title: Task-shifting training improves stroke knowledge among Nigerian non-neurologist health workers.
abstract: BACKGROUND
  The increasing stroke burden in sub-Saharan Africa far outstrips the availability of skilled human resource to provide timely and efficient acute, rehabilitative and preventive services. The objective of this study was to examine the impact of a short-term task-shifting stroke training program on the stroke knowledge of a cohort of Nigerian non-neurologist health workers (NNHWs).
  
  
  METHODS
  Utilizing a quasi-experimental design, NNHWs drawn from 53 local government areas of Ogun and Oyo states participated in an intensive, multicomponent one-day stroke workshop. Stroke knowledge was evaluated before and after the training using a self-administered questionnaire.
  
  
  RESULTS
  Out of a total of 210 NNHWs who participated in the session, 116 (55.2%) completed the pre-workshop questionnaire survey of stroke knowledge while 191 (91.0%) completed the post-workshop questionnaire survey. There were no statistically significant differences in the distribution of the age, gender and professional categories of the two groups. The participants' knowledge was significantly increased at the end of the training about stroke risk factors (p<0.001), stroke symptoms (p<0.001) and how stroke develops (p=0.009). The proportion of respondents who understood the FAST mnemonic increased from 10.3% before the training to 90.6% at the end of the training (p<0.001). The professional category of participants was associated with knowledge gain about swallowing test and thrombolysis.
  
  
  CONCLUSIONS
  Our data support the effectiveness of stroke-specific task-shifting training for non-neurologist health workers in a low resource setting. Interim studies with intermediate outcomes are needed to show that improved knowledge results in better care despite resource limitation. Randomized controlled trials will be useful to confirm findings and translate knowledge improvement into practical intervention.
authors.affiliation: Department of Medicine, Federal Medical Centre Abeokuta, Nigeria; Institute of Neuroscience, Newcastle University, UK. Electronic address: rufusakinyemi@yahoo.com.
authors.forename: Rufus O
authors.initials: RO
authors.lastname: Akinyemi
authors.affiliation: Department of Medicine, College of Medicine, University of Ibadan, Nigeria.
authors.forename: Mayowa O
authors.initials: MO
authors.lastname: Owolabi
authors.affiliation: Department of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Adebayo
authors.affiliation: Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria.
authors.forename: Joshua O
authors.initials: JO
authors.lastname: Akinyemi
authors.affiliation: Department of Medicine, Federal Medical Centre Abeokuta, Nigeria.
authors.forename: Folajimi M
authors.initials: FM
authors.lastname: Otubogun
authors.affiliation: Department of Medicine, College of Medicine, University of Ibadan, Nigeria.
authors.forename: Ezinne
authors.initials: E
authors.lastname: Uvere
authors.affiliation: Department of Medicine, Federal Medical Centre Abeokuta, Nigeria.
authors.forename: Olaleye
authors.initials: O
authors.lastname: Adeniji
authors.affiliation: Department of Medicine, Federal Medical Centre Abeokuta, Nigeria.
authors.forename: Osimhiarherhuo
authors.initials: O
authors.lastname: Adeleye
authors.affiliation: Department of Medicine, Federal Medical Centre Abeokuta, Nigeria.
authors.forename: Olumayowa
authors.initials: O
authors.lastname: Aridegbe
authors.affiliation: Ben Carson School of Medicine, Babcock University, Ilishan-Remo, Nigeria.
authors.forename: Funmilola T
authors.initials: FT
authors.lastname: Taiwo
authors.affiliation: Olabisi Onabanjo University, Ago Iwoye, Nigeria.
authors.forename: Shamsideen A
authors.initials: SA
authors.lastname: Ogun
authors.affiliation: Department of Medicine, College of Medicine, University of Ibadan, Nigeria.
authors.forename: Adesola
authors.initials: A
authors.lastname: Ogunniyi
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D020521:Stroke / Q000451:nursing / Q000517:prevention & control; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013663:Teaching
keywords: Africa; Health workers; Nigeria; Non-neurologists; Stroke; Task shifting