Syed Farid-ul- Hasnain, Syed Muhammad Israr, Saleem Jessani


Background: The Family Health Project (FHP) was implemented in the province of Sindh during
1992-99 with the assistance of the World Bank. The project was designed to bring substantial
changes in health care system for achieving improvement in the health status by strengthening the
quality and integration of primary health care services. One of the major components of the project
was to develop the institutional capacity of Ministry of Health in Sindh. This is a comparative
analysis to assess the knowledge and skills of health care providers in Area Focus Approach
(AFA) health facilities with the ones in non-AFA health care facilities. Methods: In order to
obtain a representative sample, 8 districts were selected which included, Larkana, Khairpur,
Nawabshah, Dadu, Tharparkar, Thatta, Karachi South, and Karachi West. A structured
questionnaire was designed with various sections to assess the knowledge and skills of various
cadres of health facility staff. Results: This comparative assessment has come up with some
interesting results; there is a difference between the scores of knowledge and skills between AFA
and non-AFA health care providers. This assessment identified some important methodological
issues such as the use of base-line information for comparing the results and the selection of a
comparable study population for controlling the confounding factors. Conclusions: These findings
can be used as important lessons learned for producing better results of any post training
assessment intervention.
KEY WORDS: Family Health Project, Training, Knowledge, Skills

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