‘First of all, I need training’: a qualitative study evaluating the Fiji community health worker training program

Abstract
Background Fiji faces a growing burden of diseases and a significant emigration of health workers, heightening
the role of community health workers (CHWs) in healthcare delivery. Effective training is crucial for CHWs to enhance
their capacity and service quality. This study evaluates CHW training in Fiji, aiming to identify areas for improvement.
Methods A qualitative study was conducted, encompassing a review of national policies on CHW training, six focus
group discussions, and interviews with CHWs and their supervisors across Fijian subdivisions. This study was collaboratively designed with Fiji’s Ministry of Health and Medical Services (MOHMS). Data was transcribed, coded, and thematically analyzed using the Community Health Workers Assessment and Improvement Matrix (CHW-AIM).
Findings While CHW training policies in Fiji are well-established, discrepancies exist between the policy and its
implementation. Challenges include inconsistent training for new recruits, limited resources, and variability in training
content and frequency of training across divisions, especially concerning noncommunicable disease (NCD) training.
Interpretation To enhance the CHW training program in Fiji, a restructuring and standardisation of both pre-service
and in-service training is necessary, tailored to the needs of each division. Investment in ongoing capacity building, alongside the development and revision of training guidelines, particularly for managing NCD complications
in the community, is crucial. Implementing these changes will enable CHWs in Fiji to be better equipped for providing
essential community-based care.
Keywords Community health worker, Qualitative study, Training program, Republic of Fiji