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Table 1 Comparison of standard and PALM PLUS training approaches of health care workers

From: Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package

Standard training approach by Malawi Ministry of Health

PALM PLUS training approach

Centralized by health district

Decentralized (on-site at individual clinics)

Presentations (primarily didactic and unidirectional) by external experts

Educational outreach (facilitative, case-based) by trained peer facilitators

Large groups (50-100 participants); little discussion or interaction between participants and trainer

Small groups (10-15 participants); discussion and interaction among participants and between participants and trainer encouraged

Disease specific care

Symptom-based and integrated care

Written, narrative guidelines with figures, tables and algorithms, text-heavy

PALM PLUS clinical tool consisting of algorithm- and symptom-based guidelines in a single spiral-bound book, with graphical interface

Financial training allowances given to individual participants

No financial training allowances given to individual participants

Individual staff trained one at a time

All staff at a health facility learn at the same time

Conducted over 1–14 consecutive days

Conducted over 8–12 training sessions over a three-to-four month period