Customized online and onsite training (COLT) for rabies control officers

In low and middle-income countries, it can be difficult to deliver adequate training for people working in disease control. However, with around 60,000 deaths estimated globally from rabies each year due to the inaccessibility of post-exposure prophylaxis, inadequate or absent dog rabies control programs, and lack of governmental financial support, there is much need for innovative methods to deliver appropriate education to these areas. 

Many e-training programmes are based on participatory learning models in which participants share their understanding and monitor their theoretical knowledge through discussion, questioning and interaction with mentors via the internet. The current most popular e-learning systems for resource-poor settings are massive online open courses (MOOCs) which have been used by tens of thousands of students around the globe. However, this format is not well suited for specific practical training needs, such as the management of neglected zoonotic disease and rabies.

To improve the knowledge of health professionals in rabies enzootic countries, the Institut Pasteur used customized online training (COLT), which focuses on small sets of trainees and is designed for situations where direct training of specific skills by experts is needed. With this approach, it is feasible to tailor training to each individual trainee in a way that would be impractical in a system designed for mass audiences.

In Collaboration with WHO, the University of Lausanne, Switzerland, The HSET foundation, the EU funded FP7 PREDEMICS program and the International network of Institut Pasteur, and with the active participation of FAO and GARC we first organized a COLT course on the control and surveillance of rabies in Dakar, Senegal, in December 2013. The same COLT approach was recently used with success for a second session of this training program on the control and surveillance of rabies organized first online and with the practical training in Phnom Penh, Cambodia, in November 2015.

We designed the workshop for physicians, veterinarians, public health officers and specialists in infectious diseases, virology and/or epidemiology. The course was advertised through a website and by participating international organisations and regional networks. Trainees were selected on the strength of their curriculum vitae, letter of motivation and three letters of recommendation. Twenty participants working in national and regional veterinary stations, hospitals, ministries or research institutes in 10 Eastern and Asian countries were selected and encouraged to start online pre-workshop activities. These activities lasted for about two months and required about 70 hours of individual work, followed by a second online evaluation.

Those who successfully completed these online pre-workshop activities, were admitted to the workshop activities held in Phnom Penh, Cambodia over a period of ten days. Round tables, discussions and practical training activities were given at the Institut Pasteur of Cambodia, at the Calmette Hospital in Phnom Penh and during 2 days in a small Cambodian village for field studies. A mix of international and local expertslead the training activities to ensure the support of the host country and to ensure that debates between participants were informed by a thorough understanding of the local situation in the field.

During the year following the course, discussions on the online forum will continued between the participants and the trainers. These discussions concerning practical disease management issues that arise during the participants’ work illustrate the value of the mentoring provided before, during and after the workshop.

Contributed by Hervé Bourhy of the Institut Pasteur, Paris, on behalf of all the partners involved in the workshop. There is a paper published on the approach in the Bulletin of the WHO.