ASSESSING THE EFFECTS OF TRAINING ON KNOWLEDGE AND SKILLS OF HEALTH PERSONNEL: A CASE STUDY FROM THE FAMILY HEALTH PROJECT IN SINDH, PAKISTAN
Abstract
Background: The Family Health Project (FHP) was implemented in the province of Sindh during1992-99 with the assistance of the World Bank. The project was designed to bring substantialchanges in health care system for achieving improvement in the health status by strengthening thequality and integration of primary health care services. One of the major components of the projectwas to develop the institutional capacity of Ministry of Health in Sindh. This is a comparativeanalysis 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 toobtain a representative sample, 8 districts were selected which included, Larkana, Khairpur,Nawabshah, Dadu, Tharparkar, Thatta, Karachi South, and Karachi West. A structuredquestionnaire was designed with various sections to assess the knowledge and skills of variouscadres of health facility staff. Results: This comparative assessment has come up with someinteresting results; there is a difference between the scores of knowledge and skills between AFAand non-AFA health care providers. This assessment identified some important methodologicalissues such as the use of base-line information for comparing the results and the selection of acomparable study population for controlling the confounding factors. Conclusions: These findingscan be used as important lessons learned for producing better results of any post trainingassessment intervention.KEY WORDS: Family Health Project, Training, Knowledge, SkillsReferences
Cassels A. Health Sector Reforms: Key issues in less
developed countries. (Discussion Paper No.1) Geneva: WHO,
Berman P. Health sector reform in developing countries:
making health development sustainable. Bosto: Harvard
School of Public Health, 1993.
Frenk J. Dimensions of health system reform. Health Policy
; 27:19-34.
Koeck CM. Doing better: a global medical interest. Foreward.
In: The effectiveness of CQI in health care: stories from a
global perspective, edited by Vahe A. Kazandjian. Milwaukee,
Wisconsin, ASQC Quality Press, 1997. : Xvii-xxiii.
Das NP, Shah U. Understanding women's reproductive health
needs in urban slums: a rapid assessment. Baroda, India,
Population Research Centre, 2000 Jun. 39 p.
Blaney CL. Training: an essential step. Network
;17(4):11.
Oyediran MA. The importance of training and supervision in
quality of care. Advances in Contraception 1993;9(2):175-80.
Pritchard P. Manual of primary health care: its nature and
organization. 2nd. ed. Oxford, England, Oxford University
Press, 1981. 209 p.
Cross I. Training primary health care workers in Upper Volta.
Medical Education. 1982;16(2):102-4.
Salin ML. The impact of a primary health care training
program on morbidity in Kiyeyi, rural Uganda, 1986-1991: an
evaluation of the Uganda-Finland Health Care Program. Ann
Arbor, Michigan, University Microfilms International, 1993.
xiv, 118 p. Order No. 9325846
Plata Rueda E. Mortality due to diarrhea in Latin America.
[Mortalidad por diarreas en America Latina.]In: Memorias de
Cocoyoc. Primer Seminario. Situacion y Perspectivas de la
Mortalidad en Menores de Cinco Anos en America Latina,
Cocoyoc, Morelos, Mexico, 23/26 Octubre 1988, compiled by
Pan American Health Organization [PAHO], Mexico.
Secretaria de Salud, UNICEF. Washington, D.C., PAHO,
. : 583-95.
Gray RH. Research design in the evaluation of operations
research projects--a framework. In: Health and family
planning in community-based distribution programs, edited by
Maria Wawer, Sandra Huffman, Deborah Cebula and Richard
Osborn. Boulder, Colorado, Westview, 1985. : 425-31.
Westview Special Studies in Social, Political and Economic
Development
Simbamwaka J, Nalingigwa B. Report on follow-up of
medical assistants trained in reproductive health updates in
[Dar es Salaam], Tanzania, University of North Carolina
at Chapel Hill, School of Medicine, Program for International
Training in Health [INTRAH], 1996 Feb. [5], vi, 71 p.
Huq MN. Assessment of post-course follow up of
management training by NIPORT for different tiers of
officers. Dhaka, Bangladesh, Ministry of Planning,
Implementation Monitoring and Evaluation Division,
Population Development and Evaluation Unit, 1995 Jun. [3],
xiii, 62 p.
Islam A. Health Sector Reforms in Pakistan: Future directions,
J Pak Med Assoc 2002;52(4):
Fritsche L, Greenhalgh T, Falck-Ytter Y, Neumayer HH,
Kunz R. Do short courses in evidence based medicine improve
knowledge and skills? Validation of Berlin questionnaire and
before and after study of courses in evidence based medicine.
Department of Nephrology, Charite-Campus Mitte, 10117
Berlin, Germany. BMJ 2002;325(7376):1338-41.
Ruminjo J, Cordero C, Beattie KJ, Wegner MN. Quality of
care in labor and delivery: a paradox in the Dominican
Republic; commentary. International Journal of Gynecology
and Obstetrics 2003;82(1):115-9.
Schaap B. IUD provision in rural Madhya Pradesh: results of a
providers' interview and insertion practices. J Fam Wel 1993;
(4):16-9.
Jabbour M, Osmond MH, Klassen TP. Life support courses:
are they effective? Ann Emerg Med 1996;28(6):690-8.
Ben Abraham R, Blumenfeld A, Stein M. Advanced trauma
life support versus Combat Trauma Life Support courses: a
comparison of cognitive knowledge decline. Mil Med
;163(11):747-9.
