in the FAQs/leaflets, their availability in local dialects for explicitness and use of more interactive elements such as video-based tools for information dissemination.