curricula health management crash training courseold.iss.it/binary/ures/cont/hmtc.1161243999.pdf ·...

WHO South Sudan Istituto Superiore di Sanità

CURRICULA

HEALTH MANAGEMENT

CRASH TRAINING COURSE

HMCTC

Rumbek 9 October- 4 November 2006

Under the Project: “WHO Cap2004 SUD-04/H17

Strengthening training facilities for nurses and allied sciences and capacity building of HMs”

ii

CURRICULA

HEALTH MANGEMENT CRASH TRAINING

COURSE - HMCTC

Working Group Components:

Monywir Arop, MOH, Sudan

Alfonso Mazzaccara, ISS, Rome

Viola Vallini, ISS, Rome

Alessandra Torsello, ISS, Rome

Laura Masiello, ISS, Rome

Abdullahi M. Ahmed, WHO Sudan

iii

TABLE OF CONTENTS

LIST OF ACRONYMS. 4

1. SUMMARY 5

2. BACKGROUND. 6

3. THE RELEVANCE OF HMCTC FOR HMs. 8

4. REQUIREMENTS AND CRITERIA FOR PARTICIPATION. 9

5. OBJECTIVES. 10

6. STRUCTURE OF THE HMCTC PROGRAMME. 11

7. THE TEACHING-LEARNING METHOD. 24

8. REFERENCES. 27

Annex I – The Programming. 29

Annex II – Pedagogical Contract: participants’ rights and duties 33

Annex III – Facilitator check list 35

Annex IV – Coordinator check list 36

Annex V – SWOT Analysis 37

Annex VI – Training Costs. 38

LIST OF ACRONYMS

HEALTH MANAGEMENT CRASH TRAINING COURSE - HMCTC (DRAFT CURRICULA) 4

LIST OF ACRONYMS.

CHWs Community Health Workers

HCDS Health Care Delivery System

HMs Health Managers

HMCTC Health Management Crash Training Course

HMIS Health Management Information System

HRs Human Resources

HSM Health Services Management

HSs Health Services

ISS Istituto Superiore di Sanità

NHS National Health System

MCQ Multiple Choice Questionnaire

MM Monitoring Meeting

MOH Ministry of Health

PM Planning Meeting

PHPC Provisional Health Personnel Council

PBL Problem Based Learning

PHC Primary Health Care

PSM Problem Solving Meeting

SOH Secretary of Health

SPLM/A Sudan People Liberation Movement/Army

TNA Training Need Assessment

WHO World Health Organization

1. SUMMARY


1. SUMMARY

Following the ruinous effects of the two decades long civil war, South Sudan is now facing the

enormous challenge of the reconstruction of its severely affected institutions, facilities and

infrastructures. The healthcare system, in particular, is today neither adequate nor equitably

distributed throughout the country and suffers from a severe shortage of personnel with the

required professional qualification. This complex situation implies that most of the healthcare

services in South Sudan are currently provided by NGOs, with the support of international

development agencies and foreign governments.

A great effort is then envisaged towards the provision of capacity building to the existing local

health personnel on such issues as: services management, communities’ health needs

assessment, staff supervision and monitoring of quality of services.

On the basis of the above, the TNA that was conducted by ISS in September-November 2005,

targeting the health personnel that was available in accessible areas of South Sudan,

highlighted that awareness of HMs’ responsibilities is currently very poor and most of the survey

respondents do not feel confident with planning, monitoring and evaluation issues.

The emerging need to upgrade the qualification of the existing health personnel has conducted

ISS to evaluate the proposal of a crash training course focused on basic managerial skills,

consisting of 5 residential modules designed to provide participants with fundamental elements

and concepts relative to health policy and function of health management, situation analysis,

planning, implementation, monitoring and evaluation.

2. BACKGROUND


2. BACKGROUND.

2.1. HSs Delivery in South Sudan.

The recently ended two decades of civil war in South Sudan caused violence and massive

displacement of population and severely affected all the main productive sectors of the country.

The overall demolition of the healthcare system and the consequent harsh deterioration of the

HCSD and infrastructures, in particular, were among the worst effects of this extremely complex

situation.

As a consequence:

The existing health care facilities are neither adequate nor equitably distributed throughout

the country;

There is great shortage of qualified health personnel, with the exception of few high level

cadres;

Most of the healthcare services and training of health personnel are currently provided by

NGOs, with the support of international development agencies and foreign governments.

Since the signing of the peace agreement in January 2005, the SPLM/A has embarked on

strategic development initiatives for political and socio-economic recovery and future

development.

Within the health sector, a great effort is envisaged towards the provision of quality healthcare

services at all levels to the estimated 8 million people in South Sudan and to the additional 3

million refugees in the neighbouring countries.

As a consequence of the creation of the New Sudan and the decentralization process within the

health reform, there is a great need of providing capacity building to the existing personnel on

such issues as: HSM, communities’ health needs assessment, staff supervision and support,

stimulation of community participation to the effective allocation of health resources, monitoring

of quality and managing of change.

2.2. Human Resource for health and TNA in South Sudan.

Due to both the brief and the poor quality of previous training and the several years of practice

in extremely difficult circumstances, almost all the health workers in South Sudan urgently need

to receive intensive training and an upgrading of their professional knowledge.

The total trained health workforce is estimated today at 4,600, two thirds of which are CHWs1.

The highly qualified staff are today expatriates in Kenya and Uganda. Many skilled Sudanese

have attended only one or two years of respective 3-years phased-training programmes. In

1 Jam Sudan Capacity Building & Institutional Development Vol. III 2005

2. BACKGROUND


most cases, even formal qualifications were attained through sub-standardized training

programmes. Some cadres have been trained abroad.

In order to establish proper standards with regard to contents and length of training

programmes and curriculum, the PHPC was created in the early 1990s. In 2002, the PHPC

became a permanent structure with a management board called Health Personnel Council.

A TNA survey, by means of individual interviews, was conducted by ISS in September-

November 2005, targeting the local health personnel that were available in some areas of South

Sudan selected on the basis of accessibility and security criteria.

Two different questionnaires were developed in order to assess the training needs of high and

middle health cadres, aimed at collecting such data as: candidate’s profile, job related

responsibilities and consequent gap between effective and desired skills, perceived educational

needs, existing skills in teaching methodologies.

The analysis of the collected data highlighted that:

Overall, the extent of awareness of HMs’ responsibilities is very poor;

Most of the survey respondents do not feel confident with planning, monitoring and

evaluation of HSs;

The awareness of the importance of HMIS and its use is generally limited;

The training level of the health personnel is generally very basic;

All HMs perceive the lack of qualified staff and equipment, the inadequate transport facilities

and the low services utilization as the main constraints affecting their effective performance

in HSs delivery;

Overall, the major training needs result in the areas of HSM, including health financing,

leadership and coordination between county and MOH, communication skills and health

promotion.

3. THE RELEVANCE OF HMCTC FOR HMs


3. THE RELEVANCE OF HMCTC FOR HMs.

The Ministry of Health of the New Sudan had developed a health policy and its implementation

plan. The policy document provided guidelines on the current and future direction on training of

health personnel and delivery of health care services in the country. The health policy had the

following three major areas that were identified as useful for the planning and implementation of

health care services in the country:

a) health services management;

b) health services provision;

c) health human resources development.

In order to achieve the objectives of providing quality and cost effective health care services,

human resources development was a critical success factor. The health policy recognised the

existing gaps in human resources development that need to be filled and spelt out the actions

required in planning and production of health resources resources.

In light of what above indicated, the GOS need to initiate national continuing professional

development programmes in order to update and refresh the skills of health providers and

managers and to upgrade their knowledge base and competencies, which will result into an

improvement in the organization of quality health care and delivery of the related services to

communities.

HMs need to acquire the skills required to manage HSs, including the assessment of the health

needs of the communities, the supervision of staff, the stimulation of community participation to

the effective allocation of HRs and the monitoring of quality.

4. REQUIREMENTS AND CRITERIA FOR PARTICIPATION


4. REQUIREMENTS AND CRITERIA FOR PARTICIPATION.

The HMCTC is open to graduate and non-graduate health personnel with management

responsibilities at county, hospital and PHC level. Candidates are required at least 3 years work

experience and to be confident with the English language.

REQUIREMENTS

Management responsibilities County, Hospital or PHC

Work experience 3 year

Language Confident with English

Participants will be eligible among the NHS personnel. NGOs local health personnel are also

invited to attend the course.

Previous participation to management courses and partnership or collaboration with

international organizations could be considered as further selection criteria.

Female participation to the training course is strongly encouraged and an equitable

geographical and age distribution of attendees will be considered as a success factor of the

initiative.

Criteria Weight

NHS + + + + +

Local NGOs + + +

Previous participation to management courses +

Collaboration with international organizations +

5. OBJECTIVES


5. OBJECTIVES.

The HMCTC aims at improving the knowledge and skills of health workers in planning,

managing and evaluating a given health service depending on the background and specific

professional level of individual participants.

At the end of the training programme, participants will be able to:

Describe the main features of HSs organisation and health policies and reforms in

South Sudan;

Appreciate what planning is and how it can be used effectively as a basic management

technique;

Plan, monitor and evaluate HSs in accordance with national health plans and strategies

and considering local priorities, resources and constraints;

Make effective oral and written communications.

6 STRUCTURE OF THE HMTC PROGRAMME


6. STRUCTURE OF THE HMCTC PROGRAMME.

The proposed duration of the HMCTC Programme is 4 weeks, based upon individual and self-

contained module curricula of 1 week each.

The HMCTC Programme consists of 5 residential modules designed to explore the health policy

framework in South Sudan and to provide participants with elements and concepts concerning

planning and management of HSs.

The modules 1; 2; 3 are structured in 2 units content meanwhile modules 4 and 5 are structured

in 1 unit content.

All of them delivered with the PBL approach in practical sessions, will be weighted according to

its duration in weeks (i.e. 1 week duration = 1 credit week). In order to obtain the credits,

participants will have to pass the tests foreseen per each module.

In order to achieve the HMCTC, participants are required to complete the residential modules (4

credits weeks)

The structure of HMCTC Programme is summarised in table I.

Table I - HMCTC Programme

Modules Credits

(weeks)

1 - Health policy and function of health management 1

2 - Situation Analysis 1

3 - Health Planning 1

4 – Implementation 0,5

5 - Monitoring and Evaluation 0,5

Total 4

Besides the managerial skills, a health manager needs to acquire communication skills. After

focusing on theoretical concepts and models about the nature of communication, within

different modules, participants will acquire tools and skills in interacting with people at different

levels, preparing and presenting papers, reports and plans. This module entails continuous

monitoring of participants' progress from the start to the end of the course.

6.1. Modules outline

Rationale, objectives, content, time framework, participants’ assessment and main references of

the modules are shown in the following pages.

6. STRUCTURE OF THE HMCTC PROGRAMME


1- Health policy and function of health management (credit weeks: 1)

1. Rationale

The purpose of this introductory module is to give an overview of HCDS in South Sudan in order

to support HMs with regard to the implementation of the current policy issues towards the

achievement of the new national goals.

2. Objectives

At the end of the module, participants will be able to:

Identify the main issues of the South Sudanese Health System;

Describe the challenges HMs will face in their own workplace tacking into account the

new political system;

Identify the issues affecting management in low income countries;

Identify the viable support to be provided to managers in low income countries;

3. Teaching-learning strategies.

WEEK UNIT CONTENT TEACH-LEARN

STRATEGY

ACTIVITY PARTICIPANTS’

ASSESSMENT

Monday PM

Tuesday Non PBL session

MM

Wednesday

Morning

Health Policy in

South Sudan.

PBL; practical

sessions.

PSM Essay wr i t ing and

presentation (1-5 points).

Wednesday

afternoon

Thursday PM

Friday

Function of

health

management.

PBL; practical

sessions.

Non PBL session

MM

Facilitator feedback.

Saturday

Morning



Saturday

Afternoon

Sunday

(PM=Planning Meeting; MM=Monitoring Meeting; PSM= Problem Solving Meeting)



4. List of reading materials.

4.1. Learning materials

Books

McMahon R, et al., “On being in charge. A guide to management in primary health care”, WHO,

Geneva 1992. Pages: 13- 27. (Pages amount: 15)

Articles

1. Jam Sudan Capacity Building & Institutional Development, Vol. III 2005.

Pages 24-34; 169-174; 183-190. (Pages amount: 22)

2. Country Cooperation Strategy for WHO and Sudan: 2003–2007

Pages 1-14

3. Health Policy and Management. Chapter 3. Annual Report 2004, WHO.

Pages 1-10

4. South Sudan Interim Health Policy 2006-2011, December 2005 – South Sudan Federal

Ministry of Health. Pages 1-36

5. Sudan Health Status Report, WB/AFTH3 2003

Pages 9-12; 60-66; 88-94 (Pages amount: 18)

6. Policy Document for Health in post conflict Sudan. Republic of Sudan, Federal Ministry of

Health, 2003.

Pages 1-5

7. Management, Leadership and partnership for District Health, WHO Regional Office for

Africa, 2004. Module 2, unit 1: Important management and leadership concepts, pages: 1-8.

Http: //www.afro.who.int/dsd/dhm-training/index.htm

4.2 Consultation material.

Articles and journals (if available a web link):

British Medical Journal: http://www.bmj.com.

Health Policy and Planning: http://heapol.oupjournals.org.

5. Resources Persons.

MOH South Sudan: Monwyiir Arop



2-Situation Analysis (credit weeks: 1)

1. Rationale.

Quantitative methods (epidemiology) are a fundamental tool in planning and evaluation of HSs,

from identifying priority health issues to allocating resources effectively and efficiently.

Epidemiology is the study of the distribution, frequency and determinants of health problems

and diseases in the human population. The purpose of epidemiology with the support of

statistical techniques is to obtain, interpret and use the health information needed for planning,

managing and evaluating all the activities required to promote health and prevent diseases. In

the absence of such epidemiological data there is a tendency to tackle public health problems

through indiscriminate mass intervention. Such an approach is not only wasteful but has often

proved to be ineffective.

In order to plan interventions, HMs will need the epidemiological and statistical skills required by

the following tasks:

Define population by age/sex structure, migration and vital statistics;

Assess the health status of the population and high risk groups, particularly important

causes of morbidity and mortality;

Collect health data through routine services, surveillance, epidemics and surveys;

Produce health information by analysis of data;

Decide on the priority health problems;

Use health information in order to select proper initiatives;

Estimate increase in access and coverage;

Determine changes in health status in the district population.

In particular the descriptive (diseases distribution and frequency) and evaluation epidemiology

(measure of the effectiveness of different HSs and programmes) can be extremely useful and

should be widely used by HMs.

This module will enable participants to use basic data as a tool for assessing population health

needs.

2. Objectives.

At the end of the module participants will be able to:

Register and collect the data related to the field situation;

Analyse and interpret these data;

Transmit and present the above data;

Understand the uses of epidemiological information in planning and evaluation of HSs.





STRATEGY


ASSESSMENT

Monday PM


MM

Wednesday

Morning

Data

management.

PBL; practical

sessions.



Wednesday

Afternoon

Thursday PM

Friday

The use of data

in planning and

evaluation.

PBL; practical

sessions.

Non PBL session

MM


Saturday

Morning



Saturday

Afternoon

Sunday

(PM=Planning Meeting; MM=Monitoring Meeting; PSM=Problem Solving Meeting)


4.1. Learning materials.

Books

Vaughan JP, Morrow RH. Manual of epidemiology for district health management. WHO,

Geneva 1989 (Pages 71-153).

Articles

How to conduct a rapid situation analysis. Mc Coy D. Bammford L. Health Fund Trust; South

Africa – 1998. (Pages. 1-49).

4.2. Consultation material.

Books

1. Coggon D., Rose G., Barker D.J.P. Epidemiology for uninitiated. BMJ Publishing Group,

2003.

2. Swinscow T D V Statistics at square one. BMJ Publishing Group, 1997.





The International Journal of Epidemiology: http://ije.oupjournals.org.

American Journal of Epidemiology: http://www3.oup.co.uk/aje.


WHO South Sudan: Amos Paul Bassi



3-Planning and health management (credit weeks: 1)

1. Rationale

Planning is one of the main responsibilities of HMs aimed at ensuring both the current and

future availability of resources and their efficient utilization towards the realization of defined

objectives. The basis for planning is the dilemma of scarce resources coupled with vast health

care needs, thus implying a need of making decisions about how the HMs will use its resource

in the future. After learning the differences between strategic and operational planning,

participants will have an overview of the "Project cycle" approach and its steps: situation

analysis; problem identification; priority setting; planning, management, monitoring, assessment

and evaluation of activities.

2. Objectives.

At the end of this module participants will able to:

Use available data for problem identification;

Define general and specific objectives;

Plan an activity by setting priorities according to the available resources;

Chose the most appropriate strategies to reach the defined objective.



STRATEGY


ASSESSMENT

Monday PM


MM

Wednesday

Morning

Problem

identification

and Objective

definition.

PBL; practical

sessions.



Wednesday

afternoon

Thursday PM

Friday

Priority setting

and decision

making.

PBL; practical

sessions.

Non PBL session

MM


Saturday

Morning



Saturday

Afternoon

Sunday




4. List of reading materials

4.1. Reading Materials.

Books

1. Project Cycle Management Guidelines – European Commission; (2004).158 pages.

2. Planning and implementation of District Health Services. WHO – Regional Office for Africa

Brazzaville, 2004. pages. 24 - 31.

Articles

1. Problem tree. WB – 2001 2 pages

http://web.mit.edu/urbanupgrading/upgrading/issues-tools/tools/problem-tree.html

2. SWOC - FAO 8 pages

http://www.fao.org//docrep/005/y4401e/y4401e0d.htm

4.2. Consultation Materials.

Books

1. McMahon R, et al. On being in charge. A guide to management in primary health care.

WHO, Geneva 1992.

2. A. Green. An introduction to Health planning in developing countries. 2002.



Health Policy and Planning: http://heapol.oupjournals.org.


ISS Alfonso Mazzaccara.



4 - Implementation through HRs and Communication Skills (credit weeks: 0,5)

1. Rationale.

HRs are estimated to represent up to 75% of the healthcare systems expenditures in many

countries. As such, if HRs are poorly planned, the implications for the health service itself can

be extremely serious.

Despite the above, data relative to HRs management are still poor in South Sudan. Common

problems affecting HRs in South Sudan include the following:

Small number of trained and available personnel;

High concentration of health staff in urban hospital settings and shortages in rural

areas;

Inappropriate use of personnel;

Unproductive or demoralised staff.

In recognition of this, management of HRs will be a core module within the HMCTC programme.

The module aims at providing participants with the knowledge and skills required for managing

health personnel, from leading a team in a supportive way to organising team activities and from

assessing manpower demand and supply to developing a human resource plan.

Participants will gain knowledge and skills on different methods of implementing selected

programmes and activities.

2. Objectives.

At the end of this module participants will be able to:

Prepare a job description;

Discuss a task analysis;

Design a tree diagram;

Carry out effective supervision of health workers;

Introduce change and resolve conflicts among staff;

Foster good communication among health workers;

Run a meeting.





STRATEGY


ASSESSMENT

Monday PM


MM


Wednesday

Implementation

o f p lanned

activities

through the

appropriate

HRs and using

appropriate

communication

skills.

PBL; practical

sessions.






4. List of reading materials


Articles and Report

1. Management, Leadership and partnership for District Health, WHO Regional Office for

Africa, 2004. Module 3, Unit 1: “Management of Human Resources for Health”, pages: 1-

18; Communication pp. 6-10; Supervision pp. 12-16; Managing Interpersonal Conflict pp.

17-18;

Unit 6: “Managing Time and Space" pp. 49-54

Http: //www.afro.who.int/dsd/dhm-training/index.htm.

2. Working together for health. WHO, 2006. "Working in conflict and post conflict

environments". Pages 1-4.

Http: //www.who.int/whr/2006/06_chap2_en.pdf

3. Leading, ISS reading material, 2006, pages: 1-2.

4. Identifying Communication Styles for success, ISS reading material, Rome, 2006, pages:

1-3.

5. Conflict resolution: a communication tool for change, ISS reading material, Rome, 2006,

pages: 1-3.

6. Internal communication strategies, ISS reading material, Rome, 2006, pages: 1-3.

7. Conflict and cooperation in workplace, ISS reading material, Rome, 2006, pages: 1- 2.

8. Conflict resolution, ISS reading material, Rome, 2006, pages: 1- 3.

9. Human resources for health, WHO-WPRO,p.1

Consultation Books

1. Teaching for better learning, Abbatt, F.R. WHO 1992;

2. McMahon R, et al. “On being in charge. A guide to management in primary health care”.

WHO, Geneva 1992.

Journals

BioMed Central - Online journal http://www.human-resources-health.com/


___________________________



5-Monitoring and Evaluation (credit weeks: 0,5)

1. Rationale.

HMs should be acquainted with the planning process and be able to manage and evaluate HSs

from assessing community health needs, to deciding on priorities, setting objectives, selecting

indicators, identifying activities and responsibilities and allocating resources effectively.

Participants will gain knowledge and skills on different methods of monitoring and evaluation

and their central role in health care delivery.

2. Objectives.

At the end of the module the participant will be able to:

Monitor the work progresses according to schedule;

Monitor inputs: material, financial and information resources for public and private

health services;

Monitor outputs: quality of private and public HSs performance according to local

standards;

Evaluate the achievement of health team in services delivered and their impact in

reducing the priority health problems of the community;

Evaluate the efficient use of the health team resources;

Ensure community participation in monitoring and evaluating HSs.



STRATEGY


ASSESSMENT

Thursday PM

Friday

PBL; practical

sessions.

Non PBL session

MM


Saturday

Morning

Building a set

of indicators for

monitoring.Eval

uate HSs:

quantitative

and qualitative

approach.



Saturday

Sunday






Books

Planning and implementation of District Health Services. WHO – Regional Office for Africa

Brazzaville, 2004. pg. 41-43

Participatory Monitoring and Evaluation. A strategy for organization strengthening. F.W. Mulwa,

S.N. Nguluu. 2003. Pages.38-42, 52-64, 99-113.

Articles and Report

1. Monitoring and evaluation some tools, methods & approaches. WB –2004. (26 pages)

4.2. Consultation Materials.

Books

McMahon R, et al. On being in charge. A guide to management in primary health care - WHO,

Geneva 1992.


1. International Journal for quality in Health care. http://intqhc.oxfordjournals.org/

2. Framework for programme evaluation, Execut ive Board, WHO, 2000

http://who.int/gb/ebwha/pdf-files/EB107/eeid3.pdf. (4 pages)

Resource Person.

__________________________



7. THE TEACHING-LEARNING METHOD.

The teaching-learning method adopted finds its main and distinctive pillar in the PBL approach

(1, 2, 3, 4, 5). PBL, at its most fundamental level, is an instructional method characterised by

the use of "real world" problems as a context for participants to learn critical thinking and

problem solving skills, and acquire knowledge of the essential concepts of the course. Using

PBL, participants acquire life long learning skills, which include the ability, to find and use

appropriate learning resources. The process used in PBL is the following:

1. Participants are presented with a problem (case, research paper, video tape, for example).

Participants (in small groups, 6-8 people) organise their ideas and previous knowledge

related to the problem, and attempt to define the broad nature of the problem.

2. Throughout discussion, participants pose questions, called "learning issues," on aspects of

the problem that they do not understand. These learning issues are recorded by the group.

Participants are continually encouraged to define what they know - and more importantly -

what they don't know.

3. Participants rank, in order of importance, the learning issues generated in the session. They

decide which questions will be followed up by the whole group, and which issues can be

assigned to individuals, who later present to the rest of the group. Participants and

instructor also discuss what resources will be needed in order to research the learning

issues, and where they could be found.

4. When participants reconvene, they explore the previous learning issues, integrating their

new knowledge into the context of the problem. Participants are also encouraged to

summarise their knowledge and connect new concepts to old ones. They continue to define

new learning issues as they progress through the problem. Participants soon see that

learning is an ongoing process, and that there will always be (even for the teacher) learning

issues to be explored.

Tutor/facilitator plays a central role in the PBL process, guiding and supporting the participants

as they "learn how to learn." Each student PBL group has a dedicated tutor whose role is to

stimulate discussion, hone the students' ability to analyse and critique the information they bring

to group discussions, and monitor the group process. A Tutor’s Guide will help tutors in

facilitating the PBL sessions.



A Participants’ Guide, including the module cover page, the objectives and the problems will be

provided to the participants at the beginning of each unit.

A Facilitator Guide, including the general and specific objectives, the problems and the main

lectures will be provided to the facilitator at the beginning of the course to engineering the

method and to guide in a coherent a homogenous way the facilitator.

A part from PBL, non-PBL activities, such as lectures, seminars, audiovisuals, simulation

games, informatics sessions, and exercises will be also adopted.

7.1. Monitoring and evaluation.

Monitoring and evaluation is essential for the success of any training programme. It will deal

with the implementation of the programme and the performance of the participants.

Formal evaluation will be implemented to ensure the possibility to certify at the end of the

course the achievement of the defined objective.

Formative evaluation will be implemented to stimulate the progress of the participant using self,

pair and facilitator feedback.

7.1.1. Evaluation of programme.

Due to the “pilot” value of the first course an anonymous MCQ test will be provided to the

participant at the beginning and at the end of the course to assess the participant increasing of

knowledge.

At the same time the satisfaction of the customers will be assessed by a questionnaire:

From the inception to the implementation of the training programs, a systematic monitoring of its

adequacy and how it will meet participants’ needs will be conducted. At the end of each module,

tutors will prepare and distribute a questionnaire to all participants.

The questionnaire will cover the following areas:

– Extent to which the learning objectives have been achieved

– Relevance of course contents with regard to planned learning objectives

– Quality of teaching methods

– Tutors’ professionalism, availability and courtesy

– Availability, quantity and quality of learning materials

– Time allocated for the different steps of PBL

– Ameliorative proposals.



7.1.2. Participants’ assessment

As in any programme utilising PBL, the following assessment tools will be used -

Formal evaluation:

a. Individual written test: includes multiple choice, true/false questions aimed at assessing

knowledge and skills gained, as certifying assessment.

The suggested evaluation scale is as follow:

1= Unsatisfactory; 2= Below average; 3= Average; 4= Very good; 5=Excellent

The pass mark is 3.

b. Oral presentation skills assessment: short oral presentation on a topic relevant to the

objectives of the module. This is aimed at assessing presentation skills. Handouts will be

distributed in the framework of an ad-hoc seminar.

Formative Evaluation

a. Weekly peer and facilitator feedback: aimed at monitoring group-work skills.

b. Final feedback by facilitator: aimed at assessing participant's ability to work effectively in a

group. It provides feedback on individual basis

c. Peer evaluation will be ensured asking to the participants, starting from the third week to

create an assessment grid to use during the problem-solving meeting.

d. Self-evaluation will be ensured anonymously through the MCQ pre-post test.

8. REFERENCES


8. REFERENCES.

1. Aronson B. Improving online access to medical information for low-income countries. New England

Journal of Medicine, 2004, 350:966–968. http://content.nejm.org/cgi/reprint/350/10/966.pdf

2. Barrows HS. Designing a Problem Based Curriculum for the Pre-Clinical years. Springer

Publishing Company, New York 1985.

3. Barrows HS, Tamblyn RM. Problem-Based Learning: An Approach to Medical Education.

Springer Publishing Company, New York 1980.

4. Boud D, Felleti G. The Challenge of Problem-Based Learning. Kogan, London 1991.

5. Woods D R. Problem-Based Learning: How to Gain the Most from PBL. Donald R. Woods

Publisher, Hamilton, Ontario, Canada 1994.

6. Bouhuijs PAJ, Schmidt HG, Van Berkel HJM. Problem-Based Learning as an Educational

Strategy. Network Publications, Maastricht, 1993.

7. Butler R, Inman D, Lobb D. Problem-based learning and the medical school: another case

of the emperor’s new clothes? Advances in Physiology Education, 2005, 29:194–196.

http://advan.physiology.org/cgi/reprint/29/4/194

8. Dolmans DH, De Grave W, Wolfhagen IH, van der Vleuten CP. Problem-based learning:

future challenges for educational practice and research. Medical Education, 2005,

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Some Institutions involved in PBL.

Bowman Gray School of Medicine http://isnet.is.wfu.edu/bgsm/library/hughes.html.

McMaster University http://www-hsl.mcmaster.ca/faculty/workshops.html.

Maastricht University http://www.unimaas.nl/pbl/.

Harverd University Harvard Medical School - the "new pathway".

Annex 1 - The Programming


Annex I – The Programming.

HMCTC - Pilot Study

Where: Rumbek

When: May/June

Who: Staff: 1 Project Coordinator (9 weeks)

Skills required: Post-Graduate diploma; 10 years minimum work experience,

preferbly in Africa; Relevant experience in team and project coordination,

managing logistics and administration; Specific skills: fluency in English,

knowledge of the area preferable.

The job holders:

The organization will meet the person in charge for WHO/South Sudan

office to get information about the present situation in South Sudan in terms

of logistics issues such as transport, flights schedules etc;

Jointly with WHO person in charge will meet the Director of Sudanese

Human Resources Department to finalize the already agreed criteria for

selecting participants to the Crash Training and, to get a complete list

(name, title and location) of the selected participants;

Will be responsible for procuring and purchasing “in loco” training material

and equipment (if needed). The list of material and equipment will be

provided before her/his leaving;

Will ensure a safe and prompt transportation of material and equipment to

the field (through air transportation planning);

Will be responsible for travel and accommodation arrangement of

participants and expatriates by air transportation planning;

Will establish and maintain regular communication with WHO/Nairobi/South

Sudan office and, with ISS/Rome office;



Who: Staff: 1 Course Coordinator (5 weeks)

Skills required:

Post-Graduate diploma; 10 years minimum training work experience, preferably

in Africa; Relevant experience in team and project coordination, managing

training courses and modules; Specific skills: fluency in English, knowledge of

the area preferable.

The job holders:

To draft the program and the context of the Training course, on the basis of

the TNA;

To manage and prepare with ISS staff and facilitators the learning material

(for each module: introduction; problem; reading material, seminar, the

assessment system; participant and facilitator guide);

To coordinate the Training course;

To manage and organize facilitators activities;

To coordinate facilitators and participants in the field;

To understand participants and facilitators needs;

To solve-problems between participants and facilitators;

To advise and help facilitators;

To manage the participants assessment;

To manage the module assessment;

To asses facilitators performance and give suggestions;

To improve the organization and coordination of the Training course on the

basis of the lessons learned.



Who: Staff 3 Facilitators (5 weeks each)

Skills required:

Post-Graduate diploma; 3 years minimum work experience, preferably in Africa;

Course on PBL methodology; Pevious experience in team and project

coordination; Specific skills: fluency in English, knowledge of the area

preferable.

Tasks:

The job holders:

• To collaborate with the ISS staff to the production of the learning material

(for each module: introduction; problem; reading material, seminar, the

assessment system; participant and facilitator guide)

• To facilitate the participants learning process

• To collaborate with the coordinator during the field work

• To participate to the participants assessment

• To participate to the module assessment

• To modify on the basis of the lessons learned the learning material for the

following course.

Who: Trainee A maximum of 24 participants



HMCTC – Courses

How On the basis of the course evaluation, according to the lessons learned a

maximum of 1-2 courses will be developed

Where: To define

When: October/November

Who trainers: 1 Project Coordinator (9 weeks)

Tasks:

The same mentioned above more eventual new elements to consider on

the basis of the lessons learned during the pilot course.

1 Course Quality Manager (5 weeks)

Tasks:

To coordinate with each course coordinator the Training course;

To manage and organize coordinators activities;

To standardize the methodology among the different coordinator

To solve-problems between coordinators and facilitators;

To advise and help coordinators;

To manage the coordinator supervision;

To standardize the module assessment;

To supervise coordinator performance and give suggestions;

To improve the organization and coordination of the Training course on

the basis of the lessons learned.

3 Course Coordinator

Tasks:


the basis of the lessons learned during the pilot course

6 Facilitators

Tasks:


the basis of the lessons learned during the pilot course

Who Trainee A maximum of 16 participants for each course

Annex II – Pedagogical Contract


Annex II – Pedagogical Contract: participants’ rights and duties

Structure of HMCTC and timing

The participants will receive a course (HMCTC) of 5 residential modules designed to explore the

health policy framework in South Sudan and will be provided with the fundamental elements

and concepts concerning planning and management of HSs.

Each module will be weighted according to its duration in weeks (i.e. 1 week duration = 1 credit

week). Each module will be structured in 2 units content, delivered with the PBL approach in

practical sessions.

In order to obtain the credits, participants will have to pass the written tests foreseen per each

module.

In order to achieve the HMCTC, participants are required to complete the residential modules (5

credits weeks).

Presence of participants to the entire course program is considered compulsory, in order to

obtain the final certificates of attendance from the MoH of GoSS.

Material

The participant will receive at the beginning of the course a Participants’ Guide, including the

module cover page, the objectives of the course.

The problems of each week will be provided to the participants at the beginning of each unit.

The participant will receive a mean of 10 pages for each individual study hour as reading

material.

The participants task will be to prioritise among this material choosing the main relevant topics

to study for the problem-solving meeting.

A part from PBL, non-PBL activities, such as lectures, seminars, audiovisuals, simulation

games, informatics sessions, exercises will be provided to the participants.

Participants Monitoring and Evaluation

The assessment of the participants will be based on Formal evaluation necessary to certify at

the end of the course the achievement of the defined objective.

Formative evaluation will be implemented to stimulate the progress of the participant using self,

pair and facilitator feedback.

Annex II – Pedagogical Contract


Participants’ assessment

The participants will be assessed, as in any PBL programme, utilising different assessment

tools:

Formal evaluation:

a. Individual written test: includes multiple choice, true/false questions aimed at assessing

knowledge and skills gained, as certifying assessment.

The suggested evaluation scale is as follow:

1= Unsatisfactory; 2= Below average; 3= Average; 4= Very good; 5=Excellent

The pass mark is 3.

b. Oral presentation skills assessment: short oral presentation on a topic relevant to the

objectives of the module. This is aimed at assessing presentation skills. Handouts will

be distributed in the framework of an ad-hoc seminar.

Formative Evaluation:

c. Weekly peer and facilitator feedback: aimed at monitoring group-work skills. Has a

formative purpose.

d. Final feedback by facilitator: aimed at assessing participant's ability to work effectively

in a group. It provides feedback on individual basis and has also formative purposes.

e. Peer evaluation: will be ensured asking to the participants, starting from the third week

to create an assessment grid to use during the problem-solving meeting.

f. Self-evaluation: will be ensured anonymously through the MCQ pre-post test.

Evaluation of programme.

The participant satisfaction will be assessed using a MCQ test.

It will be provided at the beginning and at the end of the course

The participant needs will be monitored through the facilitator commitment using for each unit a

questionnaire.

The questionnaire will cover the following areas:

– Extent of the learning objectives achieved

– Relevance of course contents with regard to planned learning objectives

– Quality of teaching methods

– Tutors’ professionalism, availability and courtesy

– Availability, quantity and quality of learning materials

– Time allocated for the different steps of PBL

– Ameliorative proposals

Annex III – Facilitator check list


Annex III – Facilitator check list

Material

Participant list

General objective list (course)

Specific objective list (for each module)

Learning material

Problems

Reading material

Participants guide

Facilitator guide

PBL methodology’s guidelines

Phase’s list

Questions to favourite the passage from a phase to the other one

Evaluation tools

Peer feedback format

Facilitator feedback format

Peer evaluation format

Annex IV – Coordinator check list


Annex IV – Coordinator check list

Material

Seminar presentation

Role playing guide

The Participant assessment guide (criteria assessment)

Facilitator criteria assessment

Evaluation tools

MCQ unit assessment

Participant presentation assessment criteria

MCQ pre-post test course and self evaluation

Annex V – SWOT Analysis


Annex V – SWOT Analysis

S W Relevance of HMCTC to current training

needs of health personnel in South Sudan.

Curricula designed on the basis of local

situation.

PBL as an interactive and participatory

training methodology of continuing education.

Intensive nature of programmed training.

Long-lasting lack of exposure of health

personnel to continuing education and

professional upgrading initiatives.

Limited awareness of the importance of HSM

and its use by potential participants to

HMCTC.

Limited knowledge of managerial language

and terminology by candidate participants to

HMCTC.

Limited time span to deepen management

concepts.

O T January 2005 peace agreement between

SPLM/A and the Government of Khartoum;

SPLM/A’s concern in fostering strategic

development initiatives aimed at political and

socio-economic recovery of South Sudan;

Continuing institutional interest in the

reconstruction of the heath care system and in

the development of quality health care

services in South Sudan;

Provision of healthcare services and training

by NGOs;

Perceived need of intensive training and

professional qualification of existing health

personnel;

Logistics

Post-conflict environment.

Overall poor extent of awareness of health

personnel responsibilities.

Potential political aspects linked to managing

human resources (i.e.: potential difficulties in

reintegrating health workers from different

political factions, tribes or sects)

Low level of coordination between County

and MOH.

Annex VI – Training Costs


Annex VI – Training Costs.

The cost of one-week training per participant, calculated in US$, is, distributed as follows:

ITEM COST (US$)

Tuition

(Registration, tutorials, access to the library and computers, stationary)

Welfare

(Full board accommodation)

The cost of the HMCTC programme (5 weeks) per participant, calculated in US$, is, distributed

as follows:

ITEM COST (US$)

Tuition

(Registration, tutorials, access to the library and computers, stationary)

Welfare

(Full board accommodation)

Travel

(Displacement cost)

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