CD implementation Step 9

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Develop and Conduct Training

Objectives

  • Develop training plan and training materials.
  • Identify trainers and trainees.
  • Put plans in place to start training roll out.
  • Ensure all personnel involved in CD are effectively trained.

Outputs

  • Training guide for establishing a CD channel.
  • Training plan, including initial roll-out plan and on-going training needs.
  • Training reports.
  • Pre-post assessments.

Activities

  • Convene coordination committee meeting.
  • Develop training plan and training materials, adapting existing materials, if possible.
  • Decide on stand-alone or integrated training.
  • Identify and contract trainers.
  • Plan training sessions.
  • Conduct training courses/cascades.
  • Conduct pre- and post-assessments during training courses.
  • Conduct training supervision activities.
  • Conduct refresher trainings, as planned.
Guidance

Guide the decision on whether to conduct standalone or integrated training by the following:

  • Find out what other trainings are planned.
  • Consider pros and cons such as:
    •  Pros
      • Lower training costs.
      • Reduced burden on the health system to organize and commit staff to multiple vertical trainings.
      • Reinforcement of the ITN program as part of the overall health system, instead of a malaria program added onto health personnel’s responsibilities.
      • Integration of messages in the health system.
    • Cons
      • At program start-up, communicate very specific information to multiple actors within and outside the health system, which may be too much to include as part of another training.
      • Timing of other planned trainings might delay program start-up beyond acceptable limits for donors or MOH/NMCP priorities.
  • Identify trainers following discussions with the MOH and partners. There may already be a known pool of central- or lower-level trainers. Regional and district teams may have recommendations at the lower levels.
  • Within CD, a number of specific skills are needed across a broad range of technical and operational skill areas.
    • Trainee selection should consider this.
    • Training material design should consider this; it may be appropriate to develop separate modules and hold separate training sessions for some personnel.
  • Note that while some personnel can be trained together, the division in tasks and responsibilities may mean that discrete trainings modules and training sessions are needed for different personnel.
  • Training of MOH staff will be needed, at various levels, depending on the distribution channels adopted. MOH personnel, and health facility based personnel in particular, will probably have an important role, regardless of the distribution channel chosen—in commodity supply, supervision, and reporting, at a minimum.
  • Training approaches and organization:
    • Cascade training is often used. If this approach is adopted, there should be a system to monitor whether the cascade training is successfully implemented.
    • Consider the ratio of trainers to trainees and number of hours/days needed for training: this will vary at different levels.
    • Set training dates and venues: Seek guidance from partners and the MOH at different levels.
    • Plan the training agenda.
    • Refresher trainings: Over time, staff movement and turnover are likely to reduce the number of trained personnel who understand the routine ITN distribution system. Eventually, this may reduce program effectiveness. Managers of routine ITN distribution programs should assess turnover frequency and levels to determine how often refresher trainings are needed. These trainings bring together experienced staff trained previously with newer staff to review the program elements necessary to continued quality in implementation.
    • Information collected during supervision visits about the areas that need reinforcing or clarification is an important indicator for trainers.
    • Program managers may also decide to conduct on-the-job training during or following supervision visits to reinforce key points and to correct problems early.
  • Training material development:
    • Trainers are often pulled from a number of MOH divisions and partner organizations. To prepare for any training, it is important to develop documents that will guide the training process, to reinforce consistency across the diverse pool of trainers, and to tell trainees the topics that will be covered. These should include training manual, training curricula, other training materials (e.g., job aides to give participants for future references, samples of materials, stationary, etc.), and management tools (e.g., the MOH directives on training, instructions to trainers, administrative checklists, etc.).
    • Training content should include the following points:
      • Basic design, emphasizing the difference between “pull” and “push.”
      • Design of the system in question.
      • Storage and handling issues, emphasizing reordering and restocking processes and how to avoid stockouts.
      • Recordkeeping and audit trails, particularly filling out forms and reviewing data for accuracy and accountability.
      • Addressing recipient and/or community concerns.
      • What supervision to expect and how to access support. For supervisors, expectations for supervision and how to provide support.
      • What to monitor during visits, how to review accountability documents and distribution reports, how to check storage sites and conduct physical counts of ITNs.
    • Develop training materials using adult learning techniques and with input from the training specialists.
  • Training supervision materials will also be needed to support those conducting this activity. Tools to support supervision can include—
    • A training supervision plan: For example, supervisors of the central- and district-level trainings can be drawn from the MOH or partner staff pools. These central-level trainers can then supervise their district counterparts during trainings at the health facility level. District trainers can supervise the trainings of community-level actors.
    • A schedule for deployment of supervisors and debriefings.
    • A plan for communicating problems as they arise and mechanisms for responding to problems.
    • A supervision checklist with a pre-determined set of criteria to be assessed and reported.
    • A supervision response team to review reports and to troubleshoot.
  • Complete trainings prior to starting CD distributions.
  • Pass any materials to support distribution and SBCC activities to trainees at the end of the training; this will avoid either the costs of delivering materials later or delivering them late.
  • Training can be a substantial cost in the first year, but it does not need to be repeated every year. Costs can be streamlined by keeping trainings short (one day or less), thus reducing per diem and hotel costs. However, due to turnover, reorientations may be needed. Supervisors should be trained to provide on-the-job orientations for new workers; alternatively, training on CD can be piggybacked onto planned trainings or orientations for new staff. For example, now that IPTp guidelines have been streamlined, there may be an opportunity to integrate ITN distribution training into a Malaria in Pregnancy (MiP) refresher for health facility staff.
  • Training supervision. Well-organized training requires a significant investment of time and resources. Hundreds of people are mobilized to come together for a short period of time, and a number of learning objectives are planned. To ensure the quality of each training, and to achieve the training objectives, it is important to include a supervision component. The MOH should lead training supervision and, where appropriate, integrate partners involved in routine ITN distribution to support it.

Channel specific guidance

Health facility-based distribution
  • Given the importance of the health facility staff’s role and the number of MOH and donor programs underway at any one time, training and refresher training plans should be made as sensitively as possible to limit the time taken out of health facility and district personnel working week. Conducting low levels trainings, instead of drawing trainers to the regional- or national level can help.
  • The VectorWorks document, Guide to Health Facility-based Distribution of Insecticide-treated Nets, provides more detail on these issues.
Community-based distribution
  • For any program involving personnel at the community level, the number of people who require training can increase very quickly. Cascade training will, therefore, become necessary.
  • Training sessions should probably be divided by trainee type because of the large numbers, which will allow opportunities to focus on specific aspects for specific trainees.
  • The VectorWorks document, Guide to Community-based Distribution of Insecticide-treated Nets, provides more detail on these issues.
School-based distribution
  • Training will take place only once during the year, but it should try to minimize disruption for the school personnel—and supporting health facility personnel—working week. Avoid training during exam preparation or exam times, in particular.
  • The VectorWorks document, Guide to School-based Distribution of Insecticide-treated Nets, provides more detail on these issues.

Examples

Resources

This post is also available in: Français (French)