PT - JOURNAL ARTICLE AU - Wood, Siri AU - Roberts, Ericka AU - Stout, Aurora Anna AU - Kaboré, Alain AU - Namagembe, Allen AU - Cover, Jane AU - Ndiaye, Marème Dia AU - Diokh, Mouminatou AU - Sèye, Farmata AU - Balderston, Beth TI - Capacity-Building Through Digital Approaches: Evaluating the Feasibility and Effectiveness of eLearning to Introduce Subcutaneous DMPA Self-Injection in Senegal and Uganda AID - 10.9745/GHSP-D-24-00019 DP - 2024 Sep 13 TA - Global Health: Science and Practice 4099 - http://www.ghspjournal.org/content/early/2024/09/18/GHSP-D-24-00019.short 4100 - http://www.ghspjournal.org/content/early/2024/09/18/GHSP-D-24-00019.full AB - Key FindingsThis evaluation found that eLearning can be an effective training approach for diverse health care provider cadres, including community health workers and pharmacists, as demonstrated by high scores on the subcutaneous DMPA knowledge assessment and good injection proficiency (measured by health care worker’s implementation of the 4 critical steps).Post-training supervision for eLearning trainees was found to be crucial. This aligns with the World Health Organization’s recommendations for digital training that complements, rather than replaces, traditional in-service training for health systems strengthening.Key ImplicationsThe results of this evaluation highlight that to extend our digital learning capacities, more investment should be made to develop the necessary support systems for eLearning to reach health workers with limited or no access to smartphones or computers, who live in areas with weak network connectivity, and/or who have lower literacy levels.Program managers should consider using eLearning approaches in combination with in-person skills-building sessions and on-site supervision to optimize mastery of skills by learners.Training health workers is one of the biggest challenges and cost drivers when introducing a new contraceptive method or service delivery innovation. PATH developed a digital training curriculum for family planning providers who are learning to offer subcutaneous DMPA (DMPA-SC), including through self-injection, as an option among a range of contraceptive methods. The DMPA-SC eLearning course for health workers includes 10 lessons with an emphasis on informed choice counseling and training clients to self-inject. In partnership with Ministries of Health in Senegal and Uganda, the course was rolled out in select areas in 2019–2020, including during the COVID-19 pandemic when physical distancing requirements restricted in-person training. We conducted evaluations in both countries to assess the practical application of this digital training approach for contraceptive introduction. The evaluation consisted of a post-training survey, an observational assessment conducted during post-training supportive supervision, and an estimation of training costs.In both countries, a majority (88.6% in Uganda and 64.3% in Senegal) scored above 80% on a DMPA-SC knowledge test following the training. In Senegal, where there was a comparison group of providers trained in person, those providers scored similar on the post-test to eLearners. Providers in both groups and in both countries felt more prepared to administer DMPA-SC or offer self-injection to clients after receiving a supervision visit (93%–98% of eLearners felt very prepared after supervision as compared to 45%–72% prior). The evaluation results suggest that digital approaches offer a number of benefits, can be cost-effective, and are most optimal when blended with in-person training and/or supportive supervision.