Introduction: Service delivery guidelines (SDG) are a critical tool in maximizing access to and quality of FP services in developing countries. Experts continue to debate, however, how to disseminate guidelines - and their effectiveness. In 1999-2000, we evaluated the impact of a nationwide update for providers in Kenya on the revised content of the SDGs. Methods: 72 clinics were cluster-randomized to either standard training, enhanced training, or enhanced training plus support supervision. We collected pre-intervention data from 176 providers just prior to the update intervention. Post-intervention data were collected 6 to 9 months later. Results: Significant improvements in knowledge and practices (separate indicators and combined scores) resulted in all three groups, with significant incremental impact associated with the support supervision. Significant effects extended beyond directly trained providers to co-workers who received SDG updates in the cascade update. The intervention also significantly reduced the proportion of non-menstruating clients sent home without FP services and significantly increased the proportion of clients advised to use condoms in addition to their regular FP method (dual-method use). Conclusions: This study demonstrated that updating providers on new SDG content can lead to improvements in both quality and access to care. It also showed that well-organized “cascade training” can be a rapid, effective means of updating health workers in an entire country.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: describe the central importance of service delivery guidelines in international family planning; discuss techniques for evaluating training impacts; describe how effective this training was in Kenya; and discss "cascade training."
Keywords: Family Planning, Evaluation
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.