Task sharing in rural Haiti: qualitative assessment of a brief, structured training with and without apprenticeship supervision for community health workers

Despite growing support for supervision after task sharing trainings in humanitarian settings, there is limited research on the experience of trainees in apprenticeship and other supervision approaches. Studying apprenticeships from trainees’ perspectives is crucial to refine supervision and enhance motivation for service implementation. The authors implemented a multi-stage, transcultural adaptation for a pilot, task sharing training in Haiti entailing three phases: 1) literature review and qualitative research to adapt a mental health and psychosocial support training; 2) implementation and qualitative process evaluation of a brief, structured group training; and 3) implementation and qualitative evaluation of an apprenticeship training, including a two year follow-up of trainees. Structured group training revealed limited knowledge acquisition, low motivation, time and resource constraints on mastery and limited incorporation of skills into practice. Adding an apprenticeship component was associated with subjective clinical competency, increased of confidence regarding utilising skills and career advancement. Qualitative findings support the added value of apprenticeship according to trainees.