Oops!!!! Disaster in training HSA’s in Mangochi

Are you involved in training Health Surveillance assistants (HSA’s) in health projects in Malawi? Do you have evidence based facts of their success in implementation after training?

I have just returned Mangochi where we trained a group of 30 HSA’s from Mangochi Zone and another group of 30 volunteers from Chilipa Zone where I faced major challenges with the HSA’s .Relax and I will share my experiences with you.

Having trained HSA’s in Mulanje and Zomba (a total of over 300) I thought with my vat experience, the training in Mangochi would be smooth. I had overlooked a number of issues which I would advise any one willing to train HSAs in Mangochi to seriously consider before rushing doing anything. Mangochi district ,in Southern Malawi is 190 km from Blantyre and has the beautiful Lake Malawi on one part of it and lake Malombe on the other. Lake Malawi has various tourist resorts and Hotel and the environment is very friendly .I stayed at the mini Martins Lodge
The district though very rural has various health research projects including the College of Medicine department of community Health and the Malawi Liverpool Welcome Trust. Most of the community projects involve training and using HSA’s

HSA’s take the invitations to attend the trainings as a privilege and look forward to the financial incentives that are associated with the training.
Some HSA’s claim from Mangochi that in order to win to win their favours and loyalty some NGOs pay them an allowance of up to USD 50 per day despite the government lunch allowance being USD 7.

We thought we had done our assignment well ;had talked to the responsible officers and agreed we would give an allowance of USD 7 for the one day training but in addition we would provide drinks and snacks .As a background in 2007 I had done a situation analysis in Mangochi on why HSA’s despite working in the community were not involved in identifying children with eye problems .I spoke to a group of representative HSAs (20 in total) and they all indicated what they lacked was the skill and if trained they would be willing to do such a job. So this training was organised as part of my study and in response to the findings .We conducted the first training to a group of 30 Volunteers from a different area on day one ,gave them the allowances and snacks. During day 2 we arrived at a different place to train HSA’s ;started the training but noted that the participants were not attentive. In probing why ,we learnt that they wanted to know how much money they would get at the end of training ,and whether we had brought t-shirts and other incentives for them. After explaining that we would only give USD 7 as per what volunteers got the previous day, the whole workshop turned into chaos with the HSA’s threatening to boycott the training and forfeit the highly needed skills if they did not get all their monies .

So how did it all went at the end ? Not very well – I sustained a few emotional bruises .I would like to write a whole blog about this –when I am better.
For now you can gues!!!!


Have you experienced difficulties in conducting training? What did you do? Or are you just interested to comment.

Email me!