Train the trainer: improving health education for children and adolescents in Eswatini.

Background: Eswatini has the highest HIV prevalence in the world. One issue at the root of health in Eswatini is a lack of basic health knowledge among children and adolescents, which amplifies the likelihood of disease transmission and poor health outcomes. Objectives: To address the lack of basic health education and to improve health knowledge, we developed and evaluated a medical education program to train shepherds (train-the-trainer) who are supporting children and adolescents at local CarePoints. Methods: To determine the change between pre-test scores and post-test scores, both a paired t-test and mixed-effects regression were performed. Results: The program had 67 total participants, mostly female (67.2%), with an average age of 27.1 years. Following the medical education program, participants had a statistically significant increase in post-training scores. Years of prior schooling, age, and gender did not show a statistically significant effect on post-training scores. Conclusion: Teaching basic health education knowledge to CarePoint shepherds is effective to increase their knowledge and awareness with respect to relevant health topics. This model of directed medical education could be expanded to other community members in Eswatini to bridge gaps in health knowledge and disease awareness. A similar model could be employed in other developing countries with limited health education and limited access to health information.