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Building Partnerships,
              transforming lives




Capacity building of health workers: Utilisation of a cost
efficient facility based training approach (Capacity kazini
                            Model)

         Digolo L¹, Kiragu M1, M Obbayi1, Otiso L¹


                      Capacity summit
           Birchwood Hotel 19th – 21st Johannesburg

                                                         1
                                                             1
LVCT – who are we?
LVCT – an indigenous Kenyan NGO
- country led, country managed, country priorities
1. Quality Assured HIV testing & counselling
- Home based; Mobile; Workplace;
    Celebrity; >3million clients tested
2. Linking testing to palliative care/ART
- 12,000 HIV infected individuals, VCT+
    model (families, 97% referral uptake)
3. Vulnerable & at risk populations
- MSM/Prisons – 21,000 tested, 121 on
    Rx
- Disability – 20,000 tested, Deaf VCT
- Youth (one2one youth hotline,)
- GBV/Post Rape Care – 9,000 survivors
- Sex workers - 3 post test clubs, STI Rx
                         .
                                                     2
Background
• A skilled, trained workforce can dramatically
  improve performance and add value to
  services.
• Despite implementing numerous trainings in the
  last few years, Kenya still has many health
  workers yet to receive basic HIV training
• Costly Off-the job trainings form the bulk of
  trainings
• Donor funds have been gradually reducing over
  the past few years
               Building Partnerships, Transforming lives
                                                           3
Objectives




Building Partnerships, Transforming lives
                                            4
Methods
• Cascade approach was utilised based on the
  National curriculums
• Active involvement of DMOHs and DASCOs,
  Med Superintendents.
• Trainings facility Led and management
• LVCT played supportive supervisory role
• 311 health providers trained between January
  2010 and September 2012, 298 (96%)
  successfully completed the training.
• Certification done by NASCOP and DRH
                                           5
Methods
                              National/Master trainers/Mentors



                                           Provincial TOTs/Mentors



                               District & facility TOTs / Mentors




                                                  Training of HCWs (non-
• Certified practicing HCWs                           residential/OJT)
  trained to become TOT/                                                   •   On site mentorship
  mentors to train other                                                   •   Practice of skills
                                                                           •   Observed practice
  HCWs
                                                                           •   Certification
• CMEs
• Continuous mentorship



                                            Certified HCWs                                    6
Implementation models
To be dictated by the various circumstances:
1.High volume facilities -that can have > 20
HCWS in training with no disruption of services, 3
hrs/ d when there is low client flow.
2.Low volume facilities-Participants will be
conglomerated at a central facility in the
district .The training will be 2-3 days in a week



                                               7
Results

                Off the job training   Capacity kazini model
Facilitation            352                     530

Accommodation          5700                      0


Transport               570                     352


Lunch                  1600                     230

Stationeries            300                     300


Total                  8522                    1412
Results
Advantages and disadvantages of
          FBT




     Building Partnerships, Transforming lives
                                                 10
Sustainability
• Collaborative approach: collaboration with
  key stakeholders at facility , regional and
  national level. Has been included in
  national curriculums
• Cheaper than conventional training
• Facility Led and managed
• Utilization of available resources: including
  venue and facilitators

              Building Partnerships, Transforming lives
                                                          11
Conclusion
• Facility based trainings are cheaper than
  off the job trainings/ hotel based trainings.

• This approach is replicable in most health
  facilities in Africa




              Building Partnerships, Transforming lives
                                                          12
ACKNOWLEDGEMENTS
MOH
Trocaire
LVCT staff who were willing to try out new
initiatives
LVCT Management




               Building Partnerships, Transforming lives
                                                           13

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Dr Lina Digolo - LVCT, Kenya

  • 1. Building Partnerships, transforming lives Capacity building of health workers: Utilisation of a cost efficient facility based training approach (Capacity kazini Model) Digolo L¹, Kiragu M1, M Obbayi1, Otiso L¹ Capacity summit Birchwood Hotel 19th – 21st Johannesburg 1 1
  • 2. LVCT – who are we? LVCT – an indigenous Kenyan NGO - country led, country managed, country priorities 1. Quality Assured HIV testing & counselling - Home based; Mobile; Workplace; Celebrity; >3million clients tested 2. Linking testing to palliative care/ART - 12,000 HIV infected individuals, VCT+ model (families, 97% referral uptake) 3. Vulnerable & at risk populations - MSM/Prisons – 21,000 tested, 121 on Rx - Disability – 20,000 tested, Deaf VCT - Youth (one2one youth hotline,) - GBV/Post Rape Care – 9,000 survivors - Sex workers - 3 post test clubs, STI Rx . 2
  • 3. Background • A skilled, trained workforce can dramatically improve performance and add value to services. • Despite implementing numerous trainings in the last few years, Kenya still has many health workers yet to receive basic HIV training • Costly Off-the job trainings form the bulk of trainings • Donor funds have been gradually reducing over the past few years Building Partnerships, Transforming lives 3
  • 5. Methods • Cascade approach was utilised based on the National curriculums • Active involvement of DMOHs and DASCOs, Med Superintendents. • Trainings facility Led and management • LVCT played supportive supervisory role • 311 health providers trained between January 2010 and September 2012, 298 (96%) successfully completed the training. • Certification done by NASCOP and DRH 5
  • 6. Methods National/Master trainers/Mentors Provincial TOTs/Mentors District & facility TOTs / Mentors Training of HCWs (non- • Certified practicing HCWs residential/OJT) trained to become TOT/ • On site mentorship mentors to train other • Practice of skills • Observed practice HCWs • Certification • CMEs • Continuous mentorship Certified HCWs 6
  • 7. Implementation models To be dictated by the various circumstances: 1.High volume facilities -that can have > 20 HCWS in training with no disruption of services, 3 hrs/ d when there is low client flow. 2.Low volume facilities-Participants will be conglomerated at a central facility in the district .The training will be 2-3 days in a week 7
  • 8. Results Off the job training Capacity kazini model Facilitation 352 530 Accommodation 5700 0 Transport 570 352 Lunch 1600 230 Stationeries 300 300 Total 8522 1412
  • 10. Advantages and disadvantages of FBT Building Partnerships, Transforming lives 10
  • 11. Sustainability • Collaborative approach: collaboration with key stakeholders at facility , regional and national level. Has been included in national curriculums • Cheaper than conventional training • Facility Led and managed • Utilization of available resources: including venue and facilitators Building Partnerships, Transforming lives 11
  • 12. Conclusion • Facility based trainings are cheaper than off the job trainings/ hotel based trainings. • This approach is replicable in most health facilities in Africa Building Partnerships, Transforming lives 12
  • 13. ACKNOWLEDGEMENTS MOH Trocaire LVCT staff who were willing to try out new initiatives LVCT Management Building Partnerships, Transforming lives 13

Notes de l'éditeur

  1. Information is systematically cascaded down till the facility level. (See fig XX T below). The cascade model relies on information being transmitted through a number of levels before reaching the individuals who will utilize the information in their daily work. National level TOTs/ Mentors These are master trainers whose main task is to cascade teaching skills and knowledge to regional level TOTs. They also provide on-going mentorship and supervision to regional TOTs. Regional TOTs/mentors These are trainers whose main task is to cascade teaching skills and knowledge to facility level trainers. They also provide on-going mentorship and supervision to facility trainers. The regional trainers TOT curriculum covers facilitation skills, mentorship skills and updates on HIV Facility level TOTs/mentors This group will be identified at from the facilities by the regional trainers. This is a cadre of individuals who will be charged with training and mentoring health care workers in their duty stations. They also provide support supervision and disseminate technical information to HCPPs periodically through Continuous Medical Education (CMEs). Additional tasks include conducting training needs assessment planning and implementation of trainings and follow-up for certification. Facility level trainers are selected from trained HCPs during the on-going post training mentorship who show outstanding performance in service delivery and show commitment and ability to build capacity of other health workers.
  2. The average cost of training a HCW using facility based trainings (USD 145) was 2.5 times cheaper than the cost of training a health worker using conventional off-the-job training (USD 350). A total of 651 health workers were trained compared to 269 who would have been trained using conventional workshops on a similar budget.
  3. The average cost of training a HCW using facility based trainings (USD 145) was 2.5 times cheaper than the cost of training a health worker using conventional off-the-job training (USD 350). A total of 651 health workers were trained compared to 269 who would have been trained using conventional workshops on a similar budget.