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