Provider Training – a strategy for expanding the capacity of health programs - has been a leading topic of conversation this year, following the outbreak of Ebola in West Africa. The Center for Health Market Innovations tracks a number of provider training programs globally. Training programs in the CHMI database demonstrate the variety of individuals identified as providers and include programs that train physicians, nurses, midwives, community health workers, pharmacists, drug distributers, and informal providers.
A GLANCE AT THE NUMBERS
Of the 252 programs in the database that provide training to healthcare workers, 82 programs list primary care as a main health focus. Other major health focuses of provider training programs are Maternal, Newborn, and Child Health (76), HIV/AIDS (73), Family and Reproductive Health (52), and Secondary and Tertiary Care (24). The programs are clustered in India (40), Vietnam (23), Cambodia (18) in Asia and Kenya (47), Uganda (37), and Tanzania (29) in Africa. 190 of the programs are primarily donor funded. Nearly a quarter of all provider training programs also regulate performance; 26 of which practice licensing and accreditation, and 24 monitor standards.
EMERGING TRENDS IN TRAINING
Information Communication Technology
Seventy-six of the programs implementing provider training in the database also report using Information Communication Technology to enhance their processes.
Knowledge Sharing: Web-Based Learning Platforms
Several programs in the database are developing and promoting web-based platforms to facilitate the sharing of information and techniques between providers.
Medexperts, launched in 2012, is the largest online Community of Practice in Nigeria. The platform is designed primarily for health care professionals to communicate, share, collaborate, and learn medical knowledge by engaging together online via photos and videos of interesting clinical cases, private messages, blogs and forums, and through digital learning materials available on the platform. As a more informal way to impart knowledge, this type of training is characterized by a less regimented style.
Quality Control: Using Technology to Improve Care
Marie Stopes Uganda’s Mobiles for Quality Improvement is a mobile phone-based learning platform designed to reinforce training, assess knowledge, and provide performance support to health service providers. Through SMS reminders, informational messages, and SMS assessment questions, the program targets four training areas: hand washing, sharps disposal, instrument decontamination, and pain management techniques. The program is intended to be scalable and replicable for those with no internet access, and target training areas can be adjusted based on need.
Continued Education: E-Learning
Another major trend in ICT and provider training is E-learning. Health Education and Training in Africa (HEAT), for example, is operating in Ethiopia in an attempt to upgrade the skills of Ethiopia’s 33,000 Health Extension Workers. The HEAT program is comprised of a comprehensive online knowledge bank of learning resources, including 13 health modules, combined with in person practical training.
As ICT becomes an increasingly important aspect of health care worldwide, health programs in developing countries utilizing technology to enhance provider training will be at the forefront of health systems strengthening.
Fostering Empowerment and Leadership
A second major trend among provider training programs is empowering health care providers. This approach emphasizes improving technical skills to allow for task shifting. Jacaranda Health in Kenya, for example, trains its nurses to improve clinical skills and performance andto be strong leaders and managers.
The social enterprise Vishwas is committed to transforming health care in India through its Physician Leadership Program, whichtrains physicians counseling, health policy, behavioral medicine, eco-sustainability, and leadership. Other programs like BlueStar Pilipinas empowers its social franchise providers with marketing and business management training in additional to enhancing their clinical skills.
Community-Based Approach: Training the Trusted
Several programs, such as Shasthya Sena, target trusted members of communities working in the health program sector for training. The community-based technique allows for a quicker uptake of health interventions and for the development of community ownership to improve sustainability. Shasthya Sena is integrating informal providers in rural Bangladesh into the country’s health system. The program trains informal providers known as village doctors to improve the quality of services and to reduce risky practices. These providers are then established in a network and monitored based on performance.
Healthy Child Uganda (HCU) trains village volunteers to recognize and treat sick children within their communities. Trained in problem-solving and skill development, these village volunteers work with their communities to promote health education and effective referral services.
THE FUTURE OF PROVIDER TRAINING
Determining the most effective means for provider training is invaluable for health programming in lower and middle income countries. Recognizing the importance of provider training, Liberia’s Ministry of Health has made it a key part of its $270 million plan to strengthen Liberia’s health system over the next 10 years. This plan will train 25,000 community health workers, as well as 8,000 nurses, doctors and specialists in disease prevention and surveillance.
CHMI will continue to landscape programs and to identify trends as they develop in provider training. By recognizing and sharing successful developments for programs, the response to health crises in the future can hopefully be increasingly more effective.