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    Training of health personnel for implementation of ORT program.

    Pal SC

    [Unpublished] 1983. Presented at the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C. 3 p.

    Training of health services personnel at all levels and education of both mothers and community members should be an essential and integral part of the Diarrheal Diseases Control Program. Experience demonstrates that mere distribution of oral rehydration solution (ORS) in the community fails to bring about its proper utilization. The National Institute of Cholera and Enteric Diseases (NICED) in Calcutta monitors training of health personnel at all levels in connection with the National CDD Program of India. Since 1980, 37 2-day national seminars on OR therapy (ORT) were organized by NICED with assistance of the World Health Organization (WHO). Thus far 1754 medical personnel were trained, including 1196 clinicians, 174 public health doctors, 259 health administrators, and 125 of various other categories. The training program was evaluated by WHO in 1982. Wherever training was conducted, there was a significant increase in the proportion of diarrhea cases treated with ORS. Also observed was a downward mortality trend. It is proposed to organize about 400 district level training courses to train the primary health center (PHC) doctors during 1983-84. As a WHO-collaborating Center for Research and Training in Diarrheal Diseases, NICED has conducted 6 intercountry/interregional courses on the different aspects relating to the CDD Program. 92 scientists from 11 countries have been trained. A key question is who to train first if the resources are scarce. Since the community health worker will have to play the pivotal role in home delivery of ORT, they have to be trained by the doctors in charge of PHCs. Thus, the doctors at the different levels of the health care delivery system will have to be trained first. If the decision is made to implement salt/sugar mixture at the house level rather than packets of ORS, the training of the community health workers will have to be geared and designed in such a way that they will be in a position to educate the mothers to prepare the homemade mixture properly. Training should be an integral part of a broad PHC training program. Doctors will be the best trainers because of the clinical nature of the training involved. To improve the training components of the ORT program, the following steps need to be taken: motivation of the national CDD program managers to undertake the training program, preparation of curriculum and teaching aids for the trainers at different levels, establishment of clinical demonstration centers, and provision of adequate funds for training.
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