E-combating disease in sub-Saharan Africa

by | Jul 4, 2018 | Case Studies, Evidence for Change, Featured, General

This article describes how The Medical Research Council developed a bespoke e-learning curriculum for frontline

 workers at the research unit in The Gambia (MRCG) involved in combating disease in West Africa.

This project took Bronze at the 2017 Learning Technologies Awards for Best Learning Technologies Project – International Public & Non-profit Sector.


The Challenge

The Medical Research Council (MRC) is a national funding agency, part of UK Research and Innovation, and for over one hundred years it has been dedicated to improving human health. Today, the organisation supports research across the entire spectrum of medical sciences, in universities and hospitals, in MRC units, centres and institutes. Their work ranges from laboratory research on genes and molecules, right through to research with people, such as clinical trials and population studies.

This case study will focus upon the Medical Research Council’s research unit in The Gambia (MRCG), now part of the London School of Hygiene and Tropical Medicine. The goal of the MRCG is the eradication of disease in the West African country of The Gambia through a scientific program of disease control, vaccinations and nutrition interventions. In this small country of 1.9 million people, many diseases exist, such as Malaria, Hepatitis A and Typhoid fever, mainly due to a lack of access to proper healthcare and certain preventative vaccines, proper sanitation and the ability to provide adequate treatment. 

Health and demographic research in sub-Saharan Africa relies on local fieldworkers who are recruited by research organisations and given classroom training. These fieldworkers gain the consent of local communities to gather samples and data, provide health promotion and education, and are the public “face” of health research in the region. MRCG employs approximately 1,200 staff of which 300 are fieldworkers.

Without this important role being played, essential data would be unavailable for research into scientific solutions surrounding malnutrition and disease.

Prior to 2012, fieldworkers at MRCG were recruited from local communities with a secondary-school level of education and trained in fieldwork skills by attending a 12-week classroom-based training course. Running these training courses were not only costly in terms of time and money, but also were difficult to run in a timely manner following recruitment, and difficult to refresh. In addition, classroom training depended on a cadre of 15 trainers who, over time, had dwindled in number, making classroom methods difficult to sustain.

The project’s goal was to increase the resilience of training health workers through the use of technology-enhanced learning, but before they could achieve this the MRCG would have to ensure appropriate infrastructure for e-learning, including power, network and computing facilities. They also needed to resolve issues surrounding high running costs of training and develop a sustainable supply of trainers who would provide a standardised quality of training.

The Solution

Once local capability had been tested, including power and internet access, the MRC launched a pilot initiative to explore the use of technology in the Fieldworker Development Programme. Using an existing web-based virtual learning environment already used by the MRC in the UK, they launched a pilot ‘blended learning suite’ that could be used with some basic ICT support and accessed with the low-bandwidth that was available.

The e-learning modules were written in HTML 5, which allowed trainees to access the learning on smartphones.

Initial module onwards…

The initial module, piloted with 20 fieldworkers, focussed on community engagement and tested the ‘flipped classroom’ method, before trainees attended a practical session with a community where their performance could be assessed. As the e-learning developed, further modules were developed, alongside an online exam which formed the basic fieldwork training course.

The fieldworker role

The project trains the fieldworker to work effectively with local communities, so as to gain consent for the field study to commence. Once this has been achieved they need to become proficient in a number of critical skills, such as taking physical measurements including weight of infants, sample taking and demographic data collection.

Blended learning

To reflect these duties, the programme offers e-learning alongside tutor-led face-to-face and practical training, covering core skills to get the job done, such as basic maths and writing skills and quality data collection techniques.

The tutor-led teaching is complemented by a virtual tutor who provides feedback and guidance during activities, exercises and questions. The modules contain interactive diagrams, e-workbooks, and this asynchronous approach allows the trainees to ask questions and explore the content in the Fieldworker Manual.

The Results

Over five years the MRC has successfully introduced e-learning to support the training for fieldworkers in The Gambia. This project also demonstrated that e-learning could be used even where there were bandwidth and other infrastructure difficulties.

The results show that the project delivered a learning solution that was better, faster and cheaper than the previous method, and managers reported less discarded data and better community engagement.

A cost saving of 73% running costs was also reported, plus a 60% saving in learner-time compared with classroom training.

And let’s not forget the most important result: the engagement of countless families and communities, who benefit from the knowledge, advice and assistance of the MCRG fieldworkers, contributing to helping improve the health of people around the world.

4 tips for helping to launch your content

  • A phased-in approach will ensure that e-learning projects become part of organisational culture
  • Always make sure that your learning aligns with the organisational strategy
  • Rigorously evaluate the technologies that you could employ with your e-learning
  • Try to involve senior management in the planning and ownership of the e-learning


Download this case study (PDF)


By Laura Overton, Towards Maturity
Follow on Twitter: @LauraOverton @TowardsMaturity

The case study has been created as part of the Towards Maturity and Learning Technologies Awards Good Practice Partnership, established in 2011.

About The Medical Research Council

The Medical Research Council (MRC) improves the health of people in the UK – and around the world – by supporting excellent science, and training the very best scientists. The MRC is part of UK Research and Innovation.

This case study has been independently investigated and developed by Towards Maturity as part of our Good practice Partnership with e.learning age and the Learning Technologies Awards. It was first published in e.Learning age Magazine.

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