Building Confidence and Care: The Impact of Blended Learning on Health Workers

Amira Abera, a midwife, works on a tablet while on duty at Haik Health Center in Ethiopia.

Across Ethiopia, thousands of frontline health workers are gaining new skills thanks to an innovative blended learning approach developed by the Ministry of Health with support from JSI. By combining flexible eLearning with in-person practice, the program makes training more accessible, efficient, and impactful—ensuring that health workers can continue serving their communities while growing their service offerings. At Haik Health Center in Amhara, midwife Amira Abera is one of the many providers whose renewed confidence and expanded expertise are transforming services for mothers and children.

Skills-building: Ever-needed, Difficult to Consistently Achieve

Amira Abera is one of nearly 8,000 frontline community health workers who enrolled in blended learning. These trainings, delivered in partnership with Ethiopia’s Ministry of Health by JSI’s Gates Foundation-funded Strengthening Service Delivery (SSD) project, apply an interactive and engaging approach that includes case scenarios, simulations, and practical questions and feedback. They emphasize hands-on skill practice and meaningful collaboration among learners without straining the health system.

In the past, participants like Amira often had to travel away from their health facilities for extended periods to attend training, placing a strain on remaining staff, which in turn affected service delivery. As a result, health facilities would not send providers to offsite training, limiting provider capacity and the range of services offered in health facilities.

For instance, Haik Health Center, where Amira works, was previously unable to offer intrauterine contraceptive device insertion services due to a lack of skills in this area among its health care providers. The health providers at the center also had no training on the use of ultrasound machines, which had been donated to their health center. Amira and four of her colleagues from Haik were some of the first enrollees in blended learning. The learning covered maternal and child health, family planning, and supply chain. When they completed the training in 2025, Amira and her colleagues were able to start offering intrauterine contraception device services, preconception care, antenatal care, and ultrasound scanning, all contributing to improved quality of ANC services.

With SSD’s blended learning approach, we can learn from where we are,” Amira says. “We take courses at home, during lunch breaks at work, or at night while on duty. It helps us use limited time wisely.” She also noted that the courses are convenient and concise. Amira explained that the in-person sessions were especially valuable, as they allowed participants to practice in major hospitals, learn new clinical procedures, and follow standardized protocols. “The training helped me update my knowledge and skills and build my confidence,” Amira shared.

The Approach

In 2024, the blended learning approach was rolled out, and 279 health centers with nearly 8,000 providers enrolled. Prior to this, all modules of the blended learning approach, which combine e-learning and face-to-face sessions, are nationally approved by the MOH. Significant emphasis has been placed on ensuring that both eLearning and face-to-face activities are learner-centered, with a design that incorporates social, technical, and cognitive presence to enhance the learning experience. Blended learning evaluations revealed a marked improvement in participants’ knowledge, as evidenced by significant gains between pre- and post-test scores. Participants also reported increased confidence in their clinical skills as a result of the blended learning.

Results

Findings from a recent supportive supervision visit indicate a 3% increase in first antenatal care visits subsequent to the introduction of the antenatal care blended learning program. The visit also identified an increase in intrauterine contraceptive device insertion uptake, rising from 878 to 3,970 following the implementation of family planning blended learning training.

Of the 7,785 providers enrolled nationally—2,702 in eLearning modules and 5,083 in blended learning modules—6,383 successfully completed the eLearning components, reflecting an overall completion rate of 82%. The providers trained are from eight regions across the country.

JSI and the MOH aim to expand this reach to over 8,000 participants through a combination of pure eLearning and blended learning modules. Approximately 2,400 primary health care professionals have already registered on the MOH eLearning site, showing high demand for further professional development opportunities.