Training Information/Overview

Preamble

Leprosy continues to be a devastating disease if not detected and treated in time. Despite incredible development in medical care every year more than 200,000 people (including more than 20,000 children) are diagnosed with leprosy globally. Nigeria is among the 23 global priority countries that contribute >97% of world leprosy burden. In 2018 more than 2095 new leprosy cases were reported including 6% children (indicating ongoing community transmission). In 2018, WHO endorsed the implementation of SDR-PEP as one of the strategies towards zero leprosy.

The Ready4PEP Nigeria project is an initiative between the NLR international and LTR Nigeria. It is a multi-stakeholders project aim to implement active case finding, contact screening, administration of SDR-PEP and disability prevention in Nigeria. These strategies are in line with general objectives of the National TB and Leprosy Control Programme and WHO global leprosy strategy.

The training of trainers is organized by LTR in collaboration with NLR, NTBLCP and ILEP partners. The main objective of the TOT is to train health care professional at the national level and provide them with necessary knowledge and skills needed to plan and effectively facilitate step down trainings on leprosy care including recent advances such as SDR-PEP and prevention of disability using self-care and combined self-care group.

Sixteen (16) participants were invited from the National TB and leprosy training Centre Zaria, National TB and Leprosy Control Programme Abuja and Jigawa State TB Control Programme.

Training Objectives

The main objective:

The main objective of the training is to introduce participants to the Ready4PEP project and provide them with knowledge and skills including facilitation skills that will enable them plan and effectively facilitate step down trainings for General Health Care Workers.

Specific Objectives:

• At the completion of TOT the following objectives will be
• To orient participants on the READYPEP Nigeria Project
• To ensure that participants across all level are provided with necessary knowledge and skills needed to effectively and efficiently train others on leprosy care and prevention including SDR-PEP and Combined Self Care Group
• To understand the Standard Operating Procedures guiding the implementation of the of the Ready4PEP
• To ensure that all the grey areas on SDR-PEP and CSCG addressed before the end of the training.

Methodology

Training Techniques: The following techniques were used to train participants during the TOT

• Lecture discussions
• Power Point Presentation
• Group exercise/Group work
• Role play
• Demonstration
• Group presentations

Materials

1. Power Point Presentations
2. Ready4PEP SOPs
3. NTBLCP Leprosy Training Manual
4. Short Videos
5. Skin Diseases memory cards and flash cards
6. SkinApp, Siilo and Ready4PEP electronic data collection form (ODK)

Training Activities/Sessions:

Participants were introduced to Leprosy training Module, SDR-PEP and Ready4PEP Project SOPs under the following topics:

• Suspecting Leprosy
• Diagnosis of leprosy
• Classification of leprosy
• Administering leprosy treatment
• Leprosy complication/reactions
• Leprosy and Stigma
• Contact Screening
• Eligibility and recruitment in Ready4PEP
• Screening for Skin Diseases
• Screening for leprosy (Group presentations)
• Administration of SDR-PEP
• Facilitation skills The training program was for a period of four days.

The sessions were conducted using the experiential learning model with participants using their real experiences to guide the training process. A lot of emphasis was made on the importance of using participants’ experiences during training, principle of adult learning, facilitation skills, how to deal with difficult participants and effective ways of presentation. The participants were asked to practice teach back using the Leprosy training modules and the Ready4PEP SOPs. The groups were allocated a topics and were asked to prepare a lesson plan for presentation while other participants to evaluate the performance of their colleagues using a checklist that addresses effective facilitation and learning. Facilitators gave feedback especially on areas that needed improvement.

FACILITATORS RECOMMENDATIONS

The facilitators gave the following recommendations:

1. Ensure pre session meeting to allocate time, roles and topics
2. Emphases on the use of lesson plan
3. Make a checklist of what is needed for the session (organization)
4. If handouts are available, go through it.
5. Time keeping. Be there before the participants, follow ground rules and assign a time keeper
6. Make use of parking lots/assignment
7. Carry both facilitators and participants along
8. Ensure you use your teaching aids
9. Ensure you maintain a class discipline
10. Ensure you manage difficult participants

Summary of topics covered

Opening of the TOT, introduction to SDR-PEP and Ready4PEP Nigeria project

• Overview of SDR-PEP
• Introduction to Ready4PEP Nigeria project (Aims and Objectives, Coverage and target for some indicators)

Eligibility and recruitment in Ready4PEP

• Recruitment of index cases
• Contacts Screening
• Quiz and Role-play exercise

Screening for Skin Diseases

• Skin diseases & Stigma
• Screening for skin diseases in the era of COVID-19
• Recognizing skin diseases:
  • Play Skin Diseases games
  • The SkinApp
  • The Siilo

Screening for leprosy (Group presentations)

• Suspecting and Diagnosing leprosy
• Leprosy treatment
• Leprosy classification
• Leprosy and Stigma
• Leprosy complications/Reactions
• Combined Self-Care Group (SCG)
• Self-care

Administration of SDR-PEP

• SDR-PEP administration
• Adverse event
• Medication safety

Preparation for Training

• Common rituals in training
• How to prepare for training
• Planning for Facilitation

Introduction to curriculum/lesson plan development

• Scope and lay out of a lesson Plan
• Effective facilitation
• Facilitation Obstacle
• Facilitation skills
• Identification and application of appropriate teaching aids
• Dealing with difficult Participants

Recording and Reporting in Ready4PEP

• Introduction to Ready4PEP R&R tools
• Hands on practice on Ready4PEP e-forms (ODK forms)

What Next

• Formation Siilo Group for Ready4PEP
• Direct Technical Assistance to NTBL Training Centre Zaria
• Step down trainings for LGTBLS/MDT officer and CLW

ANNEXES

Annex 1: List of Participants

Annex 2: Participants score in training evaluation

Annex 3:  Training program

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