Organisational aspects and benchmarking of e-learning initiatives: a case study with South African community health workers

Abstract

South Africa desperately needs a comprehensive approach to fight HIV/AIDS. Education is crucial to reach this goal and Internet and e-learning could offer huge opportunities to broaden and deepen the knowledge basis. But due to the huge societal and digital divide between rich and poor areas, e-learning is difficult to realize in the townships. Community health workers often act as mediators and coaches for people seeking medical and personal help. They could give good advice regarding hygiene, nutrition, protection of family members in case of HIV/AIDS and finding legal ways to earn one’s living if they were trained to do so. Therefore they need to have a broader general knowledge. Since learning opportunities in the townships are scarce, a system for e-learning has to be created in order to overcome the lack of experience with computers or the Internet and to enable them to implement a network of expertise. The article describes how the best international resources on basic medical knowledge, HIV/AIDS as well as on basic economic and entrepreneurial skills were benchmarked to be integrated into an e-learning system. After tests with community health workers, researchers developed recommendations on building a self-sustaining system for learning, including a network of expertise and best practice sharing. The article explains the opportunities and challenges for community health workers, which could provide information for other parts of the world with similar preconditions of rural poverty.

Keywords

Africa education (including health education)e-learning organizational development/ organizational change HIV/AIDS health worker case study benchmarking

Introduction

Even though South Africa is one of the strongest economies in Africa, its average life expectancy remains low. This is especially due to an estimated 10% HIV prevalence rate of total population in 2013 (1) and diseases associated with HIV. The number of anti-retroviral therapy clients is expected to increase to 3 million from the current 1.4 million by 2015/16 (2). The spending on HIV-related human resources in health services has grown by nearly 50% since 2008 (2). Combating HIV/AIDS is mentioned in a government’s agreement on main areas of focus in health system policy in 2010–14 (3). The World Health Organization’s aim of ‘responsible and healthy sexual and reproductive health behaviour’ (4) depends greatly on a well-functioning education system that reaches each part of society. But that is exactly where South Africa still has huge deficiencies (5). People in townships are often unemployed, live on welfare and many have not completed 12 years of formal education.

Due to a lack of economic training possibilities and knowledge, the failure rate for start-up projects is extremely high (6,7). The number of Internet users is increasing (8) but still far below the rate of industrialized nations. In the townships, a growing number of people use mobile phones but they hardly have fast Internet access. In a small Internet café in the township of Khayelitsha, one of the few examples for successful entrepreneurship, people are queuing to use the World Wide Web (9). In this township, a ‘digital doorway’ with Internet access points is foreseen to promote e-literacy, technical and programming skills via free unassisted learning programs. It promotes a minimally invasive education approach to information and communication technologies (ICT) through which users teach themselves e-literacy (10). Having access to a (tablet) PC or smartphone with Wifi-access means having better access to education. But Conradie (11) states that so far ‘[…] there are large disparities between e-learning ideals formulated by South African education policy makers and the realities that face e-learning practitioners’. He summarizes the reasons for the digital divide by naming access, skills/training, supporting policy/economic environment and content/applications issues. Under those preconditions the research of a joint German–South African research team started in 2012, hoping to improve learning opportunities for less privileged people.

Framework and partners

The research was rooted in an academic project that developed an e-learning framework for community health workers (CHWs) of HOPE Cape Town Association, South Africa (HOPE). ‘A Community Health Worker (CHW) may be defined as any health worker delivering health care services and who is trained in the context of the intervention but has no formal professional, certificated or degreed tertiary education’ (12). HOPE, a registered non-profit organization, was founded by Reverend Stephan Hippler and has been active in HIV/AIDS treatment since 1999 (13). It trains and places 24 CHWs in selected township clinics, mainly in Cape Town’s biggest township, Khayelitsha, home for about 1.2 million people. HOPE’s on-going training consists of classroom teaching on health-related and social knowledge in the field of HIV/AIDS, combined with interdisciplinary components. HOPE cooperates and practises in the University of Stellenbosch’s Faculty of Health Sciences and Tygerberg Hospital.

The first contact with HOPE was made in October 2011 during a university delegation on Corporate Social Responsibility in South Africa (14). Information management scientists from Neu-Ulm University of Applied Sciences (HNU, www.hs-neu-ulm.de/en) and University of the Western Cape (UWC, www.uwc.ac.za) agreed with HOPE Cape Town Trust’s chairperson, Reverend Stephan Hippler, to initiate a joint e-learning project to improve existing first attempts of the organization. Senior academics and students from HNU and UWC cooperated in this research. HOPE is using the e-learning platform ‘Medmissio Int’l Health Dialogue’, developed and administrated by the Medical Mission Institute Wuerzburg (Medmissio, a Catholic advisory organisation for international health, http://english.medmissio.de). Its online platform aims at supporting medical staff in developing countries throughout the world – i.e. in Africa, Asia, Europe, South and Central America – to gain general health-related knowledge through online courses. The project took place between January and July 2012 and included a field research week in Cape Town in May 2012 (15).

Research objectives and methods along the different phases of the project

The analysis of the benchmarking team focused on finding online sources and institutions offering e-learning content suitable for HOPE’s 24 CHWs and potentially also for other users of the Medmissio platform. The CHWs represented an initial test group, allowing insights that could partially be transferred to other African users with similarly low ICT-related knowledge. Therefore, the research question was: ‘Which tools and framework conditions facilitate learning of non-academic staff in health care and community social consulting?’

The research was conducted in three steps, which are explained subsequently:

Phase I the benchmarking process for content and organizational set-up, took place in January–April 2012 (one day per week) and involved two sub-groups with two and three students working in parallel, both sub-groups being coordinated and supervised by one professor and one scientific research assistant.

Benchmarking is the process of ‘comparison […] that identifies the sources of sustainable competitive advantage (16)’. It means learning from others and thus improving your own skills and processes. Following this concept, competitors and possible best-in-class organizations and information providers were identified and the evaluated results recommended to HOPE to be implemented into their learning process (17). Hints to good resources by medical doctors and experts through HNU’s Africa network, as well as the experience of nurses, business and information management scientists in the team, helped during the benchmarking and filtering process.

Ia. Benchmarking and pre-selection of suitable online and offline content providers and potential partners for facilitating the learning process.

To find out about the target group of CHWs and their needs, the research started with several initial phone conferences with HOPE’s leading staff and two initial questionnaires. The questionnaires were answered by 21 of HOPE’s 24 CHWs in January 2012. The first questionnaire aimed at individual objectives and interests of the CHWs and their previous learning experiences. It mainly contained open questions to give them an opportunity to articulate their own ideas. A second questionnaire was part of a bachelor’s thesis (18). It disclosed quantifiable data on their formal qualification, language and ICT skills, including previous experience in the usage of PCs and mobile devices, as well as their family and income situation.

Based on that information, the major topics for learning were identified as being health care-related knowledge as well as basic economic skills and entrepreneurship. To meet the objectives of good quality as well as usability for the target group, the teaching and learning material had to be scientifically sound and the structure and design had to be simple and motivating for users. The content had to be in English to give a common content for all international users of Medmissio. Some initiatives, as the research team soon learned, exist virtually but were closed down due to a lack of long-term funding. It was therefore necessary to contact the institutions and get references from local experts in order to verify their existence, continuous activity and claimed results. The pre-selection process filtered 22 out of 41 initially found webpages to be tested with the CHWs. The research team developed an outline/field manual for the interviews with the CHWs and prepared an e-learning course on ‘moodle’ – an open source learning management system (www.moodle.org) – linking to the benchmarking results. The structure and wording of the course were designed to meet the target group’s needs for easy use and generally understandable content with regard to their mostly very basic ICT and English knowledge.

Ib. Analysis of HOPE Cape Town’s organizational structures and benchmarking with the organizational setup of similar charity organizations. The team developed suggestions to improve the internal dissemination of knowledge and to install the function of an e-learning manager as a basis for discussion with HOPE.

Phase II took place from 21–25 May in Cape Town. It involved five HNU and one UWC student(s) and was coached by one HOPE advisor, one HNU and one UWC professor. One day (IIa) was reserved for the testing and interviews with CHWs, one day (IIb) for township and clinic visits, during which two students, including the health care management student who was a qualified nurse, did the workplace shadowing in the clinic. The remaining three days (IIc) were dedicated to interviews with potential partnership institutions to learn from their experience and to find out whether and how a partnership could be initiated.

The testing of the online and offline sources (IIa) was based on participant observation and semi-structured interviews. First, we used observation to see how the CHWs handled the online and offline sources and what they focused on during the trial phase. Second, we interviewed them to get a deeper understanding of their opinions and needs. According to Nielsen, six to seven test persons are enough to reveal up to 90% of usability problems (19). Therefore, the testing and interviews in the benchmarking team took place in three different sessions for each of the subjects (i–iii), comprising three times two and one time one CHW(s) while each time two researchers evaluated, cross-checked and documented the results:

Online teaching on health-related content: seven CHWs.

Online teaching on business and entrepreneurial skills: seven CHWs.

Print material on entrepreneurship and HIV/AIDS: four CHWs.

The workplace shadowing in the township’s ‘Delft’ clinic and township support centres (IIb) allowed the team members to learn about the local framework conditions of learning. Additional insights obtained during that time were included in the documentation of the research results in a special section and in an anonymized form (20). Discussions with local experts and partnering organizations (IIc) completed the research. Their field experience helped to generate additional insights and recommendations for practical application.

Phase 3 started the last day in Cape Town and continued at HNU and UWC: it used the testing and interview results to shorten the teaching program content down to the 18 most useful resources and a modified design. Those were added to Medmissio’s e-learning platform as well as to HNU’s knowledge base for African health care experts. The research results compiled in protocols and observation sheets were summarized in a final report to HOPE’s Board. Organisational suggestions to ensure continuous and efficient learning at HOPE were further developed, e.g. building a self-sustaining system for learning and internal mentoring. This included job descriptions for persons responsible and an e-learning manager within HOPE. Furthermore, a partnership between HOPE and complementary organisations was initiated (see Table 1).

Table 1.

List of institutions and potential partners (compiled by the authors).

Institution	Activities
Education Training Unit (ETU)www.etu.org.za	• Interview with Ms Beatie Hofmeyr on 24 May 2012: ETU is specialized in capacity building for community-based organizations, public servants and public representatives. It offers training, facilitation, materials development and strategic planning services.
Education Training Unit (ETU)www.etu.org.za	• Experts in local government, elections, public participation, government policy, community development, public issue campaigning and HIV/AIDS.
Impumelelo www.impumelelo.org.za	• Interview with Ms Rhoda Kadalie on 23 May 2012: Impumelelo identifies rewards and promotes projects improving the life of underprivileged people, awards initiatives in an annual programme.
Impumelelo www.impumelelo.org.za	• Possibility of operational or strategical partnership.
International Labour Organization (ILO) http://ilo.org/empent/areas/entrepreneurship-and-enterprise-development/lang–en/index.htm	• Interview with Ms Marina Clarke, certified ILO Master Trainer and Consultant, National Director of Epilepsy South Africa and EXCO Member on 22 May 2012: ILO provides classroom and field trainings and illustrated print learning materials on entrepreneurship.
	• Suggestions on capacity building strategy for HOPE and implementation of business skills and entrepreneurship knowledge in CHWs work.
Medicine for Africa http://www.garvenmd.com/Med_articles/subject_index.html	• E-mail contact to Dr Tom C. Garven, Director, on 30 April/17 May 2012: Knowledge exchange on teaching health care and basic economic skills to CHWs. The non-governmental organization (NGO) was founded to make a contribution on the level of health care and general medical knowledge of professional and non-professional citizens of sub-Saharan countries
	• Allowed the team to use their ‘Medical Information Brochures’ for testing with HOPE’s CHWs.
South African Institute for Distance Education (SAIDE)www.saide.org.za	• Interview and group work with Ms Christine Randell on 21 May 2012: Assistance in developing open learning and distance education methods. Support for programmes in sound and innovative course design, materials development, learner support, management and the use of technology.
	• Expertise in the field of accreditation processes.
Small Enterprise Development Agency (SEDA) www.seda.org.za	• Interview with Mr Lionel Achilles, Department of Trade and Industry; and Mr Karabo Maelane, Western Cape Destination Marketing Investment and Trade Promotion Agency on 23 May 2012: Both refer to SEDA for small enterprises.
	• Interview with Ms Zaida Jackson, SEDA Branch Manager, Winelands Western Cape, on SEDA’s experiences on small enterprise development on 24 May 2012.
Stellenbosch University (SUN) http://www.sun.ac.za:80/english/learning-teaching/learning-teaching-enhancement/learning-technologies	• Interview with Dr J.P. Bosman, head of SUN’s e-learning centre, focusing on the ongoing process of innovation in e- and m-learning on 24 May 2012: Know-how and expertise in the field of distance education.
	• Interview with Dr Jerome Slamat, head of SUN’s centre for community interaction on 24 May 2012: Information on SUN’s projects in community interaction. Develops short courses in several fields of knowledge for people taking part in the university’s research programmes, e.g. as interviewers in the townships.
T-Systems South Africa Corporate Social Responsibility Projects	• Interviews with Ms Ronell Stutzer and Ms Malena vd Westhuizen on 7 May 2012: Information on T-Systems Digital learning projects CIDA and HAZYVIEW and on their experience and suggestions on teaching ICT-skills and other subjects, overcoming the scarcity of Internet access and possible cooperation with other institutions.
	• Further sharing of knowledge and cooperation planned.
Archive for Sexology Humboldt University, Berlin ‘Open Access’ Curriculum in Sexual Health	• E-mail response to HNU press release on the project from Professor Erwin J. Haeberle, Founder and Director of the Archive for Sexology, on 30 June and 19 July 2012. He is running similar and very successful ‘open access’ online courses on sexual health, available in English, Russian, Chinese, Czech and Hungarian. The platform is being used in Africa and has received many awards, e.g. by the UNESCO.
	• This source has been added to the benchmarking course on the Medmissio e-learning platform.

The research team would like to thank the persons named in the table for their kind support and cooperation.

Observations and limitations

According to the CHWs’ feedback in the first questionnaire (Phase I), they were enjoying the possibility to participate in a scientific project and glad to receive international attention for their personal and professional situation. The answers showed a huge willingness to cooperate and a partially ambitious humanitarian motivation. The results of the second questionnaire revealed that the group had a very heterogeneous health-related as well asICT-related knowledge. It became clear that most of them are struggling with the challenges of their demanding jobs, poor infrastructure, transportation and security standards in the townships and their own personal, family and budgetary situation. Regarding those framework conditions it became obvious that it does not make much sense to focus on optimizing the design of the learning tools while ignoring the practical challenges of giving the CHWs time and a safe place to learn. Therefore, we decided to emphasize the partnering network as a means to initiate a self-sustaining learning circle for HOPE’s CHWs.

Underlying assumptions and behavioural patterns or attitudes (21) are crucial for a proper understanding of learning processes in a social context and for the development of adapted learning methods. This could only be reached through specific research methods that require more time and an absence of supervision or other interferences. Here are a few examples for the shortcomings of the initially applied methods and the ones applied later to gain deeper insights. The evaluation of the initial questionnaires had to consider that many people do not fully articulate their knowledge in written texts (22). One potential reason could be that, for CHWs, English is the second or third language after isiXhosa or Zulu. It could also be because the questionnaires were collected and sent to HNU by their supervisors. Some issues may have been left out because they are sensitive or difficult to explain. The team therefore made use of various opportunities to talk to individual interview partners to reveal such types of implicit knowledge on sensitive issues. Another type of restraint could apply for texts that the research team used and for interviews with South Africans who have gotten so used to the situation in their country that they do not stress certain points that they think are too normal to mention. Therefore, the set-up of two interviewers with one or two persons and the method of semi-structured interviews proved very useful and allowed us to dig deeper if issues were not formulated in plain words. One of those was, for example, the dependency of many township inhabitants on social welfare and how this affects entrepreneurial initiatives. The researchers only understood this obviously quite political connection after several indirect hints. The HIV/AIDS-related hygienic and often very personal attitudes and experiences were similarly difficult to be formulated explicitly and/or explored.

Research results: challenges (a) and recommendations (b)

The information provided by the CHWs in the forms and interviews was summarized along the challenges that CHWs are facing in South Africa to implement learning resources. Recommendations to address these challenges also arise from the interviews with the CHWs and with experts from other organizations active in South Africa (best practice examples, see Table 1) that inspired ideas from the research team. The recommendations listed under 1–3 may also prove useful for other e-learning initiatives, i.e. in rural South African communities that have similar preconditions. Recommendations 5–7 primarily apply for CHWs being multipliers for their township communities but could, in a wider sense, also represent ideas for other initiatives, which are facing similar challenges.

1a. Challenge: identify and/or develop appropriate teaching material on HIV/AIDS, general health-related knowledge and entrepreneurial skills.

The target group for this type of e-learning initiatives in South Africa comprises people who are lacking previous experience in scientific research, health-related and/or ICT-related knowledge. They might not be able to differentiate between good and bad sources in terms of content quality. Several platforms also charge money for users or finance themselves through advertising, which is very distracting for people who are not used to differentiating such offers from the real content on platforms. Due to several taboos, wrong assumptions and attitudes regarding prevention, infection and treatment of HIV/AIDS, it is especially important to provide accurate information.

1b. Recommendation: pre-select easily comprehensive resources that are scientifically sound and regularly updated and provide well-structured link-lists.

Make sure that the learning material is based on scientifically sound sources that are regularly updated according to the latest available knowledge. Access to the learning material needs to be free and without distracting banners or links. The material has to be well-structured and tailor-made for their needs.

In order to ensure fast access to valuable knowledge, the research team preselected useful resources and compiled them in a moodle-based e-learning platform. Well-designed e-learning platforms like moodle have a clear advantage compared to mere Internet access with search functions because people with low ICT experience get access to sources that refer to their learning objectives. This helps the users to focus on the learning rather than being distracted by the broad range of other types of activities on the Internet.

2a. Challenge: comprehensibility and attractiveness of the teaching and learning material.

Many otherwise valuable sources on the Internet are addressing scientists rather than practitioners with only very basic language and subject-related knowledge. Extremely long and sophisticated texts might be demotivating and less well applicable to the practical needs of people from township or rural communities.

2b. Recommendation: Use easy language, explanatory pictures and videos as well as activating tasks and competitions.

The content has to be formulated in simple language. Additionally, the testing proved the advantages of visualization. Cartoons like those shown in ILO’s brochures (23), pictures, videos as well as interactive elements like topic-related tests and games were highly appreciated by the CHWs. We therefore recommend that the content should contain pictures and videos along with proper explanations how to use them (i.e. to double-click on an underlined link to open the respective webpage or to press the triangle sign to see a video). In order to increase the learner’s involvement and motivation (24), activating parts like completing tasks or participating in small competitions can be very helpful.

3a. Challenge: need for information without Internet-access; no access to printers and print material.

In our research, the original plan of using the ‘digital doorway’ in Western Cape turned out to be too ambitious. Currently, the facility offers free access to PCs, gaming and technology books to the public, but so far (as of January 2014), there is no Internet access. This is only planned for a later, not specified, date. Therefore, the information has to be provided offline.

Reading material is scarce in the township – there are only five libraries for 1.2 million people. Most of them, like the Harare Library (25), contain a small amount of HIV/AIDS-related books and media (14). Due to the time constraints and the sensitivity of the topic, the CHWs would prefer take away material for their patients, family members and neighbours. But copiers and printers as well as paper turned out to be rare in the townships, as they are in rural South African communities. So far, teaching material for the CHWs is being copied in HOPE’s offices in the ‘Tygerberg clinic’. Therefore, CHWs were glad to get a set of print leaflets of the ‘Medical Information Brochures’ from Medicine for Africa from the research team and asked for more as takeaways for patients to multiply the knowledge throughout the township communities.

3b. Recommendation: provide the essential material offline and in print form.

To decrease dependency on online sources, the most relevant information like glossaries, basic health intro courses, or video tutorials should be made available on hard disks, CD-ROMS or USB sticks wherever the training takes place.

One of the sources for easy and self-explaining HIV/AIDS learning brochures, the NGO ‘Medicine for Africa’ has established a system for getting the printout of the leaflets sponsored by companies that are allowed to put their name on the last page. Cooperation with ‘Medicine for Africa’ and some of HOPE’s donators is recommended for HOPE and similar initiatives to establish similar funding possibilities for educational material.

4a. Challenge: accessing tablet PCs for learning when there are cost and security issues.

CHWs are relatively well paid compared to other township inhabitants. Their average household income is €94 per week. But their average for weekly savings is still only €7.50 (18). Many CHWs have mobile phones but they only allow slow progress in structured learning. Initially, smartphones and tablet PCs looked like an optimal solution. That is why HNU donated four tablet PCs for trial usage. But the interviews and side-talks with the CHWs revealed that tablet PCs are an object of pride and envy and that they were likely to be shared with family members and neighbours. Although CHWs would love to have tablet PCs, they are at the same time afraid to carry and keep them at home due to unsafe conditions in public transportation and private housing.

4b. Recommendation: classroom teaching on Fridays/Saturdays in schools.

A possible solution is combining classroom teaching with online-learning on Friday afternoons or Saturdays in the clinics or in schools, which could store the tablet PCs safely. The learners would thus benefit from less commuting time and from blended learning (26) at the same time. First, the joint learning experience in a classroom atmosphere is very enjoyable and meets their need for personal contact and knowledge exchange. Second, they are enabled to deepen their knowledge through individual e-learning with texts, pictures and films as well as with practical applications.

5a. Challenge: need to connect to daily life.

For the target group of CHWs, the daily learning experience in their practical work in the clinics and townships is crucial. As learners and multipliers to the patients, they must be able to respond to immediate practical questions and needs and further investigate on hygienic issues, body functions, diseases or economic subjects. In order to complete the learning-cycle (27), CHWs need the possibility to actively search for information regarding the challenges they are facing in their daily work.

5b. Recommendation: integrate learning into the daily routines.

Acquiring the knowledge the very moment you need it is the best time to absorb it with a high level of attention and a keen desire to directly apply it in their practical work. Access to good sources should therefore be made available in the clinics. Research can thus become an integral part of daily routines. It would enable CHWs to enter into a semi-formal process of self-directed learning (24,28) and eventually take patients along in this learning experience by letting them see what they research. Additionally, educational videos on diseases and their treatment can be shown on screens in the waiting areas of the clinics.

6a. Challenge: reaching every CHW team member and deepening personal knowledge exchange.

Although 24 CHWs is a pretty small number, HOPE does not have the financial resources to teach them all on the relevant health and community issues. According to their articulated wishes and HOPE’s goals, there is a need to deepen the daily work experience through a complementary and structured learning process. The significance of personal contact for knowledge exchange especially in equivocal and high context issues is stressed by Lengel and Daft (29). CHWs mentioned that they appreciated their regular meetings once per month and that they would like to have more time for personal exchange.

6b. Recommendation: blended learning and building a network of competencies and consultants.

Experience is generated through real life and in its social contexts. It can be best forwarded through informal talks (30) at their monthly meetings. A combination of e-learning with various forms of classroom teaching, print material and platforms and space for formal and informal exchange of knowledge and experiences is advisable. To intensify knowledge exchange among CHWs, the researchers suggest building a network of competencies and consultants. The CHWs would then get trained by knowledgeable partner institutions in specific fields related to their individual interests and experience. The newly trained person has the role of an expert and mentor for the others in the specific field. Questions and ‘calls for help’ from CHWs would be passed to the expert via a blog and feedback function on the distance learning system or simply via SMS or phone call. The availability of a mentor’s (remote) support at the workplace provides the bridge between experience and learning, which is essential for a deeper reflection of the on-going processes (28). Groups of two to three trained persons form centres of competencies who are accessible fast and uncomplicated through a mobile group function. HOPE could use a system which combines blogs, SMS, e-mails or mobile instant messaging like ‘mxit’ (Africa’s biggest social network), to keep the CHWs in touch with each other and to build a ‘network of expertise’.

An internal network of competencies and consultants helps HOPE to save time, money and human resources. Additionally, special events like celebrations for successful completion of courses can provide opportunities for such an informal exchange. This will even contribute to forming a feeling of belonging and foster team spirit of HOPE.

7a. Challenge: quality maintenance.

Online courses can lead to an improvement of formal qualifications if officially acknowledged/accredited by the authorities (i.e. health or education ministry). The quality of the online and offline training material and courses has to fulfil their respective standards.

7b. Recommendation: monitor the results and seek official accreditation.

The assessment of individual learning progresses is a prerequisite to give feedback, initiate a continuous improvement process and facilitate the acquisition of certificates and a formal accreditation. For HOPE’s courses, it is strongly suggested to seek an official accreditation. SAIDE has supported projects in which distance learning has been implemented for people working in communities and provides detailed reports on the accreditation processes (31).

Conclusion

Both e-learning and conventional learning have to be combined and adapted to local circumstances and needs. The teaching and learning material needs to be easily comprehensible and fun at the same time and be made available offline as well as in print format to enable access in various forms and places. The learning process has to be integrated in daily life and work routines. Space for personal interaction of the learners and exchange of experience has to be provided. A network of internal experts and external partners can help to broaden the existing scope of knowledge and activities. The formal process should be accredited and individual progress monitored and honoured with formal degrees. The research highlighted several organizations that provide easy, non-commercial and sound online and offline resources on HIV/AIDS, general health-related knowledge and entrepreneurial skills and combined them to a programme that can also be used by other initiatives, i.e. in rural communities of South Africa.

Footnotes

Acknowledgements

The researchers want to thank HOPE Cape Town’s Chairpersons Rev Fr Stefan Hippler and Dr Monika Esser, Board member (Prof Dr Bernd Rosenkranz, Training and Outreach Officer Pauline Jooste and community worker Oddie for their support during the project. Special thanks are addressed to the members of the organization and benchmarking team for their great effort and contribution to the project. The members were: Janet Daniel, Sonja Denzel-Schneider, Ferdinand Fetscher, Susanne Heining (all from HNU), Tinashe Chimbambo from UWC, Noeline de Goede from HOPE as well as Markus Sieber from HNU with his bachelor thesis on ‘Teaching entrepreneurial skills to people with limited resources – Development of a course for inhabitants of the townships of Cape Town, South Africa’. For his support in contacting potential partners in Cape Town we would like to thank Mr Denis Stupan from the Cape Chamber of Commerce.

Conflict of interest

None declared.

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

References

Statistics South Africa. Statistical release. P0302. Mid-year population estimates 2013, May 2013. Available from: http://beta2.statssa.gov.za/publications/P0302/P03022013.pdf (accessed January 15, 2014).

Blecher

Kollipara

DeJager

Zulu

. Health Financing. South African Health Review, 2011: 29–48. Available from: http://www.hst.org.za/sites/default/files/sahr_2011.pdf (accessed January 15, 2014).

English

Padarath

. Editorial. South African Health Review, 2011: VII-IX. Available from: http://www.hst.org.za/sites/default/files/sahr_2011.pdf (accessed January 15, 2014).

World Health Organization. WHO Country Cooperation Strategy 2008–2013 South Africa, 2009. Available from: http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=3347&Itemid=2111 (accessed January 15, 2014).

Cargill

. Trick or treat. Rethinking black economic empowerment. Johannesburg: Jacana Media (Pty) Ltd., 2010.

Herrington

. Education and ICT foundation for entrepreneurial success. Leader.co.za, 2010. Available from: http://www.gsb.uct.ac.za/files/SALeader120210.pdf (accessed January 15, 2014).

Terblanche

. Lack of entrepreneurial skills still holding SA back. Sunday Times, May 29 2011. Available from: http://www.timeslive.co.za/business/money/2011/05/29/lack-of-entrepreneurial-skills-still-holding-sa-back (accessed January 15, 2014).

Internet World Stats. Internet users in Africa 2012 - Q2 (South Africa from about 6% to 17% between 2000 and 2012), 2012. Available from: http://www.internetworldstats.com/stats1.htm (accessed January 15, 2014).

Herrington

Kew

. Tracking entrepreneurship in South Africa: A GEM perspective, 2009. Available from: http://www.gsb.uct.ac.za/files/Gembook2009.pdf (accessed January 15, 2014).

10.

Western Cape Government. Internet Access Point: Khayelitsha Digital Doorway, 2013. Available from: http://www.westerncape.gov.za/facility/internet-access-point-khayelitsha-digital-doorway (accessed January 3, 2014).

11.

Conradie

. Realities vs Ideals with Regard to E-learning in South Africa. South Africa: Tshwane University of Technology, 2004. Available from: http://www.hsrc.ac.za/en/research-outputs/ktree-doc/971 (accessed January 15, 2014).

12.

Health Systems Trust. Community Health Workers – A Brief Description of the HST Experience, 2011. Available from: http://www.hst.org.za/publications/community-health-workers-brief-description-hst-experience (accessed January 15, 2014).

13.

Grill

Hippler

. Gott, Aids, Afrika – Eine Streitschrift. Köln: Kiepenheuer&Witsch; 2007. [In German.]

14.

Reisach

. HNU Alumni and Campus Club in Cape Town South African CSR initiatives: some impressions by Prof. Dr. Ulrike Reisach, Alumni Commissioner. Travel Report. HNU Alumni CampusClub Neu-Ulm, 2011. Available from: https://www.hs-neu-ulm.de/fileadmin/user_upload/Forschung/Kompetenzzentren/Corporate_Communications/ueberarbeitet_Alumni_Delegation_to_Cape_Town_report_complete_komprimiert_final2.pdf (accessed September 22, 2014).

15.

Neu-Ulm University of Applied Sciences. Two Universities Join Hands to Delivering an e-Learning Environment for Community Health Workers. Press release. Cape Town/Neu-Ulm, June 18 2012 . Available from: https://www.hs-neu-ulm.de/fileadmin/user_upload/Forschung/Kompetenzzentren/Corporate_Communications/Press-Release-UWC-HNU-HOPE_18062012_final.pdf (accessed September 22, 2014).

16.

Hax

Majluf

. The strategy concept and process. A pragmatic approach, 2nd ed. Upper Saddle River, NJ: Prentice Hall, 1996.

17.

Wheelen

Hunger

. Strategic management and business policy. Achieving sustainability. International edition, 12th ed. Upper Saddle River, NJ: Prentice Hall, 2010.

18.

Sieber

. Teaching entrepreneurial skills to people with limited resources – Development of a course for inhabitants of the townships of Cape Town, South Africa. Bachelor Thesis. Neu-Ulm: University of Applied Sciences, 2012.

19.

Nielsen

Landauer

. A mathematical model of the finding of usability problems. In: Proceedings of ACM INTERCHI’93 Conference, pp. 206–213. Amsterdam, April 24–29 1993.

20.

Colton

Ward

. Telling tales: oral storytelling as an effective way to capitalise knowledge assets, London, 2003. Available from: http://www.sparknow.net/publications/Telling_Tales.pdf (accessed January 15, 2014).

21.

Schein

. Organizational culture and leadership. A dynamic view, 4th ed. San Francisco: Jossey-Bass, 2010.

22.

Collins

. Tacit knowledge, trust, and the Q of sapphire. Soc Stud Sci 2001; 31: 71–85.

23.

International Labour Organization. Start and improve your business, practical management for small businesses. Geneva: ILO, 1994–1999.

24.

Leonard

Swap

. Deep smarts. How to cultivate and transfer enduring business wisdom. Harvard: Business Review Press, 2005.

25.

Cape Town Government. Library and Information Services. Cape Town. Harare Library, 2013. Available from: http://www.capetown.gov.za/en/Library/Pages/HarareLibrary.aspx (accessed January 2, 2014).

26.

Picciano

Dziuban

Graham

(eds). Blended learning: Research perspectives, volume 2. London: Routledge Chapman & Hall, 2013.

27.

Kolb

. Learning-style inventory: Self-scoring inventory and interpretation booklet. Boston: McBer & Company, 1985.

28.

Yeo

Gold

. The inseparability of action and learning: unravelling Revans’ action learning theory for Human Resource Development. Hum Resource Develop Int 2011; 14/5: 511–526.

29.

Lengel

Daft

. Information richness: A new approach to managerial behavior and organization design. Res Organiz Behav 1984; 6: 191–233.

30.

Erlach

Orians

Reisach

. Wissenstransfer bei Fach- und Führungskräftewechsel. Erfahrungswissen bewahren und weitergeben. Munich: Carl-Hanser-Verlag, 2013. [In German.]

31.

Welch

Reed

. Designing and delivering distance education. Quality criteria and case studies from South Africa. NADEOSA Quality Criteria Task Team: South Africa, undated.

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