The number of evidence based international and national strategies, plans and guidelines released in the last four years are evidence of the political will to combat the causes of child and maternal illness and deaths in our country. Yet, changing HIV treatment guidelines and an increase in ART eligibility to prevent new infections constantly challenge the practising health provider's knowledge and healthcare service delivery (Venter, 2012/ 2013). There is global consensus that health worker training is a priority for effective policy implementation and high quality care. Large numbers of healthcare workers in South Africa require clinical training to improve the quality of care for priority populations, yet the accessibility of training and the availability of follow-up mentoring are limited.
In response to the call for effective health worker training, South to South has developed various training programmes. These are built on the belief that the need for the student to learn is more important than the need for us to teach, and that students construct new learning based on previous knowledge and experiences. During training we strive to create experiences from which our students can construct their own learning. These learning experiences are tailored to the audiences and are designed to build on the knowledge and experience they already have. Student assessment follows a competency model to ensure that, by the end of the course, they have the knowledge, attitudes and skills to be safe and competent practitioners. In order to achieve this, our training courses use a variety of training approaches. These include on and off site face-to-face teaching as well as distance learning components, field visits and mentoring. Teaching methods include presentations, group discussions, assignments, demonstration, practice, and clinic visits.
The South to South training programme also prioritizes inter-professional and lifelong learning. Our trainers are drawn from a variety of cadres. They are doctors, nurses, dietitians, pharmacists, psychologists and social workers, each training in their area of expertise. Where feasible, different cadres of health professionals are trained together. Participants are encouraged to participate in discussion groups using various information and communication technologies (ICT) both during and after their courses as we strive to build sustainable communities of learning. In this way we hope to establish district-level expertise. We also provide technical assistance and develop the training material required for a variety of clients and a variety of audiences.
Six-level Framework for Training
South to South strives to build capacity for clinical excellence by training healthcare workers and improving healthcare delivery systems areas where resources are limited. We have developed training programme standards to help ensure that these objectives are supported consistently across training activities.
Our Health Systems Strengthening Programme is aimed at helping organisations build their capacity through staff training and development. Healthcare workers often have all the technical knowledge required to improve health outcomes, but obstacles such as resource limitations make it very difficult to implement best practices.
By facilitating the Quality Improvement Learning Collaborative, we help healthcare workers to develop and implement health standards and guidelines. This approach integrates many of the basic elements of traditional health programmes (standards, training, job aids, equipment and supplies) with modern quality improvement elements (team work, process analysis, monitoring of results and client satisfaction), resulting in a dynamic learning system in which teams from different sites collaborate to share and update strategies for improving the quality and efficiency of health services in a targeted technical area.
The central innovation of the Quality Improvement Learning Collaborative is the structured shared learning among many teams working on the same problem area; this feature helps teams to rapidly share best practices.
In order to ensure the necessary structural support, we also address the external environment in which organisations and individuals function. This includes setting standards, guidelines and requirements at the national level, including supportive policy and legal environments.
Systems below the national level also require capacity building, such as systems of coordination and support, reporting, referrals and linkages at regional or local levels of service delivery. We provide platforms where experts can exchange ideas and support national and provincial health system structures that ask for technical assistance.
Our Strategic Information Programme uses quantitative and qualitative scientific methods to inform improvements in service delivery by measuring, evaluating and reporting the effectiveness, efficiency and quality of services delivered by the programme.
Research
Our training and development programmes are evaluated through
- process evaluation measures;
- effect evaluation;
- comprehensive programme evaluation; and
- costing analysis.
This allows us to adapt, duplicate and implement the programmes in a variety of contexts. Furthermore, a rigorous assessment of needs and opportunities for innovation enables us to develop and institutionalise our programmes in a way that incorporates the necessary knowledge, skills, abilities and behaviour needed in the southern African context.
Monitoring and Evaluation
Our monitoring, evaluation and reporting strategy measures not only progress but also obstacles towards progress. In addition, the strategy measures the effect of programme interventions to overcome obstacles and illustrates to what extent we have achieved the goals that we set for the intervention.
The evidence collected by the Monitoring and Evaluation Unit demonstrates the progress of the programme and is an accurate reflection our activities. Data quality is central to managing the process of collecting evidence.
