• a. Physiological factors---include how people feel, their physical health, and their levels of fatigue at the time of learning, the quality of the food and drink they have consumed, their age, etc.
• b. Psychological factors---such as mental ill-health or mental tension and conflict all hamper learning. No learning can take place in the absence of motivation. In general, for motivation to take place in health education sessions, encouragement and praise stimulate learning of health-related skills. You will need to encourage the people to whom you are giving your health education messages.
• c. Environmental factors--states that learning is hampered by bad environmental conditions such as distraction, noise, poor illumination, bad ventilation, overcrowding and inconvenient seating arrangements.The location (including the organisational set up) of the health education setting, the internal setup, the accommodation, decoration and sanitary conditions are all very important for efficient learning. For example, if you are giving a health education session in your Health Post, and if the room is very overcrowded with healthy as well as sick individuals, some of them sitting on the floor and others by the door, this will hamper the learning among all of the attendants
• d. Teaching methodology and materials----your teaching methods and materials should be planned and organised in an appropriate manner to address the way of life of the individual/ community. For example, for uneducated members of the community, role play/drama with posters and pictures would be appropriate methods and materials, respectively. Whereas leaflets, for example, are good teaching materials for those community members, who can at least read. On the other hand, if you are teaching your community about ITNs utilisation, you need to use demonstrations. For example, if you want to teach a mother about proper position and attachment for breastfeeding, it is good first to demonstrate the correct position of the mother. You can then test whether she has learnt this correctly by asking her to demonstrate the proper positioning and attachment back to you. You should encourage her to practice it until she gets it right. This should continuously be accompanied by your comments and feedback on her level of achievement.

Types of Training

• Pre-service: involves the preparation in general of any trainee for qualifying for a certain set of professional or specific job oriented roles.
• Orientation training: refers to preparation for the specific job to be performed in a particular position.
• In-service training: It is a refresher course given with a view of updating knowledge and skills of the workers in any department or organisation

Phases of Training (Arrange Training in Different Phases)

a) Preparation (pre-training) phase---this phase involves several activities to be carried out:

• Conducting training needs assessment. This is to ask whether there is a need gap for a certain kind of health workers to carry out some work.
• Identify aims of the training program.
• State needs or problems that are expected to be solved
• Identification of the trainees. Recruiting and selecting learners is the single most important step in any training program.
• Know who the trainees are. Their educational and training background experiences they have with this problem, topic or subject, their interests, and their social and cultural background.
• Identify resources available- time, equipment, space, trainers and teaching materials including posters, flipcharts, leaflets...etc
• Determine the four important areas (domains) of training going to be changed (knowledge, belief, attitude and skill).
• Determine the training methods to be used depending on the targeted domain of learning. The methods include lecturing, lecture and discussions, demonstrations, or role plays/drama, etc.
• Arrange the logistic condition of the trainees and facilitators.
• Determine how the trainees and the program be evaluated. This may include pre-test and post-test, feedback from the trainees at the end, follow-up for the graduates.

b) Training phase---in the actual training phase, you need to give training based on the training curriculum or guidelines for a model households or any community health development agents, and the training phase must insure the opportunities for learning by doing and also creating necessary climate or environment in which learning can take place effectively

c) Post-training phase (follow-up component or evaluating the training) --- evaluation is a process of determining the degree or amount of success with pre-determined training objective.

While You Are Evaluating Your Training, You Should Consider the Following Points:

• Input evaluation- examines what resources were used based on which we can calculate the cost per graduate-efficiency.
• Process evaluation- looks at what methods are used; see how trainees are progressing, training run as per the schedule...
• Output evaluation- reviews the quality and numbers of people trained to see if they meet standards and the targets or objectives set during the planning process. This includes the knowledge and skill tests.
• Outcome/Impact evaluation- examines what the results or effects the graduates have achieved in the work they are trained for. This is performed using field assessment through observations and surveys.