CAHSS eLearning Impact Evaluation

Impact Evaluation: Assessing the Effectiveness of an eLearning Intervention in Afghanistan and Tajikistan
Grant Award: CAD 183,899

eLearning provides an opportunity to improve knowledge and skills of health care professionals in underserved, remote areas, helping enhance their professional, clinical and managerial capacities. The French Medical Institute for Children (FMIC) provides eLearning services to health care practitioners at Bamyan and Faizabad Provincial Hospitals and Mirwais Regional Hospital, Kandahar in Afghanistan and to the Khorog Oblast General Hospital in Tajikistan.

AKDN eHRC in collaboration with various international partner institutions, including Aga Khan Health Service, Afghanistan (AKHS, A); Aga Khan University (AKU); the French Medical Institute for Children; faculty from Dalhousie University, Canada and faculty from Notre Dame Institute of Education, Pakistan undertook a research study to determine the effectiveness of the eLearning programme offered in Afghanistan and Tajikistan.

The research study aimed to determine the effectiveness of the eLearning intervention in improving retention of knowledge and clinical skills of nurses and midwives on improving Maternal, Newborn and Child Health (MNCH). It focused on assessing whether health care professionals retained knowledge and practiced what they learned through eLearning sessions. Moreover, along with strengths and weaknesses, the factors that lead to success or failure of such interventions in health care settings in low- and middle-income countries were also assessed.

During 2015, the School of Nursing and Midwifery (SONAM) at AKU and AKDN eHRC worked together to design and develop eLearning sessions with pre- and post-tests to measure the impact of the eLearning intervention through an observation list. Knowledge test and results were analysed by researchers along with content experts. Ethical approval was obtained for these studies from AKU’s Ethical Review Committee. In 2016, survey tools were developed and validated while AKDN eHRC designed and developed eLearning Observations, a mobile app to assist with data collection. Thereafter, eLearning sessions on MNCH topics were delivered by SONAM while data was collected from participants through the app. Data analysis, reporting and dissemination activities are planned for 2017.

The study adopted a mixed methods design and data were gathered using a variety of qualitative and quantitative tools. To determine changes in the participants’ knowledge and skills after attending the sessions, MNCH-related knowledge was compared and measured through a pre-, post- and delayed-tests of knowledge. Changes in clinical skills were determined using an observation scale. To assess the strengths and challenges of the approach and underlying factors that enable or hinder the successful implementation of the program, a questionnaire was administered to those attending the sessions; semi-structured interviews of facilitators, program developers and managers/leadership were conducted; and documents related to the Central Asia Health Systems Strengthening eLearning programme such as evaluation reports were analysed.

The two-year research study initiated in April 2015 and concluded in early 2017. The research study project is funded by the Government of Canada, through Global Affairs Canada and Aga Khan Foundation Canada.

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