Impact of a training program for community health officers on neurological disorders: insights from the Karnataka brain health initiative.

Abstract

Background: Neurological disorders pose a substantial burden on India's healthcare system, contributing significantly to disability and mortality. In rural areas, where access to specialists availability is limited, Community Health Officers (CHOs) play a crucial role in bridging the gap in care. However, the lack of structured training programs for CHO's in neurological disorder management highlights an urgent need for targeted capacity-building interventions. This study evaluates the impact of a structured training program on the knowledge and skills of CHOs in managing common neurological disorders under the Karnataka Brain Health Initiative (KaBHI).

Methods: The quasi-experimental study was conducted across three districts in Karnataka-Chikkaballapura, Kolar, and Bengaluru South. A total of 295 CHOs participated in a two-hour training program delivered by expert neurologists, covering headache, epilepsy, stroke, and dementia through lectures, discussions, and case-based scenarios. Pre- and post-training knowledge assessments using a standardized multiple-choice questionnaire evaluated the program's impact. Feedback from participants was collected to assess training quality.

Results: Of the 295 participants, 280 completed both pre- and post-training assessments. Significant improvements were observed in knowledge scores across all disorders, with a mean score increase from 57.46 ± 16.4 to 75.79 ± 12.9 (mean difference: 18.3, p<0.001). The program was effective regardless of prior clinical experience, indicating its adaptability. Feedback highlighted high satisfaction with the training's structure, content, and delivery.

Conclusion: This study provides strong evidence that structured training programs can significantly enhance CHOs' ability to diagnose and manage neurological disorders, particularly in resource-limited settings. Beyond immediate knowledge gains, these findings highlight the broader potential for integrating similar capacity-building initiatives for neurological care into national healthcare programs, such as the Ayushman Bharat Mission and Health and Wellness Centers (HWCs). By equipping frontline healthcare providers with specialized skills, such programs can improve early diagnosis, facilitate timely intervention, and enhance patient outcomes, ultimately reducing the burden of neurological disorders at the primary care level. Future phases of KaBHI, implemented state-wide, will focus on ensuring long-term sustainability by refining and expanding this training model to address a wider range of neurological conditions and strengthening its integration into primary healthcare frameworks.