Training health cadres to response the COVID-19 pandemic in Pujon Kidul Village Malang Regency

Article history Received: 2021-08-12 Revised: 2021-10-04 Accepted: 2021-10-26 Published: 2021-10-29


INTRODUCTION
Training of health cadres on the prevention and control of COVID-19 is an important and strategic effort. Health cadres who have been trained can participate in screening the ones who are suspected or questionable to have the cases, thus they can help carry out quarantine or self-isolation or immediately direct the suspect person to a hospital if they are

Article history
suspected of being infected with COVID-19. Health cadres can urge people to stay at home. An important measure to protect the public from exposure to infection is to encourage them staying indoors (Qian et al., 2020). Meanwhile, at the same time, health workers such as nurses and doctors are working hard in hospitals to treat COVID-19 patients. Corona Virus  has become a worldwide pandemic. Every country is facing a threat from this virus. The number of confirmed cases in the world reported as of November 19, 2020 was 55,928,327 and 1,334,003 cases of death (WHO, 2020) while in Indonesia 488,310 confirmed cases included: 62,080 in treatment (12.7% of confirmed cases), 410,552 cases recovered (84 ,1% of confirmed cases), 15,678 cases died (3.2% of confirmed cases) (Gugus Tugas Percepatan Penanganan COVID-19, 2020).
The urgency of this community service lays on the need to control the transmission of COVID-19 by carrying out promotive, preventive, curative, and rehabilitative efforts. The important role of health cadres is to socialize clean and healthy living behavior during the pandemic. Training of health cadres in preventing and controlling COVID-19 in Indonesia is rarely carried out. The results of community service published in 2020 show that there were no any cadre training related to the prevention and control of COVID-19. Previous community services that provided training to health cadres included: posyandu management (Angelina et al., 2020), diabetes mellitus prevention (Hendrawan, 2020), posyandu financial management (Hiswati & Sapariyah, 2020), adolescent health (Veftisia et al., 2020), basic life support training (Maulidta K W1, Dyah R P1, 2020). This is what distinguishes the community service carried out by the aforementioned authors, it is by providing training for health cadres related to the prevention and control of COVID-19. The purpose of this community service is to increase the knowledge of health cadres related to the control and prevention of COVID-19 in Pujon Kidul Village using an online platform with YouTube videos.

METHOD Problem solving framework
The initial development of this community service program was designed to strengthen the health sector in Pujon Kidul Village in regards to the many visits from outside the region to Pujon Kidul village. Pujon Kidul Village, Pujon District, Malang Regency is one of the most developed villages in the field of economic empowerment and village development with tourism managed independently by the village. Existing tourism is an attraction for tourists to visit this village. According to a report from the Head of Pujon Kidul Village, there are no less than 2000 visitors on weekdays and on weekends is up to 6000 visitors. The increase in tourist visits, of course, needs to be anticipated regarding the health status of the local community of Pujon Kidul Village and also the tourists. The spread of disease due to environmental factors and poor health behavior is a typical problem that needs to be anticipated with preventive and promotive measures in tourist areas such as Pujon Kidul Village.
Furthermore, the problem-solving framework at the beginning of this community service program is designed to change in concerns to the COVID-19 pandemic progress in Indonesia in March 2020. The changes made by the service team, which initially focused on empowerment in the health sector for the prevention of infectious diseases as an impact of tourist villages turned into how the Pujon Kidul Village is facing the COVID-19 pandemic. The COVID-19 pandemic has greatly impacted the daily lives of the people of Pujon Kidul Village. The impact in the health sector is fear and confusion to face the COVID-19 pandemic. Taking concern on this condition, the community service team focused on assisting the health cadres by providing training to carry out efforts to control and prevent the COVID-19.

Realization of problem solving
Realization of problem solving is by providing training to health cadres in Pujon Kidul Village using online methods. The training management process used an input-process-output approach. The indicators for input include: determination of training participants appointed by the Pujon Kidul Village government, training equipment, training books/modules, training media (video uploaded on YouTube). The indicators for process include: providing training using an online method, it was by sharing a video link that had been uploaded on YouTube, providing comments on questions from training participants in the YouTube chat room. The indicator for output is an increase in the ability of the health cadres of Pujon Kidul Village in dealing with the COVID-19 pandemic.

Target audience
The target audience of this community service program is the health cadres of Pujon Kidul Village. The criteria for health cadres include: having experience being a health cadre for toddlers or the elderly, being active in community activities, having communication facilities such as mobile phones, internet networks, willing to participate in online training, being appointed by the village government.

Method used
The method used was training with an online platform. The online platform used was videos uploaded on YouTube. Furthermore, training participants were given a video link. Feedback from viewing videos in the form of questions and discussions was done using the YouTube chat room.

Participants of COVID-19 prevention and control training
This online platform training was attended by 10 health cadres. Recruitment was carried out in coordination with the Village Head as the head of the driving force for Family Welfare Development (PKK). Health cadres were selected according to the following criteria: active cadres, having a communication device (mobile phone), and were recommended by the head of the PKK Pujon Kidul Village. Demographic characteristics of health cadre include: age, education, experience, and occupation can be seen in Table 1. From Table 1 it can be seen that the average age of the health cadres is 41.2 years with experience as a health cadre for 13.8 years. The highest level of education is junior high school (40%). The work of the health cadre was divided into the same two groups, namely working (50%) and not working (50%). This shows that health cadres are in productive age and have good experience being a health cadre.

Online training through YouTube video platform
The training materials consists of five materials including: communication management to deal with the COVID-19 pandemic, prevention and control of COVID-19, village preparedness in dealing with COVID-19, community empowerment during the COVID-19 pandemic, and spiritual approaches during the COVID-19 pandemic (Table2). This training material is presented in the form of videos and module books. All videos above can be seen on this channel link https://www.YouTube.com/channel/UCpF7KQycZY7gjrEiZKOth1A (Figure 1).

Figure 1. Video material on training health cadre in Pujon Kidul Village
Furthermore, to see the effectiveness of the usefulness of online training with YouTube video platform, an analysis can be carried out using YouTube Studio. The analysis was carried out at an interval of 19 August 2020 since the video was first published until 18 November 2020. The results of the analysis can be seen in Table 2 to communication management facing the COVID-19 pandemic were 15 comments (48.4%). The comments submitted by the training participants included questions related to the theme of the training material. The weakness of training with the online method of viewing videos is the certainty of participants seeing the complete video presented from beginning to end. This can lead to missing messages delivered in video. Books/training modules As an effort to avoid missing messages due to the uncertainty of the duration of the video watched from the beginning to an end, training materials are also provided in the form of books/modules. The module is entitled "Module of Covid-19 Prevention Training for Health Cadres" with a total of 54 pages with ISBN number 978-979-796-525-9. This module has also received a copyright certificate from the Ministry of Law and Human Rights with registration number: EC00202034636, 21 September 2020; Registration number: 000204548; 2020. Participants in the overnight online training process were able to combine the provided media, both viewing videos and reading training books/modules. The training module is written in simple language and assisted by visualization in the form of images. It aims the module can be easily understood by the trainees. Understanding related to the training material was measured by a questionnaire measuring 2 times before and after the training. There are 11 questions in the questionnaire including: communication with COVID-19 patients, symptoms of COVID-19, modes of transmission, places of isolation, self-isolation, COVID-19 response villages, health checks, community empowerment, cadre duties, spirituality, lockdown policies. The results of measurements before and after training can be seen in Table 3. From Table 3, it can be seen that there is no difference in scores before and after training. This shows that the use of good media with a combination of modules and videos is maximal in providing knowledge to participants. While the weakness is the accuracy and honesty of participants in filling out the questionnaire between before and after the training. Our online training model cannot control the existing situation and conditions, including during the evaluation.
Constraints in this training, as shown in table 3 above, the results of the pre-and post-training assessments were the same for all cadres. This is very subjective and difficult to control by the service staff because of the lack of supervision during pre and post-tests. Another obstacle is the lack of 2-way interaction because the service is very limited in using online platforms, for example using zoom or G-Meet. This is due to the limited facilities and infrastructure of health cadres.
Training of health cadres on the prevention and control of COVID-19 is a strategic service program to carry out. Health cadres are non-medical elements of society who are the front-line in efforts to prevent and control COVID-19 (Nyashanu et al., 2020;Prescott et al., 2020). Health cadres who have good knowledge capacity will greatly assist the village government in controlling COVID-19. This was also confirmed by the Head of Pujon Kidul Village and the coordinator of health cadres. There is 1 health cadre who does not have a cellphone. Making training videos is an alternative in this community service program. In this pandemic condition, there are various ways and methods that can still be done, even with the existing limitations. The spirit to serve and empower the community, multi-sectoral collaboration is one of the keys in efforts to prevent and control COVID-19.

CONCLUSION
Knowledge of health cadres related to COVID-19 is considered very good after receiving online training. The health cadres who are good in knowledge capacity will greatly assist the village government in controlling the COVID-19.