Development of National Training Systems

Based on the lesson that training in family planning (FP)/reproductive health (RH) does not have a long term impact unless it is integrated into a larger framework, the SFPS Project has adopted a strategy to develop national training systems in the SFPS target countries. This system is based on JHPIEGO’s framework for Integrated Reproductive Health Training (see Figure 1), which is designed to develop a sustainable national structure that brings together the educational and health systems of a country to prepare a cadre of providers to deliver standardized, high quality services. This system consists of the following essential elements which are being supported by SFPS in each of the target countries:

• Training Needs Assessment: Before policy can be revised or national guidelines developed, the RH situation in a country has to be well understood and defined. To do this, JHPIEGO has developed tools that are used by SFPS as needed.

• International Resource Materials: Accurate scientific information on RH is essential to the development of national policy and guidelines if a country wishes to maximize the quality of its services and eliminate unnecessary barriers to their provision. In conjunction with its training activities, SFPS disseminates of up-to-date international information to the target countries.

• National Policy and Service Guidelines: National Policies define a government’s strategy toward RH (who receives services, which services are provided, what level of professional cadres provides service, etc.). Service Guidelines are more technically focused and are used by service delivery providers to guide their work (who is eligible to receive each type of service, how each service is provided, indications and precautions for use of modern contraceptive methods, etc.) Services Guidelines are necessary to define and guide the content of RH training courses. In SFPS countries where guidelines do not exists or are outdated, SFPS is committed to providing the information and the technical assistance to develop or update them.

• Inservice and Preservice Training through National Trainers: Inservice training ensures that health professionals already providing services have the opportunity to update their knowledge and skills. Preservice training is a relatively cost-efficient way to ensure that professional obtain this training prior to graduating from their medical or paramedical institution. Either type of training needs to be conducted by trainers who have not only the standardized technical skills in RH, but also the capacity to transfer these skills through training, including the humanistic training approach, which requires that clinical procedures first be practiced on models prior to practice on real clients. SFPS has been developing national training teams in the target countries to ensure that this capacity exists.

• Service and Clinical Training Sites: Whether RH training is conducted through preservice or inservice channels, an essential element to ensure that trainees learn the necessary skills to be deemed competent is the provision of clinical training at service delivery sites. Training sites are all standardized as to essential equipment, supplies, infection prevention practices and RH services. SFPS is working in all four target countries to identify, assess and strengthen the national clinical training sites.

• Service Delivery Points: Once trained clinical service providers return to their sites they should be able to provide standardized, quality RH services. SFPS also provide service delivery inputs (contraceptives, equipment, supervision, etc.) to support 190 service delivery points in the SFPS target countries (see Briefing Paper on Service Delivery Strategy).

• Evaluation: Regular feedback is needed to assess how well the integrated training system is functioning. This feedback is provided through built-in evaluation mechanism and routine data collection, which SFPS also supports in its target countries (see Briefing Paper on SFPS Site-level Database).

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