2 pages 7hrs please

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Assignment # 2:  Training Diagnosis Plan and Report Template 

Training Topic: Comprehensive Training/Practical Preparation of  Healthcare Workers to Create Awareness and Provision of Efficient  Contraceptive Methods and Services ‐ for Indigenes living in the 

Northwestern Communities of Haiti  TRAINING METHODS AND CONTINUING EDUCATION FOR HEALTH WORKERS 

Rationale and Overview:

Following the definition of the problem, highlighted by the issue of unintended pregnancies amongst women of reproductive age (15 to 49 years) in the Northwestern region of Haiti, this necessitates training and continuing education of health care workers to tackle this problem. The proposed intervention to address this issue is to train relevant stake holders on the need to implement feasible and sustainable efficient contraceptive education/services to these communities. As community participation is integral to the successful outcome of the program, hence the need for the training to be inclusive of community volunteers, selected by the indigenes and culturally acceptable to the focus group and the communities at large is paramount. The utilization of evidence-based scientific literatures to underscore the efficiency of the proposed contraceptive forms were explored and referenced to support the advocated training. `

Training Needs Diagnosis Goal:

This includes to:

 Assess the knowledge, skills, attitudes and practices of the designated health care providers(via demonstration and interviews), specifically in the Obstetrics/Gynecology and General Family Medicine departments, in the provision of contraceptive education and services, with emphasis on scientifically proven efficient modern contraceptive to women of reproductive age group in our focus communities.

 Evaluate available resources to provide and sustain the proposed health services to the communities ,the need for collaboration between health care providers and Non- Governmental Agencies( NGOs) focused on similar goals (in this instance women’s reproductive health) and to ensure full participation by the communities by incorporating community nominated volunteer workers into the training/implementation of these services.

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 Establish priority of the training needs proposed for efficient contraceptive services which is the focus of the health care providers, community volunteers, etc, who are involved in this training program.

Instrument Design and Information Sources:

Methods employed to ascertain the needs assessment for the stakeholders were via Observation, Documentation, and Surveys/Interviews:

Designated Health Care Providers- (Physicians, Midwives/ Nurses, Auxiliary nurses, and other relevant allied health workers):

 Observation of the health personnel during patient contact (following informed consent from patient) that pertains to contraception education/services.

 Documentation review via records of reproductive services regarding contraceptive

education/services  Surveys (via questionnaires) and interviews were administered to evaluate their existing

knowledge base and skills on contraceptive options/services in general and specifically to evaluate their perception and attitudes towards the implementation of the proposed efficient forms of contraception services. This was done to customize training appropriately (either for the development of new skills or for refresher trainings on current guidelines regarding the use of efficient modern contraception -intra uterine device(IUD) and hormonal contraceptives (depots and implants)

Head of Port-de-Paix's Cuban Medical Brigade and the Chief Hospital Administrator:

 Question- based surveys and interviews administered to determine their understanding of

the training content and commitment to a successful outcome, by making resources needed for the implementation/sustenance of the program, as well as willingness for collaboration with NGOs and community volunteers.

NGO Representative (NGO on women’s health issues):

 Interviews and questionnaire administered to determine their understanding of the training content and commitment to a successful outcome, by making resources needed for the implementation/sustenance of the program, as well as willingness for collaboration with NGOs and Community volunteers.

Communities:

 Focus group discussions, town hall meetings and outreach programs were scheduled and implemented to ensure full participation/buy in on the part of the communities most especially the target population- women of reproductive age 15 to 49 years, to evaluate the communities perception, their needs and wants regarding the proposed services, clarify grey areas and gear them to choose their community volunteers.

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A checklist of resources (including financing, methods of presentation to training committee and time allocation) to access feasibility and sustenance of program was drafted. Collection Procedures to obtain Records (aimed at examining current/existing contraceptive services): This was achieved by:

 Accessing medical records to evaluate documentation pertaining to contraceptive services in the departments of Obstetrics/Gynecology and General Family Medicine. (Whilst ensuring patient confidentiality/privacy is protected)

 Through Surveys/Interviews; Questionnaires

 Observations during patient contacts (following informed consent from patient)

Review of Records obtained pertaining regards to current contraceptive practices /services: Following the collection of records, they were reviewed, analyzed and the information obtained used to customize the proposed training program to address the areas of need identified. Therefore ensuring the program objectives are justified and clear to all stakeholders involved in the proposed training- including the Health providers, The Chief Hospital Administrator, Head of Port-de-Paix's Cuban Medical Brigade, NGO representative and the community leaders/ nominated community workers. TRAINING DIAGNOSIS PLAN Audience Information

Needed Information Collection Method

Role of Potential Trainees

Potential trainees within each multidisciplinary team involved (Physicians, Midwives, Auxiliary nurses and other relevant allied health workers)

To determine the concerns and issues surrounding the low utilization of contraception, especially efficient methods. Analyze the current background knowledge, attitude and skills related in the provision of

Surveys/interviews; Questionnaires Observations during patient contacts(following informed consent from patient)

To provide information requested in real context for all collection methods

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such services. Identify the loopholes and priorities to emphasize during training.

Documentation of contraceptive services provided in patient records, still ensuring confidentiality

The Chief Hospital Administrator

To analyze commitment to training program, by provision of support and resources needed for implementation and collaboration with other relevant parties .e.g. NGOs, etc.

Question based surveys Interviews

Provide information requested in real context

Head of Port-de-Paix's Cuban Medical Brigade from the Public Sector

To determine the role of the public sector input in the proposed intervention/training in terms of resources, support and collaborations.

Question based surveys Interviews

Provide information requested in actual context pertaining to their role

Communities: leaders, nominated volunteers ,focus population and community at large

To assess the knowledge, attitude, needs and wants of the communities in reference to contraceptive services.

Focus group discussion (FGD) Outreach programs Personal interviews

Provide information requested in real context Integrated in proposed training to foster community participation/commitme nt via choosing community volunteers to be involved in the proposed training. Accessing avenues designed to address concerns, questions and ideas regarding the proposed services to

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target training and improvement.

Records Departments Obstetrics/Gynecology and General Family Departments Clinic Records

Access medical records for documentation regarding contraceptive education and services

Reviewing patient records, ensuring confidentiality is protected

Training group: health personnel with access to records ,will convey findings to the entire training group

FINDINGS AND PRIORITIES Summary of Key Findings:

 Training group committed to implement and commence continuing education on knowledge /skills required for patient counseling and provision of efficient contraceptive methods, including the recognition of potential adverse effects and scenarios that warrant referrals to specialist.

 Reasons attributed for the inefficient use of the existing contraceptive methods amongst the focus group included: lack of awareness based on low education levels, poor access to reproductive services including contraception and lack of finance.

 Reasons for not utilizing contraception at all included: beliefs and customs opposed to using contraception, economic values attached to having children and fear of negative consequences including perceived sterility.

 Reasons for discontinuing contraceptives were mainly attributed to adverse effects, lack

of finance and inconsistent availability of these contraceptives.

 The need to provide consistent free and/or subsidized efficient contraception exists in these communities and this should proceed in a culturally sensitive way to ensure community buy in/participation and hence the success of the program.

 The need to collaborate with NGOs and other health sectors in the community for their support to advocate and ensure supply of resources needed to sustain proposed intervention, especially if this would be at no cost or subsidized.

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 It is integral that community nominated volunteers be involved in the training to bridge any gaps in communication between the communities and health-care workers and give insightful feedback on how best to serve these communities.

 Need to improve community accessibility to services by the provision of clinic stations within these communities as well.

Priority Training Needs:

 To create awareness and build a fundamental knowledge base within these communities with the help of the community volunteers. Their perception on the quality of service provided will have a positive impact on utilization and success of the proposed services

 Provision of clinic stations within the communities - to improve access to services and

sustenance of contraception use by the recipients.

 Provision of free and/ or subsidized contraceptive services to these communities, removing the obstacle of inadequate finances as a limitation to accessing these services. a

 Provision of regular continued education to the designated health care workers to ensure

up-to-date knowledge base, skills, feedbacks and for subsequent training of new recruits.

 Effective Monitoring / Surveillance of the utilization of the proposed services (via community forums, patient interviews, community worker feed backs to evaluate patient/ community satisfaction or complaints, preferred services/type of contraception which will be beneficial in future planning and for improvement purposes.

Sample Training Need Information Document attached: please see below: Questionnaire for Health Care Providers (For Physicians and Midwives / Registered Nurses)

Name: ___________________________________ Date: ___________________

Instructions: Circle the letter(s) for all that apply. (Some questions may have more than one correct 

answer.) Follow specific directions for each section.   

Multiple Choices For each of the following questions, circle the letter(s) of the correct answer(s).  

1. Which of these are examples of effective nonverbal behaviors?  

A. Leaning forward, facing client

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B. Nodding your head C. Using short prompting words to make sure the client understands D. Open and relaxed body posture (arms and legs uncrossed) E. Using a warm and caring tone of voice

2. What do you say to a client to assure them of confidentiality? 

A. That you will not tell anyone else what the client says or tells you B. That her record will be kept along with other client’s records in the clinic’s record room C. That only the doctor will see her record. D. It is best to not discuss it.

3. Which of the following is true of informed choice? 

A. It is only necessary if men and women are making a decision about sterilization. B. It is based on the information given by the provider. C. Clients need to be able to choose their method from an array of FP options. D. The provider can make the decision after she has informed the client about the method.

4. For the best outcome for the mother and her infant, how long after birth should she wait before 

trying to become pregnant? 

A. Any time, as long as she wants to get pregnant B. Two years C. Six months D. Three years

5. Which hormonal FP method might be more challenging for women to use? 

A. The Pill (oral contraceptives) because a user has to remember to take a pill every day

B. The IUD because it is inserted by a provider

C. The implant because when it is inserted it is effective for a long time.

D. Sterilization because it is only suitable for women who want no more children.

6. If a client is unsure about which method to use, the provider should 

A. Tell the client which method you think is best for her B. Give her information about all of the methods and tell her to go home and think about it C. Explore with the client about which method would fit best with her daily life, her present

family life and her goals about having more children D. Don’t mention any method that you think the client might not be able to use correctly.

7. Which is the best way to counteract a rumor about an FP method? 

A. Tell the client that the rumor is very silly. B. Ignore it because it is just a rumor. C. Tell the client that people who believe such rumors are stupid.

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D. Politely explain that the rumor is not true and why it is not true.

8. Which are examples of open‐ended questions? 

A. What do you know about the pill? B. Have you heard about the IUD? C. What have you heard about the IUD? D. Do you want to have more children?

True or False Circle true or false for each statement. 

The provider should avoid discussing rumors that the client has  heard. 

True  False 

Clients are more willing to continue using a FP method if they have  been informed about possible side effects.  

True  False 

A good counseling session is one that the provider leads and keeps  control of the discussion. 

True  False 

It is acceptable for the provider to persuade the client to use a  method if it is the best method for her. 

True  False 

Active listening involves both verbal and non‐verbal  communication. 

True  False 

During counseling, you should not discuss the client’s sexual  activity because it is too personal. 

True  False 

A counseling tool is useful because it helps the counselor organize  her thoughts and helps guide decision‐making for the client. 

True  False 

Helping the client to carry out his or her decision is the 4 th  stage in 

family planning counseling.  True  False 

The provider should question the client closely about their  knowledge of and attitudes toward family planning methods. 

True  False 

Couples should not be counseled together because it is best to  counsel them individually. 

True  False 

Fill in the Blank Fill in the correct answers

Name at least 3 of the 4 questions you should ask to identify methods suited to your client’s needs and goals. a) b) c) ______________