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Building Partnerships, Transforming Lives: A Cost-Efficient Facility-Based Training Approach
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
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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
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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
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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
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
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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
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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.
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.
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.