Atelier paludisme: an international malaria training course held in Madagascar
© Domarle et al; licensee BioMed Central Ltd. 2008
Received: 10 March 2008
Accepted: 09 May 2008
Published: 09 May 2008
The Atelier Paludisme (Malaria Workshop) is an international training course organized by the Institut Pasteur de Madagascar, which has been held annually for the past five years. The course was designed for both young and experienced researchers, as well as for healthcare professionals, mostly from malaria-endemic countries. Its objective is to provide participants with a broad knowledge of all features of malaria, to improve their skills in project management, to break geographical isolation by using the Internet as a source of documentary information. This six-week course makes use of concepts of andragogy and problem-based learning, i.e. a relationship between participants and tutors, which promotes a process of exchange rather than the simple transmission of knowledge, where participants have to search actively for information. This approach to training, combined with the wide background and experience of those involved, creates positive dynamics and enables participants to acquire new skills, develop their critical and analytical abilities. This paper describes the course and the lessons learned from its evaluation.
Malaria control programmes are based on several strategies, which work best when used in synergy. These strategies continually evolve as the result of technological advances, discovery of new tools, new drugs or new insecticides, as well as the results of innovative interventions carried out by experts. At country level, the efficacy of malaria control programmes depends on the establishment of coherent strategies, adapted to the specific needs of the country and with optimal use of limited resources.
For any strategy to be effective, the individuals involved need to have the best possible understanding not only of their own area of activity, but also of all the other technical disciplines involved in control programmes (e.g. diagnosis, treatment, epidemiology, entomology, education, communication, etc). In reality, at country-level, one finds that the various specialities involved in malaria control are often compartmentalized, and, even among decision-makers, knowledge of malaria is often limited and frequently out-of-date. The different actors, including clinicians, researchers and public health administrators, need to broaden their outlook beyond their own specialities in order to comprehend the problem as a whole. There are, currently, few courses that include the 'ability to comprehend the broader picture' as their main training objective.
The Atelier Paludisme, developed at the Institut Pasteur de Madagascar, makes use of original training methods, including problem-based learning techniques and encouraging participants to play an active role in their own training, under the supervision of experts.
Organization of the workshop
Breakdown of the programme
Domains and situations
Number of hours
Presentations by tutors
Presentations by participants
• Group work
• Individual work
• Assessment and individual evaluation
Tutors and participants
In addition to course organizers, the teaching faculty consists of a group of 10–15 invited experts, who act as tutors to the participants. Each tutor stays with the course for one week (two or three tutors per week). The role of tutors is to guide the participants in their search for information on the internet, to help them to critically evaluate the information found and to make sure that their presentation is accurate (in order to avoid exposing the other participants to presentations containing erroneous information or misunderstandings).
Each tutor is asked to give a 50-minute lecture on a topic of their choice, usually their own research, and the lectures are followed by an open discussion with participants, course faculty and guests. These lectures by tutors represent the only formal teaching of the course and they represent only 10% of the overall contact time of about 256 hours.
Evaluation and follow-up
Both tutors and participants were asked to evaluate the training, and their comments and suggestions were used to improve the workshop from one year to the next. An external audit of the five first sessions of the workshop was carried out in 2007, based on theoretical educational concepts. The design of this training was considered appropriate to its aims, particularly with respect to the acquisition of transverse skills, the use of appropriate learning models, the phases of knowledge acquisition, the identification of problems to be solved, material aspects, the availability of the tutors during the workshop, exchanges of experience between participants and tutors and the self-confidence acquired, especially when giving presentations. The preparation and delivery of presentations, and online bibliographical searches were considered important skills that the participants will be able to use in their professional lives, whatever their future post. The audit identified the following weak points, including a tendency to information overload, due to intensive weekly cycles preventing adequate consolidation of the knowledge acquired. This external viewpoint will be taken into account to improve future workshops.
Follow-up of former participants and comparison with matched controls.
Better able to assume functions since the training
Yes for 88% (36/41)
Better able to give presentations
Yes for 73% (30/41)
Yes for 58% (11/19)
Better able to train others
Yes for 80% (33/41)
Yes for 68% (13/19)
Better professional relations since the training
Yes for 85% (35/41)
Development of new activities since the training
Yes for 80% (33/41)
Development of a project as:
Yes for 34% (14/41)
Yes for 37% (7/19)
Yes for 68% (28/41)
Yes for 68% (13/19)
Obtained funding as:
Yes for 20% (8/41)
Yes for 21% (4/19)
Yes for 44% (18/41)
Yes for 37% (7/19)
Training has helped with grant applications and obtaining funding
Yes for 63% (26/41)
Change in professional activities since the training (as assessed by third party/superior)
Yes for 78% (32/41)
The annual budget was approximately €80,000, covering the full costs for 15 to 16 participants and 10 to 15 invited tutors. It was considered essential to cover the cost for participants in order to be able to select them not on financial criteria, but on pertinent criteria such as past experience, country of origin, present involvement in malaria research or control. The Réseau International des Instituts Pasteur (the Institut Pasteur International Network) and Impact Malaria/Sanofi-Aventis have covered a large portion of this budget, with contributions from the Institut Pasteur de Madagascar, the Institut de Recherche pour le Développement, a French Overseas Development grant, the Direction des Affaires Sanitaires et Sociales de Mayotte, the World Bank, the WHO/Roll Back Malaria programme, the Agence Universitaire de la Francophonie and private partners (Fondation Mérieux, Natixis, Medical International and Technikon). This mixed funding reflects the variety of stakeholders needed for such a course and is important for its long-term viability.
The Atelier Paludisme is currently one of the few courses to give a broad working knowledge of malaria and, as such, it meets the training needs of healthcare personnel involved in malaria research and control, enabling them to remain up-to-date with recent developments in the field. Because it focuses less on content and more on the resolution of problems and information finding, it contributes to honing the professional skills of participants. The Atelier Paludisme has recently been accepted as a module in the new mastère spécialisé de l'École Pasteur/CNAM de santé publique  and, since 2007, a sister-course in English is now run in Tanzania, as a collaboration between Institut Pasteur, the Swiss Tropical Institute and the Tanzanian Centre for International Training in Ifakara . An expanded version of this paper was recently published in French .
The Atelier Paludisme has been run under the auspices of the Ministry of Health, Family Planning and Social Protection of Madagascar. The Minister of Health himself has often honoured us with his presence. We thank those who have provided us with funding and support and who have shown us continuing interest and confidence. We also thank all those who have participated at the Atelier Paludisme: the participants and tutors for their availability and for investing so much in their functions by adhering fully to this training approach. We especially thank Prof Marcel Hommel, who actively helped us with the design, setting-up, running and maintenance of this training. The Atelier Paludisme is organized through collaboration between different units within the Institut Pasteur de Madagascar. The external audit was carried out by ASFOR, a company specializing in training, recruitment, auditing and consultancy at Antananarivo, Madagascar. We are grateful to the Editor-in-Chief of Médecine Tropicale for allowing us to publish this commentary.
- Institut Pasteur de Madagascar: Atelier Paludisme de l'Institut Pasteur de Madagascar. [http://www.pasteur.mg/Atelier-Palu/]
- CNAM/Pasteur: Mastère spécialisé de santé publique de l'école Pasteur/CNAM de santé publique. [http://www.cnam.fr/pasteur]
- Tanzanian Training Centre for International Health: Capacity building in malaria with a focus on e-learning in Ifakara, Tanzania. [http://healthtrainingifakara.org/Malaria.Course2007.html]
- Domarle O, Randrianarivelojosia M, Duchemin JB, Robert V, Ariey F, Hommel M: Formation francophone sud/sud: l'Atelier Paludisme de l'Institut Pasteur de Madagascar. Med Trop. 2007, 67: 505-512.Google Scholar
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