Community Transformation Training (CTT) is broadly aimed toward the whole community. It is accomplished by trained local people sharing the truths they have learned with their neighbors.
Briefly, the CTT concept as practiced by International Health Resources (IHR) can be summarized under the following five points:
Prevention: Higher priority is given to home to home preventive medicine than to curative medicine through clinics. While clinics are used as back up, the chief concern is to provide understanding and instruction in the area of preventive medicine, which aims to avoid disease and health breakdown. IHR health workers are nevertheless trained in treating basic health problems as well as in the skills of recognizing basic diseases, which then are referred to clinics or hospitals.
Multiplication: IHR seeks to multiply the hands of doctors through training community health workers who visit door to door, in a preventive health care mode. Ordinary people can be taught basic health by repeated cycles of training at several levels.
Multi-sectoral: IHR believes it is important to deal in an integrated way with different sectors of society including medicine, economics, agriculture, sanitation, etc. IHR seeks to serve people in an integrated, holistic fashion, simultaneously serving the physical, emotional, and intellectual concerns of man. True health is viewed as living at peace with one’s inner person and with the world around him, with others and with nature.
Community: IHR seeks the involvement of the community at large in solving their own problems, rather than bringing in solutions from the outside. Rather than giving people a fish, an attempt is made to teach them to fish. Here is where local problems are identified and addressed. This achieves ownership of the projects by the local community. The people own the project and support it, only then can there be hope of enduring, sustainable transformation.
Cultural Adaptation: Because of the wide variety of cultures as well as local health circumstances, the CTT concept as practiced by International Health Resources is sensitive to the need to adapt to each local situation.
Community Health Worker Training: The training of the community health workers begins with two basic trainings ideally one month apart. The first training includes some health lessons but concentrates mostly on the basic concepts of CTT such as how to gather information and begin work. After this first training community health workers go into their community to gather needed data necessary for the work of CTT.
The second training concludes the basic health training and prepares the workers to begin work as a community health worker. The Health Care Worker’s Performance List explains what the community health worker is able to do after basic training. Other training sessions follow with emphasis on meeting the specific needs of the community. Each training time lasts for three days. After this in-class training, trainers ideally accompany the workers into the community to model what has been trained and to assist the workers. Community health workers receive physical training; however, human/moral values also are emphasized since changed behavior is the only way to achieve lasting change in a community.
Lesson Plans: Lesson plans are designed to present the lessons in ways that use a high degree of learner participation that will aid the learner to do a good job. Each lesson plan starts with a problem posing play or picture that leads the learner to see the problem under study and why it is important to them. They are then involved in discovering the causes and solutions to the identified problem. Everything they learn is then put into action in their own homes and also shared with their neighbors.
Picture Booklets: Though there may be a high literacy rate we have found picture books to be useful. The community health workers visit their neighbors using the picture books to share what they have learned. This ensures that the teachings are properly transferred from the to their neighbor and onward.
The booklets are also used as a review of the community health worker training on a given topic, such as diarrhea. They follow the same sequence as did the individual lessons for the topic. Then the CTT trainees practice using the booklet with each other. They are then given an assignment to share the booklet with at least three of their neighbors. The books include:
New booklets are continually being developed to meet the specific needs of a country or area.
