19-07-2014, 02:55 PM
An evaluation study on the relevance and
effectiveness of training activities in Northern
Uganda
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A B S T R A C T
Introduction: In-service training is required for quality health service delivery, particularly in a human resource constrained
setting. However, detailed evaluation of training effectiveness is rarely conducted because the improved theoretical knowledge
demonstrated by trainees during training is commonly used as a proxy indicator of effectiveness. This study focused on a trained
health workforce in Northern Uganda. The retention of specifically-trained staff 12–15 months after attending training was
examined, as was the relevance and usefulness of the training as perceived by the health workers.
Methods: This cross-sectional descriptive study used a structured questionnaire to interview 104 health workers (mainly
paramedics) who received training in the Northern Uganda Malaria, AIDS & HIV and TB Program in the period July 2007 to
February 2008.
Results: Of the 104 interviewed health workers, 71% were still deployed at the original work site at the time of the interview and
87% reported they found the training event attended to be useful. However, any form of follow up was provided to only 40% of
respondents, and 25% reported having attended another similar training event on the same topic at some point in time.
Conclusion: All programs with a substantial training component should conduct a periodic methodical evaluation of the training.
Results
In total, 115 health workers from 9 districts who participated
in 5 training events were identified. It was possible to
establish current work place and measure retention rate for
112. However, only 104 participants (92%) were interviewed
(Fig1).
Face-to-face interviews were possible in 63 cases (61%); the
remaining 41 were interviewed by telephone.
The respondents’ characteristics are summarized (Table 1).
Of the 112 participants whose whereabouts could be
established, 79 (71%) were still deployed at the original
work site and 8 (7%) of these were currently undergoing
long-term training (Table 2). Thirty-three participants (29%)
had left the facility: 25 had moved to another unit in the
same district and 8 had left the district.
When asked about the training they had attended (Table 2),
78 of 104 respondents reported they were using skills
acquired during the training, although in some cases this was
only partial. The question did not apply for those undergoing
further training and one participant did not provide an
answer.
Regarding the perceived usefulness of the training content in
relation to the health workers’ main tasks, 91 (87%) of the
104 respondents reported they found the event useful to
some extent (Fig2); only 6 (6%) reported that the training
had not been useful at all.
Training usefulness and effectiveness
Although the majority of interviewed health workers
considered their training useful, some also suggested more
training should be offered, and for longer periods. The latter
suggestions may have been motivated by the financial
advantage (in terms of allowances) associated with training
participation.
Conclusions
Successful in-service training broadens the skills and
competencies of health workers, ultimately improving the
quality of health services. Adequate evaluation of a training
event provides invaluable information to the organizers and
offers accountability to those who funded it. Customary
appraisal of trainees (eg the pre-test/post-test approach or an
evaluation form on completion) are insufficient. The value of
training is best assessed at some time after the event. Among
useful and easily assessed evaluation end-points are staff
retention at their original worksites and their current use of
acquired skills.
All programs with a substantial training component should
commit to periodic, methodical evaluation. Failure to do so
may undermine the value of training by perpetuating
common training issues that require correction. Simple and
effective training evaluation can only enhance the work of
the program or organization.