Getting back to work: Training health staff for life and work after Ebola

July 2015

As countries with cases of Ebola virus disease work tirelessly to get to zero cases, efforts are already underway to re-train health workers and return them to the workforce. In May, a pilot training programme was completed in Lofa County, Liberia.

Training of Ebola health workers, Liberia
WHO/M. Winkler

More than 700 Liberian health workers have completed a pilot training programme. The new course was rolled out by Liberia’s Ministry of Health and WHO in northwestern Lofa County over 6 weeks. The participants - nearly 70% of the county’s health care workforce - included doctors, nurses, hygienists, physicians’ assistants, drug dispensers, cleaners, nurses’ aides, vaccinators, clinic supervisors and social workers.

Foday Kanneh, a Ministry of Health training coordinator, says a new training package was needed for health workers returning to their jobs—to refresh important skills but also address weaknesses exposed by the Ebola outbreak.

“Many health workers who became infected with Ebola got sick because they were not following or aware of basic infection prevention and control measures like hand hygiene, wearing gloves or proper waste disposal,” says Kanneh.

“When minimum safety precautions for any health care setting are not being practised, it’s very challenging to suddenly scale up to the heightened measures required for an Ebola outbreak,” says Dr April Baller, who heads WHO’s clinical management and infection control and prevention teams.

Kanneh, Baller and other Ministry of Health and WHO staff worked together to design a rigorous training programme to address these gaps, and one specifically adapted to the post-Ebola context.

“The course aims to support the restoration and strengthening of the health system which virtually collapsed during the epidemic, while also giving health workers the confidence and capacity to respond in the event that Ebola re-emerges,” says Baller.

Experiences in Ebola put to use for return to basic health services

The Lofa County training sessions took place in the towns of Voinjama, Zorzor, and Kolahun and drew health workers from the county’s 59 health facilities. Clinical and non-clinical staff were divided into 2 groups. Every participant had 4 days of theoretical and practical training on infection prevention and control (IPC) measures and psychosocial support for patients, followed by 3 days of targeted Ebola response training at a functioning Ebola Treatment Unit (ETU). Clinical staff also took refresher classes on triage and emergency case management.

Training of Ebola health workers, Liberia
WHO/M. Winkler

Some 40 trained facilitators led the sessions. Nearly all had experience during the outbreak as ETU health workers and trainers. The training team also included Ebola survivors, who play the part of patients during simulation exercises and critique the trainees on the quality of care received.

“I normally do outreach in communities to prevent HIV and gender-based violence,” says Doris Sannoh, a trainee and social worker from Vahun. “During the Ebola outbreak I found myself helping out in the triage area of our hospital, counselling and assisting sick patients. I never had any infection prevention training as a social worker, but I needed it. As health workers, we all need training like this.”

Kanneh says on-site mentorship and monitoring will be key to ensuring that IPC measures and clinical skills acquired during the training course are put to regular and effective use.

Data and surveys from the pilot training course in Lofa County are currently being reviewed by the Ministry of Health and WHO. If found effective, the programme would be refined as needed and expanded nationally in coordination with partners.

The goal is to reach all 10,000 of the country’s health care workers and train mentors in all 15 counties by the end of 2015.