Options for maintaining quality family planning counseling: strategies for refresher training.

OBJECTIVE

To maintain knowledge over time, new family planning providers require refresher training and support, which can be costly and time consuming. The Knowledge Improvement Tool (KIT), guides family planning supervisors to ask recently trained providers a list of questions, reinforce correct answers and address knowledge gaps regarding provision of the Standard Days

METHOD

(SDM).This study compares the cost and effectiveness of the KIT to other methods of reinforcing SDM knowledge.

DESIGN

An experimental design was used.

SETTING

Several departments around Guatemala City and in the highlands of Guatemala.

PARTICIPANTS

Providers belonging to PROREDES, a network of non-governmental organizations (NGO) funded by the United States Agency for International Development.

INTERVENTION

Providers received either: (i) individual KIT, (ii) group KIT, (iii) 2-h refresher training or (iv) no refresher training.

MAIN OUTCOME MEASURES

Total provider scores on pseudo-simulated client counseling session and costs associated with each refresher type.

RESULTS

All groups who received refresher training scored well overall (over 70%), compared with only 42% for the group with no refresher training. Providers who received individual KIT retained more knowledge over time, but it was the most costly.

CONCLUSIONS

Some type of reinforcement is needed following initial training. Programs must consider what is most practical in terms of existing supervision systems and budgets. Individual application of KIT is primarily appropriate for programs that already conduct routine supervisory visits of individual providers and can integrate KIT. Group KIT or traditional refresher training produce slightly lower results at significantly less cost.