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This VTT is a train-the-trainer project that trains health care professionals and workers to complete a clinical diagnosis of strep throat to treat patients and prevent the development of rheumatic heart disease. Three groups will be trained: 1) healthcare professionals will be trained in a train-the-trainer format so they can become a National Training Team and can train health center/post nurses 2) health center/post nurses will learn the knowledge and skills for patient assessment and management and when to refer patients, 3) community health workers, teachers, and pharmacists will learn to recognize symptomatic children and how and when to encourage parents to seek treatment for children with sore throats that could develop into rheumatic heart disease.
The Nkwazi Rotary Club completed a community needs assessment and reported:
Community members and stakeholders consistently emphasised the need for accessible, timely healthcare that prevents childhood diseases from becoming lifelong disabilities. They prioritized strengthening local health system capacity, equipping frontline workers with proper tools and training, and keeping children healthy and in school. The importance of community education to address health misconceptions was also highlighted.
The Nkwazi Rotary club further described these gaps and challenges:
challenges and gaps in the community's behaviors, skills, and knowledge.
• Clinical Skills Gap: Frontline nurses lack standardized training in early diagnosis of streptococcal infections, ARF, and RHD, despite seeing numerous sore throat cases.
• Community Awareness Gap: Limited understanding among families about the seriousness of untreated strep throat and its connection to heart disease.
• Systemic Gap: Fragmented referral pathways and inconsistent follow-up for suspected cases.
• Behavioral Gap: Delayed care-seeking due to competing priorities, transportation challenges, and initial reliance on home remedies or informal treatment.
The project will address these gaps and challenges through:
The project employs a three-tiered "train-the-trainer" model:
Tier 1: An inbound Vocational Training Team will train 10 Zambian medical professionals to form a National Training Team (NTT).
Tier 2: The NTT will train 36 health center/post nurses in evidence-based protocols for identifying and managing strep throat, ARF, and early RHD signs.
Tier 3: Trained nurses, supported by the NTT, will train Community Health Workers, teachers, and pharmacists in early recognition and referral.
Key components include:
• Standardised curriculum adapted to Zambian context
• Provision of diagnostic tools (stethoscopes, otoscopes) and educational materials
• Post-training mentorship program via WhatsApp for ongoing support
• Integration with existing Ministry of Health systems and data collection
The long term plan for sustainability includes:
Oversight: Transition to Ministry of Health's Non-Communicable Disease unit, with Beat RHD Zambia providing technical support. District Health Offices will monitor integration into routine services.
Financial Responsibilities: The Ministry will incorporate successful elements into national RHD prevention programs. Patients' costs for follow-up will be covered through national health insurance (NHIMA), with project assistance for enrollment.
Expected Behavior Change: -
1. Health workers will consistently apply early detection protocols
2. Community members will seek timely care for sore throats
3. Schools will integrate RHD awareness into health education
4. Referral pathways between community and clinical settings will be strengthened
Sustainability Mechanisms:
• The National Training Team remains as a permanent resource
• Training materials become part of national nursing curriculum
• Data collection integrated into existing health information systems
• Community health committees assume ongoing awareness activities
The timeline for the project:
January 2026- cadre review, grant submission
March 2026 - grant approval by TRF
April-June 2026 - grant preparations by the Nkwazi and Lander Rotary Clubs
July 2026 - VTT in Zambia for training
August-September 2026 - Training continues in Zambia through the mentorship program
October 2026 - Data collection in Zambia
November-December 2026 - Data analysis
January 2027 - final report
Project funds will be used for:
VTT Expenses - Travel and Accommodations
Zambian Personnel Expenses - Travel and Accommodations for Zambians
Equipment - Stethoscopes and otoscopes for each training participants; projector
Project management - agreement with Ministry of Health
Publicity and Signage
Monitoring and Evaluation
Training Supplies - printing of manuals and instructional toolkits given to each participant
In-Country transportation for Zambian project facilitators and VTT
Stakeholder partner meeting to facilitate sustainability
Contingency
Lander Club members are involved through:
-Participation on the VTT
-Developing and maintaining financial records
-Assisting in grant writing
-Making travel arrangements
-Ordering supplies
-Developing curriculum and instructional materials for three different conferences
-Providing instruction
-Assisting in evaluation and monitoring
-Assisting with data analysis
-Assisting with final report
-Raising grant funds
-Obtaining cadre review
Nkwazi Club members are involved through:
-Training conference management
-Ordering and preparing instructional materials for conferences
-Designing and implementing a public relations plan
-Conducting needs assessment
-Making travel arrangements
-Assisting in grant writing
-Curriculum review
-Identifying participants for training
-Developing and maintaining financial records
-Assisting in evaluation and monitoring
-Assisting with data analysis
-Assisting with final report
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