Evaluation of a synchronous training program on common primary care medications for community health workers in Karnataka, India

Community health workers (CHWs) are a sustainable solution for chronic disease care in rural India. Though CHWs often face medication-related questions from patients, they do not receive standardized training on primary care medications. In our study, we delivered a workshop on medication use, mechanism of action, appropriate dosage, and side effects to 147 CHWs in two districts of rural Karnataka and assessed its effectiveness in increasing the knowledge, self-efficacy, and confidence of participating CHWs. This quasi-experimental study evaluated a workshop that was collaboratively designed with stakeholders from primary health centers (PHCs)—including medical officers and community health workers (CHWs)—to enhance CHWs’ medication-related knowledge, confidence and self-efficacy. One workshop covered 64 CHWs in Ramanagara district, while four workshops together covered 83 CHWs in Madhugiri. Participants completed a pre-workshop and post-workshop assessment of medication-related knowledge, self-efficacy and confidence. The pre- and post-workshop median knowledge scores and proportion of CHWs with high self-efficacy and confidence were compared using Wilcoxon’s signed rank test and McNemar test, respectively. Overall, 140 of the 147 (95.2%) participating CHWs completed the pre- and post-workshop assessments. More than 87% of CHWs reported medication-related responsibilities, but fewer than 33% had received information on medications in the past year. After attending the workshop, the median knowledge scores out of 20 increased from 11 to 16 (p < 0.01), and there was a statistically significant improvement in self-efficacy and confidence in completing medication-related responsibilities. Over 92% of CHWs found the training engaging, easy to understand, and relevant to their duties. This workshop was successful in providing CHWs with a baseline level of knowledge and confidence to manage medication regimens, particularly when CHWs are often confronted with medication-related tasks. This workshop provided the foundational knowledge for CHWs to better promote medication adherence and monitor for side effects.