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WHO MAKE THE BEST ADVISERS OR SUPERVISORS?
Instructors from the training course are often The best persons to provide health
workers with follow-up and support from their program. If instructors and students
develop a friendly and trusting relationship during training, this is likely to continue
after the course is over.
On the other hand, problems often
arise when the supervisors are doctors
or nurses. They may tend to ‘take over’
during their visits to village health posts.
Even if a doctor tries to remain in the
background, the very fact that he is a
doctor causes people to seek his advice
rather than that of the local health worker.
So the doctor finds himself in a ‘double
bind’: If he attends those who beg him
for medical care, he weakens the position
of the health worker. If he refuses
(however politely), he sets an example
of someone who denies assistance he
could easily give. It takes an unusually
sensitive person to handle this situation
well.
One way around this problem is to
have advisers who have neither the
advanced medical knowledge nor the
prestige of doctors. In several programs
in Guatemala, the more experienced
village health workers provide support
for the others. In Honduras, young
school teachers have been specially
prepared to serve as advisers. Their
teaching skills, together with special
training in sanitation, public health, and
community organization, allow them
to work effectively with the village
health workers in organizing community
activities. Yet their relative lack of
medical knowledge—and the fact that
they are teachers, not doctors— lessens
A more experienced health worker meets
with newer health workers from neighboring
villages.
the temptation to provide medical care. They are less likely to take charge and
reduce the health worker to the role of a servant.
WHAT SORT OF RECORD KEEPING IS NEEDED?
Records can be helpful in several ways. Health workers can use them to
evaluate their own work and to get suggestions from their advisers. A training
program can use health workers’ records to plan appropriate follow-up training.
Also, most health authorities require certain records if they are to provide free
vaccines, family planning methods, or medicines for tuberculosis, malaria, or
leprosy.