The presentation will describe steps followed to develop a training programme for Nurses and health professionals to facilitate quality health care and services delivery in the health facilities. Quality improvement training refers to any activity that explicitly aimed to teach health professionals about methods that could be applied to analyse and improve quality care. It also aims to empower health professionals with knowledge, skills and abilities to enhance quality health care delivery. This was echoed by the difficulties experienced by health professionals in rendering quality health care delivery cannot overlooked as most had not received any training in quality assurance and quality improvement components. Without appropriate training and empowerment, health care delivery would continue to yield unsatisfactory. This process was done in four phase as illustrated in methodology.
Phase 1: The first phase undertaken in this study to gather information was a situation analysis, which had two objectives. The findings would be a base for the educational programme developed. The first objective of the situation analysis focused on the health facilities to understand the status of existing quality improvement and quality assurance. A checklist was administered to the management members to confirm the approaches regarding quality health care delivery in the health facilities. The methodological approach pursued to achieve this objective was detailed in chapter 2. The part two of the situation analysis was to explore and describe the experiences of health professionals about quality improvement and quality assurance in the health facilities with the view to improve quality health care delivery. In this phase, the individual interviews and FGD with health professionals and managers were conducted. In objective one objective revealedloophole in the availability of policies and guidelines, leadership to facilitate care delivery, health system infrastructure and patient safety as well as research and information to facilitate quality health delivery. In objective 2, five themes and 18 sub-themes were identified. The themes revealed that the participants experiences lack of availabilities, guidelines and structure to facilitate QI and QA; inadequate management of resources; inadequate interpersonal relationship between the health workers inadequate understanding of QI and QA and lastly inadequate research and information, monitoring and evaluation and indictors of monitoring and evaluation.
Phase 2: The conceptual framework of this study was based on the Practice Oriented Theory by Dickoff (1968, p. 434), which helped to explain the concepts used in developing quality improvement training programme for health professionals in the health facilities. Dickoff (1968, p. 438) Practice Oriented Theory consists of the agent, recipients, context, procedure, dynamics and the terminus. In this study the agent is quality specialist; recipient are health professionals, context is health facilities; dynamic are challenges experiences by health professionals; procedure is training programme and terminuses is knowledgeable, skilful health professionals in quality health care delivery.
Phase 3: During the development of quality improvement training programme, two main theories were adapted. The prominent was a model by Meyer and Van Niekerk (2008, p. 54), which was adapted to guide the process of developing the training programme. The Kolb’s Experiential Learning Theory, which explains the learning process and styles of developing knowledge through experiences. The educational programme includes the purpose/aim; objectives, structure/design; process (facilitation process); implementation process and evaluation of the programme.
Phase 4: Phase 4 of the study focused on developing the guidelines for implementing the training programme. The guidelines in this study were developed to direct and promote effective implementation of the training programme. They are the guiding document outlining the process, activities and issues required to implement the programme. The purpose of the guidelines in is to assist the implementers and beneficiaries on steps to be followed in implementing the training the programme.
Phase 5: Phase five was focuses on the evaluation of quality improvement training programme. To achieve that, two (2) practical frameworks were adopted in this study namely the United Nations Population Fund (UNFPA, 2013) based on four phases, which were used to guide the team of evaluator or facilitator on how to conduct the evaluation.
In conclusion, based on the evaluation programme by the participants revealed that quality improvement training programme for health professionals in Ministry of health and Social Services is needed. It was recommended that the educational programme should be tested within in which context the study was conducted.