HUMAN RESOURCES FOR HEALTH ASSESSMENT

DATA COLLECTION TRAINING

TRAINER’S MANUAL

February 2008
This publication was produced for review by the United States Agency for International Development.
It was prepared by Gilbert Kombe, Fred Rosensweig, and Amy Taye for the Health Systems 20/20 project.
Recommended Citation: Kombe GIlbert, Fred Rosensweig, and Amy Taye. February 2008. Human Resources
For Health Assessment: Data Collection Training.Trainer’s Manual. Bethesda, MD: Health Systems 20/20 project, Abt
Associates Inc.

Download: Download copies of Health Sytems 20/20 publications at: www.healthsystems2020.org

Project No.: GHS-A-00-06-00010-00

Submitted to: Karen Cavanaugh, USAID/GH/HIDN/HS, CTO

Yogesh Rajkotia, USAID/GH/HIDN/HS, co-CTO
Bureau of Global Health
Global Health/Population and Reproductive Health/Service Delivery Improvement
Center for Population, Health and Nutrition
Bureau for Global Programs, Field Support and Research
United States Agency for International Development

Abt Associates Inc. I 4550 Montgomery Avenue, Suite 800 North I Bethesda, Maryland 20814
I T: 301.347-5000 I F: 301/652-3916 I www.healthsystems2020.org I www.abtassoc.com

In collaboration with:
I Aga Khan Foundation I BearingPoint I Bitrán y Asociados I BRAC University
I Broad Branch Associates I Forum One Communications I RTI International
I Training Resources Group I Tulane University School of Public Health and Tropical Medicine

The author’s views expressed in this publication do not necessarily reflect the views of the
United States Agency for International Development or the United States Government.
Human Resources for Health Assessment

Data Collection Training

TRAINER’S MANUAL

February 2008
The author’s views expressed in this publication do not necessarilly reflect the views the
United States Agency for International Development or the United States Government.
Table of Contents

Session 1. Introduction..........................................................................................................1
Session 2. Context and Rationale for HRH Assessment................................................5
Session 3. HRH Assessment Process..................................................................................9
Session 4. Data Collection Instrument............................................................................ 17
Session 5. Skill Practice....................................................................................................... 51
Session 6. Field Practice...................................................................................................... 57
Session 7. Developing a Field Implementation Plan...................................................... 60
Session 8. Wrap-up and Next Steps................................................................................. 65

Table of Contents
Purpose of the Trainer’s Manual

This trainer’s manual contains a suggested workshop design for use by individuals and
organizations planning Human Resources for Health (HRH) Assessments. These materials
can be used to train supervisors and data collectors to conduct an HRH assessment.
Foreword

1. Overview
This document is a trainer’s manual for training data collectors to conduct a Human
Resources for Health (HRH) assessment in the health sector. The two-day workshop
is designed for a group of approximately 25 participants organized into five teams
of five individuals. Each team consists of a supervisor and four data collectors. The
guide contains step-by-step instructions for the trainers to conduct the workshop. It
is intended for use in conjunction with the accompanying participant manual, which
contains the technical materials that the participants will receive during the workshop,
and a CD with the PowerPoint presentation materials.

2. Participants
Training participants include supervisors and data collectors, who are organized into
teams. Each team is led by a field supervisor (typically a nurse or doctor) and has
approximately four data collectors (often college/university students). The participants
are expected to have at least a college/university level of education.

3. Training methodology
The training is conducted in a workshop format with approximately 13 hours of actual
workshop time excluding breaks. All session times are estimates based on earlier
training experience, and they may vary slightly in this workshop. The workshop uses the
principles of adult learning and the experiential learning methodology. (See Annex A for a
description of the Experiential Learning Methodology). The course is highly participatory,
with a mix of presentations, small group tasks, role-playing, and full group discussion.

Foreword
 HRH Assessment: Data Collection Training
Trainer’s Manual

4. Workshop Purpose and Objectives

The purpose of this workshop is to prepare the data collection teams to carry out the
data collection step in the HRH assessment process.

Specific workshop objectives are to:

 Understand the context and rationale for the HRH assessment

 Discuss the overall HRH assessment process

 Describe the field strategy for the assessment

 Become familiar with the data collection instrument

 Practice skills required to use the instrument effectively

 Develop a plan for field implementation

 Clarify the logistical issues related to field implementation

5. Sample Workshop Agenda

Day 1 Day 2
8:30 Introduction 8:30 Field Practice
 Hospital
9:30 Coffeee/Tea Break  Clinic
9:45 Context and Rationale  Debrief

10:30 HRH Assessment Process Coffee/Tea Break between sites

 Overview
 Field Strategy

11:30 Data Collection Instrument

12:30 Lunch 12:30 Lunch

1:30 Interview Skill Practice 1:30 Developing a Field Implementation Plan

 Interviewing Skills Presentation  Overview
 Demonstration  Roles and Responsibilities
 Action planning

3:30 Coffee/Tea Break 3:30 Coffee/Tea Break

3:45 Interview Skill Practice (continued) 4:30 Wrap-up and Next Steps

5:00 End 5:00 End

6. Trainer’s Manual
The material in this training manual is designed to be delivered by a skilled trainer
(preferably a team of two trainers) experienced in conducting surveys and supervising
data collection teams and knowledgeable about HRH assessments. The trainers are
expected to work as a team in delivering the training.

7. Participant’s Manual
This trainer’s manual should be used in conjunction with the participant manual. The
participant’s manual is organized by sessions, with documents presented in the order in
which they are used in the workshop. The trainer’s manual makes specific reference to
these documents and when and how they should be used.

8. PowerPoint
A CD included with this trainer’s manual contains electronic PowerPoint versions of
all the materials that the trainers will present to the participants. These include all task
instructions, presentation materials, and instruments. Most of these materials are also
replicated in the participant manual.

9. Workshop Venue
The workshop will generally be conducted in a venue that is affordable, convenient,
and appropriate for training. The site should have a large training room that can
accommodate up to five small breakout groups without overcrowding. The room should
be arranged with rectangular tables for breakout groups, that is, it should not be set up
in classroom or theater style. This will allow participants to interact easily. If possible,
separate breakout space for the small group sessions should be available. The venue
should also have a projector and screen for PowerPoint presentations.

Foreword
10 HRH Assessment: Data Collection Training
Trainer’s Manual

10. Evaluation of Workshop

At the end of the workshop, the participants will fill out a short evaluation questionnaire.

11. Performance Expectations

Participants are held to a high performance standard. They are expected to be punctual
and participate in the entirety of the two days of training. At the end of this training,
participants will be required to:

1. Explain the rationale for HRH data collection

2. Discuss the questions in the data collections instruments

3. Understand the interview techniques

SESSION 1
Introduction
Goal:
Ensure that
participants have a
clear understanding
of the goals
and agenda

Session Overview
Total Duration:
Steps and Duration 1 Hour
1. Welcome: 10 minutes

2. Introductions: 10 minutes

3. Getting Started: 20 minutes

4. Review of Goals and Agenda: 10 minutes

5. Guidelines for Working Together: 5 minutes

6. Logistics and Housekeeping:: 5 minutes

Materials
 Participant Manual pages 1-4

 PowerPoint Slides 1-9


Session 1
Introduction
  HRH Assessment: Data Collection Training
Trainer’s Manual

1. Welcome:10 minutes

Ideally, the welcome should be done by a representative of the Ministry of Health, US

Government or other sponsoring agency, and the technical
team leader.

The welcome should focus on the following points:

 Importance of the activity in addressing the critical

shortage of qualified personnel in the health sector

 Skills and experience of the participants

 Importance of the data collection training in the HRH

assessment process

2. Introductions: 10 minutes

The trainers/facilitators introduce themselves. Their introduction serves as a model for

the participants to use when introducing themselves.

Task: Introduction

Please tell us:

 Your name

 Your full-time occupation

 One thing you hope to learn in

this workshop

1
Session
3. Getting Started: 20 minutes
Session
1
Tell the participants that you want to get the workshop started with something
interactive.

Post on five flipcharts located around the room five reasons for the HRH shortage one
reason per flipchart. While the trainer can select the specific reasons most applicable to
the country, five fairly typical reasons are the following:

 Inadequate compensation

 Ineffective training institutions

 Poor supervision and management

 Poorly motivated staff

 Lack of interest in working in areas of the country that need the most help

Ask the participants to complete the following task:

Task: Getting Started

 Go stand by the flipchart with the reason that best

captures why there is a human resource shortage
in this country’s health sector.

 Form a group with the others who also chose that

reason.

 Share with the group why you chose this reason.

 Be prepared to share the highlights of your group

discussion with the entire class.

Take 10 minutes

Ask each group to briefly share why they chose that reason. This reporting should move
quickly. Summarize the common themes once all the groups have reported.


Session 1
Introduction
  HRH Assessment: Data Collection Training
Trainer’s Manual

4. Workshop Goals and Agenda: 10 minutes

Review the workshop purpose and objectives. Refer participants to the list of objectives
on page 1 in the participant manual.

A. Workshop Purpose and Objectives

Workshop Purpose

Prepare the data collection teams to carry out the data collection component of the
HRH assessment process.

Workshop Objectives

 Understand the context and rationale for the HRH

assessment

 Discuss the overall HRH assessment process

 Describe the field strategy for the assessment

 Become familiar with the data collection instrument

 Practice skills required to use the instrument

effectively

 Develop a plan for field implementation

 Clarify the logistical issues

related to field implementation

1
Session
B. Agenda
Session
1
Present the workshop agenda using the block
calendar on page 2 of the participant manual, and
show how the objectives will be achieved through
the various sessions. Below is a sample agenda that
can be modified to suit local circumstances.

Workshop Agenda
Day 1 Day 2

8:30 Introduction 8:30 Field Practice

 Preparation
9:30 Coffee/Tea Break
 Hospital
9:45 Context and Rationale  Clinic
 Health Center
10:30 HRH Assessment Process
 Debrief
 Overview
 Field Strategy 9:30 Coffee/Tea Break

11:30 Data Collection Instrument

12:30 Lunch 12:30 Lunch

1:30 Interview Skill Practice 1:30 Developing a Field Implementation

 Presentation Plan
 Demonstration  Overview
 Practice Interviews  Roles and responsibilities
 Discussion  Action planning

3:30 Coffee/Tea Break 3:30 Coffee/Tea Break

3:45 Interview Skill Practice (continued) 4:30 Wrap-up and Next Steps

5:00 End 5:00 End


Session 1
Introduction
  HRH Assessment: Data Collection Training
Trainer’s Manual

5. Guidelines for Working Together: 5 minutes

Discuss some behaviors that the group should adopt – ways the group can work
together to help achieve the workshop objectives by creating a safe, efficient, and
effective learning environment.

Discuss each of the behavior guidelines, explaining what

each might look like in action.

Proposed Guidelines for Working Together

 Participate actively

 Listen and ask questions

 Balance level of participation

 Start and end on time

 Do not smoke in sessions

 Turn cell phones off during session

Ask if there are any other guidelines the participants wish to suggest. Write any
additional guidelines on a flipchart. Ask participants for agreement. Post the flipchart
list on the wall along with the workshop objectives so that people can refer to them
throughout the workshop.

6. Logistics and Housekeeping: 5 minutes

Review any logistics information such as start times, location of breakout space, and
arrangements for coffee breaks, lunch, and dinner.

1
Session
Slide Presentation
Session
1


Session 1
Introduction
  HRH Assessment: Data Collection Training
Trainer’s Manual

1
Session
 Session
1


Session 1
Introduction
10 HRH Assessment: Data Collection Training
Trainer’s Manual

1
Session
11 HRH Assessment: Data Collection Training
Trainer’s Manual

1
Session
SESSION 2
Context and Rationale
for HRH Assessment
Goal:
Understand the
context and rationale
for the HRH
assessment

Session Overview
Total Duration:
Steps and Duration 50 Minutes
1. Introduction: 10 minutes

2. Presentation – Context and Rationale for HRH Assessment: 15 minutes

3. Plenary Discussion: 15 minutes

4. Summary: 10 minutes

Materials
 Participant Manual pages 5-8

 PowerPoint Slides 10-14

Session 2
Context and Rationale for HRH Assessment 13
14 HRH Assessment: Data Collection Training
Trainer’s Manual

1. Introduction: 10 minutes

Introduce the goal of the session – to understand the context and rationale for the HRH
Assessment.

Explain that the lack of qualified HRH has been identified as one of the major challenges
in meeting the Millennium Development Goals (MDGs) and the targets of other
programs such as the US President’s Emergency Plan for AIDS Relief (PEPFAR) and that
the HRH assessment is one important step in trying to address this challenge.

Refer participants back to the getting started activity in the previous session and remind
them of the reasons behind the lack of qualified health personnel. Possible reasons
include:

 Lack of incentives, especially to work in rural areas

 Emigration of trained personnel to developed countries

 Quality of training institutions

 Inadequate working conditions and access to supplies and equipment

 Lack of a human resources information system (HRIS)

 Poor supervision and management

 Lack of professional standards and licensing

Point out that the HRH assessment will not address the full range of issues related
to the HRH shortage, such as how to hire and retain personnel and train them more
effectively. Rather it will focus on the starting point – understanding the make-up of the
current health sector workforce.

2
Session
15 HRH Assessment: Data Collection Training
Trainer’s Manual

2. Presentation – Context and Rationale for HRH

Assessment: 15 minutes
A. Context and Rationale

Using PowerPoint, give a brief presentation that makes

the following points:

 The HRH shortage is a problem across sub-Saharan

Africa. It reflects social, political, and economic
challenges in the region. Although lack of human
resources is proving to be the major bottleneck to
increasing people’s access to health care services,
little has been done to address the shortage. The
issue needs to be considered in the context of the
entire health sector.

 Programs like the MDGs and PEPFAR reinforce

the importance of addressing the HRH shortage.
Human resources are a critical component of
achieving program targets – lack of HRH threatens
achievement of the goals.

 The first step in reducing the HRH shortage is to

get a clear picture of the current human resources
situation in the public health sector – in effect, to
carefully define the dimensions of the problem. The
assessment gives the clear picture needed.

Note: If any figures are

available in the assessment
country from other studies
or national government
statistics, these should be
briefly summarized.

3
Session
16 HRH Assessment: Data Collection Training
Trainer’s Manual

B. Objectives of the Assessment

The specific HRH assessment objectives are to:

 Quantify existing and project future HR needs

 Determine the gap between what is needed and

what is available

 Assess whether the country will reach certain

international goals with existing human resources

C. Key Questions

The HRH assessment will address the following key

questions:

 What is the current HRH situation?

 How much time does staff spend on HIV/AIDS,

tuberculosis (TB), malaria, maternal health, child health,
and other services?

 Will the country be able to reach national, MDG, and

PEPFAR targets?

2
Session
3. Plenary Discussion: 15 minutes
Session
2
Ask the following questions to the group:

 Are there any other contextual factors that have not been mentioned that
contribute to the HRH shortage?

 What other programs have contributed to the HRH shortage in addition to PEPFAR?

 Why is it important in the data collection process to understand the context for
the HRH assessment? (Note: Responses should include the following: 1) as data
collectors, they need to be able to explain to the interviewees why the assessment is
being conducted and 2) it will help them do a better job if they understand why they
(are collecting the data.)

4. Summary: 10 minutes

Ask the participants what they want to be sure to remember about the context and
rationale for the HRH assessment.

Then ask them to jot down the key points they want to remember in the learning log
for this session.

Say that the next session will be an overview of the HRH assessment process.

Session 2
Context and Rationale for HRH Assessment 17
Slide Presentation
Session
2

Session 2
Context and Rationale for HRH Assessment 19
20 HRH Assessment: Data Collection Training
Trainer’s Manual

2
Session
 Session
2

Session 2
Context and Rationale for HRH Assessment 21
SESSION 3
HRH Assessment Process
Goal:
Discuss the overall
HRH assessment
process.
Describe the field
strategy for the
assessment.

Session Overview
Steps and Duration Total Duration:
1 Hour
1. Introduction: 5 minutes

2. Presentation – HRH Assessment Process: 20 minutes

3. Plenary Discussion: 10 minutes

4. Interactive Presentation: 15 minutes

5. Summary: 10 minutes

Materials

 Participant Manual pages 9-16

 PowerPoint Slides 15-24

Session 3
HRH Assessment Process 23
24 HRH Assessment: Data Collection Training
Trainer’s Manual

1. Introduction: 5 minutes

Ask the participants if they have ever participated in an HRH assessment. If so, ask for a
few brief examples of the scope and nature of the assessment.

Say that this session will describe the specific HRH assessment process that will be used
in this study. State that this process has been used in other countries including Cote
d’Ivoire, Kenya, Nigeria, and Zambia, so the methodology is well developed.

Review the goals of the session – to understand the overall HRH assessment process
and to describe the field strategy for the assessment.

2. Presentation – HRH Assessment Process: 20 minutes

A. Assessment Process

Explain that the overall HRH assessment process has six steps:

Step 1: Specify the objectives of the assessment. As discussed in the previous session,
the objectives typically are to quantify existing and project future need, determine the
gap between what is needed and what is available, and assess whether the country will
reach certain international goals with existing human resources.

Step 2: Decide which variables to focus on. Variables

are usually quantitative, measuring the number or
proportion of available health workers, where they are
located, the type of skills they have, and the training they
received.

Step 3: Design or modify the data collection

instruments. The technical team has already prepared the
data collection instrument; it will be reviewed later in the
morning.

Step 4: Develop the sampling methodology.

The technical team has also prepared the sampling
methodology using random sampling techniques with a
margin of error of plus or minus 5% at a 95% confidence level.

Step 5: Collect, enter, analyze, and disseminate. The focus of this workshop is
on data collection. Once the data are collected, they are verified by supervisors to

3
Session
determine if there are any discrepancies, then the data are cleaned, and entered in a data
Session
3
set. After data entry, analysis and interpretation occurs. Findings are presented at the
national level.

Step 6: Develop an action plan. The final step is the development of an action plan
based on the findings.

Emphasize that these six steps represent the overall process and confirm that the
participants are clear that the focus of this workshop is on the data collection described
in Step 5. Also, say that Steps 1-4 were addressed prior to this workshop and that Step 6
will happen once findings are determined. Refer participants to pages 10-12 for a written
explanation of the assessment process.

B. HRH Assessment Components

Explain that the data collection instrument is addressed to the following entities:

 Levels of care

 Tertiary – teaching and specialized hospitals

 Secondary – regional hospitals

 Primary – health centers and dispensaries

 Types of facility

 Government

 Mission / Faith-based condolences

 Key categories of staff

 Doctors, nurses, laboratory technicians,

pharmacists, radiographers, counselors, administrators, etc.

Session 3
HRH Assessment Process 25
26 HRH Assessment: Data Collection Training
Trainer’s Manual

C. Key Service Areas of the Assessment

The assessment will focus on the following elements,

each of which has a section in the data collection
instrument:

 HIV/AIDS

 TB

 Malaria

 Maternal health

 Child health

D. General Assessment Queries

The instrument will collect data on the following general

questions:

 What type and number of staff work on which

service?

 How long do staff spend per patient per service?

 How many days per week are services provided?

 What services are provided?

 How many people are covered?

E. Expected Products

There are four overall products that will result from the
assessment.

 Completed data collection forms

 Comprehensive and high quality data

 Properly cleaned data set

 Comprehensive report with findings that accurately

reflect the current HR situation

3
Session
At the data collection stage, we are focused on the first two of these products. Explain
the process for cleaning and entering the data and how the report will be produced.
Session
3
3. Plenary Discussion: 10 minutes

Conduct a brief plenary discussion on the presentation to ensure that the participants
understand the overall parameters of the assessment.

Ask the participants what they think the main challenges will be in conducting this
assessment.

4. Interactive Presentation - Field Strategy: 15 minutes

Present an overview of the field strategy for the assessment using PowerPoint.

The following points form the basis of the field

strategy:

 Need for accurate representation (in terms of

geography, population, levels of care, and specific
diseases)

 Need for statistically significant data

 Need for specific focus on five main health services

(HIV/AIDS, TB, malaria, child health, and maternal
health)

The following points form the basis of the sampling

framework:

 Facilitate the selection of a representative

probability sample of public or private health
facilities

 Use public or private facility list as appropriate

Session 3
HRH Assessment Process 27
28 HRH Assessment: Data Collection Training
Trainer’s Manual

Hand out the list of facilities selected and explain how the following selection criteria
were applied:

1. Large facilities are selected from the pool of public and

faith-based facilities.

2. Remaining facilities are sorted by type and location.

3. Number of facilities was selected based on population

size of area, total number of facilities, etc.

Ask participants if they have any questions on how the

facilities have been selected.

Say that the field strategy will be implemented over a

two-week period and will include:

 Data from public hospitals, health centers, and dispensaries

 Data at the national level from the Ministry of Health. Data come mainly from
published reports and the national health management information system.1

Then share the following illustrative timeline. (The dates are illustrative, only meant to show
the duration of the steps in relation to one another.) Refer participants to page 14 in the
participant manual.

Training of data collectors April 20-21 (2 days)

Data collection April 24-May 5 (2 weeks)

Data entry May 1-12 (runs concurrently with 2nd week of

data collection)

Data analysis May 15-June 15 (<1 month)

Report writing June (1 month)

Be sure to point out who is responsible for each step.

1
Documents include the human resource plan, annual HRH reports, HMIS summary reports and human
resource policy and strategy

3
Session
29 HRH Assessment: Data Collection Training
Trainer’s Manual

5. Summary: 10 minutes

Ask the participants the following questions in plenary:

 What have you learned about the HRH assessment process that you want to be sure
to remember?

 How will these lessons learned affect the data collection you are about to do?

Then ask the participants to capture these key lessons in their learning logs.

Make a transition to the next session on the data collection instrument.

3
Session
Slide Presentation
Session
3

Session 3
HRH Assessment Process 31
32 HRH Assessment: Data Collection Training
Trainer’s Manual

3
Session
 Session
3

Session 3
HRH Assessment Process 33
34 HRH Assessment: Data Collection Training
Trainer’s Manual

3
Session
 Session
3

Session 3
HRH Assessment Process 35
SESSION 4
Data Collection Instrument
Goal:
Become familiar
with the data
collection instrument.

Session Overview
Total Duration:
Steps and Duration 1 Hour
1. Introduction: 5 minutes

2. Presentation – Overview of Instrument: 15 minutes

3. Individual Task: 15 minutes

4. Plenary Discussion: 20 minutes

5. Summary: 5 minutes

Materials

Participant Manual: pages 17-50

PowerPoint Slides: 25-36

37
Session 4
Data Collection Instrument
38 HRH Assessment: Data Collection Training
Trainer’s Manual

1. Introduction: 5 minutes

Tell participants that the objective of this session is to become familiar with the data
collection instrument. Ask if any of the participants have had previous experience in
collecting interview data with a highly structured instrument. If so, ask the participants to
briefly describe some examples.

2. Overview of Data Collection Instrument

Provide an overview of the instrument by explaining the following:

A. Organization of the Instrument

 Facility identification information

 Human resources status

 Type of services provided in this facility

 HIV/AIDS services

 TB services

 Malaria services

 Maternal health services

 Family planning services

 Child health services

 Addendum

 Acronyms and definitions

B.Type of Data to be Collected

4
Session
 Number of health workers by staff type
Session
4
 Reasons why health workers leave a facility – important for calculating attrition rates

 Types of health services provided by the facility,

related to:

 HIV/AIDS

 TB

 Malaria

 Maternal health

 Family planning

 Child health

 Number of patients seen in a facility for each

service

 Time health workers spend per patient: current and

ideal number of minutes

39
Session 4
Data Collection Instrument
40 HRH Assessment: Data Collection Training
Trainer’s Manual

C. Instructions for Data Collection

 Key points for data collectors to keep in mind:

 We need accurate and reasonable data.

 Incorrectly filled data instruments will not be

accepted. Concerned data collector will be sent back to
facility to rectify the mistakes.

 The data instrument cannot be left with respondent

for him/her to complete. Only you should fill in the
information.

 Supervisor signature is required for each survey.

 Validity of data collected will depend mainly on

interviewing skills.

 Identify the right people in the facility to answer each group of questions.

4
Session
3. Individual time to review the instrument: 15 minutes
Session
4
The instrument is found in Annex B of the Trainer’s Manual.

Give the following individual task. Refer participants to the instrument on pages 20-48 in
the participant manual.

Task: Review Data Collection Instrument:

Take 15 minutes

Individually, read the health facility questionnaire, noting

its organization and the questions that are asked.
Note down any questions you have about the instrument.

4. Plenary discussion: 20 minutes

First, respond to individual participants questions.

Then make the following specific comments about the

questions in the instrument:

 Questions 1-4

 If data are not available or not collected, put

9999 with a brief explanation in the “Notes”
of the reasons why the data were not
collected.

 If this staff type is not available in this facility,

put 0 for the number of staff.

 Questions 7, 14, 16, 19

 If data are not available or not collected, put

9999 with a brief explanation in the “Notes”
of the reasons why the data were not
collected.

 If this service is not provided in this facility,

put 0 for the number of patients in the last
three months.

41
Session 4
Data Collection Instrument
42 HRH Assessment: Data Collection Training
Trainer’s Manual

 Questions 8, 9, 10

 If the staff type is not providing the service or not

available in this facility, put 0 for the number of minutes
per patient.

 For the tables where the number of minutes per

patient needs to be recorded:

 Enter numbers only, not text; for example write “15”

and not “15
mins.”

 Round
time to the
nearest minute; for example
write “9” instead of “8.5.”

 Enter only one number, not a

range. If respondent gives you
a range, write down the mid-
point. For example, if they say
5-10 minutes, write “8.”

 Note that time per patient needs to be recorded.

5. Summary: 5 minutes

Ask participants the following questions:

 What are the most important points you want to remember about the data
collection instrument?

Ask the participants to write down the key points they want to remember in their
learning logs.

Make a transition to the next session on interviewing skills.

4
Session
Slide Presentation
Session
4

43
Session 4
Data Collection Instrument
44 HRH Assessment: Data Collection Training
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4
Session
 Session
4

45
Session 4
Data Collection Instrument
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Trainer’s Manual

4
Session
 Session
4

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Session 4
Data Collection Instrument
48 HRH Assessment: Data Collection Training
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4
Session
SESSION 5
Skill Practice
Goal:
Practice skills
required to use the
instrument effectively.
Become familiar with
the data collection
instrument

Session Overview
Total Duration:
Steps and Duration
3 Hours & 10 Minutes
1. Introduction: 10 minutes

2. Presentation – Interviewing Skills: 20 minutes

3. Demonstration: 30 minutes

4. Skill Practice: 100 minutes

5. Plenary Discussion: 20 minutes

6. Summary: 10 minutes

Materials
 Participant Manual pages 51-56

 PowerPoint Slides 37-41

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Skill Practice
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1. Introduction: 5 minutes

Review the goal of the session – to practice skills required to use the data collection
instrument effectively and to continue to become familiar with the instrument. Note that
tomorrow morning’s session will provide additional practice in the facility setting.

Ask the participants what they think they need to do to use the instrument effectively.

Take a few responses. Explain to participants that they will have the opportunity in this
session to “try out” and practice using the instrument in a mock interview setting.

2. Presentation - Interviewing Skills: 20 minutes

Refer participants to the sheet on interviewing tips and techniques (page 51-52 in the
participant’s manual), and discuss each point.

Interviewing Tips and Techniques

 Establish a rapport with the person you are interviewing — this is a FRIENDLY
interview. Be courteous. Give your name. Thank him/her for agreeing to spend this
time with you.

 Explain the purpose of the interview. Let him/her

know how much time you expect to need (e.g., “This will
be a 90-minute conversation”).

 Be patient. Listen to what the person says, help

him/her give you the correct answer, but do not make
assumptions or answer for the person. Accept the
response, as long as it is within the range of expected
answers.

 Question responses that are outside of expected

answers. Note the reason for deviation from the normal
response.

 Signal the respondent when you move to another section (e.g., “We are now turning
to the next section of the interview”).

5
Session
 Control the conversation. A little small talk is okay, but do not let it take up too
Session
5
much time or the interview will go on too long. Stick to the questions in the data
instrument. Answer the interviewee’s questions, but
try to stick to the topic. Limit participation from third
parties.

 Keep up pace of the conversation; do not get bogged

down on one question. Move on and come back to a
question if you have to.

 Paraphrase to check for understanding if the individual’s

response is unclear.

 Express appreciation at the closure of the interview;

explain briefly again what happens with the data
collected.

Respond to individual questions as you walk the participants through the interviewing
tips and techniques sheet.

Ask them which categories or specific questions in the instrument they anticipate having
problems with. Ask for suggestions on how they might re-phrase a question or check for
understanding.

3. Demonstration: 30 minutes

Explain that you will now model an interview. Refer to the observer’s sheet (page 53-54
in the participant’s manual) and announce that participants will observe the interview
and make notes in response to each question on the observer’s sheet.

Place two chairs in the front of the room, and ask one person to take the role of the
interviewee. This could be the co-trainer or one of the participants.

Conduct the “demonstration interview” for approximately 10-12 minutes. The focus of
the demonstration should be on modeling good interviewing skills.

Debrief the demonstration by asking participants to share their responses to the

questions on the observer’s sheet (included in the participant manual). Take a few
responses for each of the five questions:

51
Session 5
Skill Practice
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Trainer’s Manual

1. What did the “interviewer” say at the beginning of the interview? Did that set the right
tone for the interview?

2. During the interview, how clearly stated was each question? Were the follow-up
questions clear?

3. In summary, what did the interviewer do that was effective?

4. What are 1-2 specific things the “interviewer” could improve upon?

5. What are 1-2 things the interviewee had trouble with?

4. Skill Practice: 100 minutes

Tell the participants which teams they will be on for their field work. As mentioned, each
team will have one supervisor and four data collectors.

Then divide the participants into groups of three. To the extent possible, the trios should
be formed from the field teams. In all cases, supervisors should work with two of their
team members so they can become familiar with their strengths and weaknesses.

Set up the trio practice by saying that each person will take turns being the “interviewer,”
the “respondent,” and the “observer.”

Remind the participants that there are two objectives to this practice: to develop
interviewing skills, and to become more familiar with the specific questions in the
instrument.

Say that when they are the respondent they should not be too difficult! But it is okay to
pretend once in a while that you do not understand a question the first time in order to
give the interviewer a chance to practice explaining the question.

Explain that each round will be 30 minutes, for a total of 90 minutes.

Pass out additional observer’s sheets.

Explain the task:

Trio Practice Task – Data Collection Interviews

The first “interviewer” will cover approximately the first third of the instrument.
Each practice round is 30 minutes:
20 minutes to practice interviewing the “respondent”
10 minutes to get feedback from the “observer” and discuss the feedback

5
Session
Repeat for second “interviewer,” who will begin the practice where first “interviewer”
Session
5
stopped (approximately the middle third of the instrument)
Repeat for third “interviewer,” who will begin the practice where second “interviewer”
stopped (approximately the final third of the instrument)

Before the trios begin practicing, pass out a copy of the completed data collection
instrument to each participant. It should be used by each “respondent” to answer the
questions in the practice interview.

Note: The completed data collection instrument is in the participant manual.

5. Plenary Discussion – Debrief of the Practice: 20 minutes

First, discuss the interview process by asking the “interviewers” the following:

 What positive feedback did you get from the “observer”?

 What suggestions for improvement did you get?

Discuss the responses and additional “do’s and don’ts” that surface.

Ask participants if they experienced any difficulties with particular sections of the
instrument or with specific questions.

 Which questions were easy to administer and why?

 Which questions were difficult to administer and why?

6. Summary: 10 minutes

Ask the participants the following questions in plenary:

 What have you learned about using the instrument that you want to be sure to
remember?

 What do you want to remember to do differently or better when you conduct the
interviews?

Then ask the participants to capture these key lessons in their learning logs.

Make a transition to the next session on field practice. Go over any pertinent logistical
information about the field practice.

53
Session 5
Skill Practice
 Session
5
Slide Presentation

55
Session 5
Skill Practice
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Trainer’s Manual

5
Session
 Session
5

57
Session 5
Skill Practice
SESSION 6
Field Practice Goal:
Practice skills
required to use the
instrument effectively

Session Overview
Total Duration:
Steps and Duration 4 Hours
1. Introduction: 5 minutes

2. Preparing for Field Practice: 20 minutes

3. Travel to Facilities: 15 minutes

4. Hospital Practice: 90 minutes

5. Travel to Clinic: 10 minutes

6. Clinic Practice: 45 minutes

7. Travel Back to Workshop: 10 minutes

8. Debriefing: 30 minutes

9. Summary: 15 minutes

Materials

 Participant Manual pages 57-58

 PowerPoint Slides 42-45

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Skill Practice
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1. Introduction: 5 minutes

Tell participants that we are continuing to work on the same goal as the last session – to
practice skills required to use the data collection instrument effectively. In this session,
however, we will have the opportunity to practice and observe how the instrument is
used in a real life situation. Say that we will be using the instrument in two settings – a
hospital and a nearby clinic.

Ask if anyone has additional questions about the instrument or the practice they
experienced in yesterday afternoon’s session.

2. Preparing for the field practice: 20 minutes

Provide an overview of the field practice. Explain the following:

 7-8 participants will have the opportunity to conduct the field practice interviews,
and the other participants will be observers.

 Hospital practice:

 We will spend 90 minutes

at the hospital.

 The actual interview will

last 75 minutes.

 Select the 4-5 people

(one from each of the
data collection teams)
to conduct the hospital
interview, in the order they will be interviewing.

 Assign specific questions to each interviewer.

6
Session
 Health center or clinic practice:
Session
6
 We will spend 45 minutes at the clinic.

 The actual interview will last 40 minutes.

 Select the 2-3 people (each from different

data collection teams) to conduct the
hospital interview, in the order they will be
interviewing.

 Assign specific questions to each interviewer.

 Guidelines for the “observers”:

 As you observe the interviews, take notes

using the five questions on the observer’s
sheet from the skill practice in the last
session.

Take questions from participants, and provide additional

information about the hospital and the clinic – who will
be interviewed, etc.

Go over logistical information about travel from the

workshop site to the hospital and clinic.

3.Travel to the hospital: 15 minutes

4. Hospital Practice: 90 minutes

Introduce the participants to the hospital health care worker who will be interviewed.

Explain to the respondent the mechanics of the sequential 4-5 “interviewers,” and point
out who they are. Say that you will be the timekeeper and help with the transition from
one “interviewer” to the next.

Proceed with the interview.

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Field Practice
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5.Travel to the clinic: 10 minutes

6. Clinic practice: 45 minutes

Introduce the participants to the clinic health care worker who will be interviewed, and
briefly review the mechanics of the sequential 2-3 “interviewers,” noting who they are
and saying that you will be helping with the transition from one “interviewer” to the
next.

7.Travel back to workshop site: 10 minutes

8. Debriefing: 30 minutes
Debrief the “interviewers” first by asking:

 What did you find challenging or surprising?

 What one thing would you do differently next time?

Then debrief the observers by asking the following:

 What positive feedback do you have for the “interviewers”?

 What suggestions for improvement did you note?

 What similarities and differences did you see in the interview at the hospital versus
the interview at the clinic?

 What difficulties did you observe with particular sections of the instrument or with
specific questions?

9. Summary: 15 minutes

Ask the participants the following questions in plenary:

 What insights did you gain today about using the instrument that you want to be
sure to remember?

 What interview technique(s) do you especially want to apply when you conduct
interviews?

Ask the participants to capture these key lessons in their learning logs.

Make a transition to the next session on developing a field implementation plan.

6
Session
 Session
6
Slide Presentation

63
Session 6
Field Practice
 64 HRH Assessment: Data Collection Training
Trainer’s Manual

6
Session
SESSION 7
Developing a Field
Implementation Plan
Goal:
Develop a plan for
field implementation.
Clarify the logistical
issues related to field
implementation.

Session Overview
Steps and Duration Total Duration:
2 Hours
1. Introduction: 5 minutes

2. Roles and Responsibilities: 15 minutes

3. Presentation: Field Implementation: 20 minutes

4. Field Planning: 70 minutes

5. Wrap-up: 10 minutes

Materials

 Participant Manual pages 59-64

 PowerPoint Slides 46-52

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Developing a Field Implementation Plan
66 HRH Assessment: Data Collection Training
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1. Introduction: 5 minutes

State that the goals of the session are to develop a plan for field implementation and to
clarify all logistical issues. Explain that at the end of this session a schedule of facilities to
visit with assignments to specific team members will be produced. Mention that tomorrow
will also be available to make final preparations before the team departs on Sunday.

2. Roles and Responsibilities: 15 minutes

Refer participants to organigram, the reporting and communication structure for data
collection, and the sheet on roles and responsibilities of data collection team members
on pages 60-61 in the participant’s manual. Walk the
participants through the structure. Explain the roles of the
following:

 Team Leader – has overall responsibility for the HRH

assessment

 Technical Leader – reports to the team leader and

responsible for direct supervisions of data collection teams
and liaises with the client(s)

 Field Supervisor – supervises four data collection team

members and reports to technical leader

 Data Collectors – collect data in facilities using data

collection instrument

 Data Entry Clerks – enter data collected

Ask participants if they have any questions about their

individual roles and responsibilities.

7
Session
3. Presentation - Overview of field implementation plan:
Session
7
20 minutes

Provide an overview of the field implementation plan (see page 62 of the participant’s
manual).

 Schedule for next two weeks.

 Departure – Sunday (so interviews can begin

on Monday)

 Interviews – Monday-Friday of Week 1

 Interviews – Monday-Thursday of Week 2

 Return to the capital – Friday

 Remind participants which data collection teams they

are assigned to.

 Pass out the list of facilities assigned to each team. Tell

the teams that in the next activity, they will be asked
Note: This facility
to develop a schedule to visit each facility. The supervisors will be responsible for assignment list must
be prepared before the
notifying the facilities when they will be visited to ensure staff availability. workshop.

 General guidelines for conducting interviews. Working in sub-teams of two,

 Start with the provincial hospital: interviews

will take two members one full day.

 Then visit the district hospitals: interviews

will take two team members a half day.

 Then visit the clinics: interviews will take one

person about two hours.

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Developing a Field Implementation Plan
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Trainer’s Manual

 Explain the logistic arrangements.

Explain how the following will be
handled:

 Transportation (whether
vehicles will be rented or
public transportation will be
used)
Note: Logistic
arrangements will vary  Lodging when in the field
from country to country.

 Per diem

 Communications (cell phones)

 Copies of survey instruments

 Copies of letters of introduction to the facilities

4. Field planning: 70 minutes

Tell the participants that they will have the next hour to
develop a specific plan for the next two weeks including a
schedule of visits to the facilities.

Ask the participants to work in their data collection

teams and give the following task:

Task: Develop Field Implementation Plan

In your data collection teams,
 Develop a schedule of visits to the facilities that
follow the general guidelines. Use the attached format to
develop this schedule.
 Assign specific team members to facilities.

 Plan for the supervisor to observe the teams interviewing for the first two days.

 Make agreements on when the sub-teams will communicate with the supervisor on
how things are going.

 Develop a list of administrative and logistic items that must be completed prior to
traveling to the field..
Take 65 minutes

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Session
69 HRH Assessment: Data Collection Training
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5. Wrap-up: 10 minutes

Ask the participants if they encountered any difficulties in developing their field
implementation plans.

Ask what agreements they made about communicating with the supervisors. Tell the
supervisors how often you would like them to communicate with you as technical leader.

Finally, ask the supervisors to make copies of the schedule of visits so the technical
leader has a complete set.

Transition to the final session.

7
Session
 Session
7
Slide Presentation

71
Session 7
Developing a Field Implementation Plan
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Trainer’s Manual

7
Session
 Session
7

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Session 7
Developing a Field Implementation Plan
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Trainer’s Manual

7
Session
SESSION 8
Wrap-up and Next Steps
Goal:
Close the workshop

Session Overview
Total Duration:
Steps and Duration 35 Minutes
1. Introduction: 2 minutes

2. Review of Next Steps: 10 minutes

3. Workshop Evaluation: 20 minutes

4. Closure: 5 minutes

Materials

 Participant Manual pages 65-68

 PowerPoint Slides 53-56

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Wrap-up and Next Steps
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Trainer’s Manual

1. Introduction: 2 minutes

Explain that this session will be the last one in the workshop. Say that the purpose is to
do a brief evaluation and close the workshop.

2. Next Steps: 10 minutes

Give the following overall reminders:

 Confirm the geographic coverage of each team

 Recognize the timeline for completion

 Review the reporting structure

 Review the compensation guidelines. Remember: salary

will be commensurate with quality of work

Remind the participants of the immediate next steps.

The day after the workshop is usually used for final
preparations including finalization of travel arrangements
making sure each team has adequate copies of the data
collection instrument. Review these next steps so that
everyone understands.

3. Workshop Evaluation: 20 minutes

Go around the room and ask each participant to say briefly what they have most
appreciated about the workshop.

Then refer participants to the evaluation forms on pages 66-68 of their participant
manual and encourage them to write comments that will
explain their ratings.

4. Closure: 5 minutes

Trainers should thank the participants for their efforts

and encourage the application of what they have learned
over the next two weeks.

8
Session
 Session
8
Slide Presentation

77
Session 8
Wrap-up and Next Steps
 78 HRH Assessment: Data Collection Training
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8
Session
Annex A.The Experiential Approach to Training 1
By: James A. McCaffery

Introduction

Experiential learning is exactly what the name implies – learning from experience. The
experiential approach is learner centered and allows the individual trainees to man-
age and share responsibility for their own learning with their teachers. Effective training
strategies which incorporate experiential learning approaches provide opportunities for
a person to engage in an activity, review this activity critically, abstract some useful insight
from the analysis, and apply the result in a practical situation. (Gudykunst and Hammer,
1983, provide a brief historical review of the experiential approach.)

A graphic representation of the model is presented below and may be applied to cross
cultural training in the following ways:

Figure 1.The Experiential Model

Experience

The experience phase is the initial activity and the data producing part of the experiential
learning cycle. This phase is structured to enable participants to become actively
involved in “doing” something.

1
This is an excerpt from a paper entitled, “Independent Effectiveness: A Reconsideration of Cross-Cultural Orientation
and Training.” International Journal of Intercultural Relations Vol. 10 (1986): 159-178. Reproduction only with
express permission from Training Resources Group Inc.

Annex
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80 Data Collection Training for HRH Assessment
Trainer’s Guide

Doing, in this instance, has a rather broad definition, and includes a range of activities like
the following:

 case studies

 role plays

 simulations

 games

 lecturettes

 films and slide shows

 skill practice

 completing an instrument

 living with a family from another country

This sample list indicates that the range of training techniques varies from the more
passive and artificial (lecturette) to the more active and real (living with a family). Exactly
which technique one chooses as an educational activity would depend largely on the
session goals.

Process

Once the experience stage is completed, the trainer or instructor would guide the group
into the process part of the cycle. During this phase, participants reflect on the activity
undertaken during the experience phase, and they share their reactions in a structured
way with the whole group. This may happen on an individual basis, in small work groups,
or in a full training group. Individuals share both their cognitive and affective reactions
to the activities in which they have engaged. In addition, with trainer assistance, they try
to link these thoughts and feelings together in order to derive some meaning from the
experience.

The trainer’s role as facilitator is very important during each phase of the cycle.
During the process phase, he/she should be prepared to help the participants think
critically about the experience and to help the participants verbalize their feelings and
perceptions, as well as draw attention to any recurrent themes or patterns which appear
in the participants’ reactions to the experience. The trainer’s role involves helping the
participants to conceptualize their reflections on the experience so that they can move
toward drawing conclusions.
Generalization

The generalization stage is that part of the experiential learning cycle in which the par-
ticipants extract conclusions and generalizations which might be derived from, or stimu-
lated by, the first two phases of the cycle. During this phase, participants are helped to
“take a step back” from the immediate experience and discussion, and to think critically
in order to draw conclusions that might be generalizable to “real life” or to a particular
theoretical construct. This stage is perhaps best symbolized by the following questions:

 What did you learn from all this?

 What more general meaning does this have for you?

The trainer or instructor structures this part of the experiential learning model so that
participants work alone first, and then guides them into sharing conclusions with each
other so that they may serve as catalysts to one another. In addition, the trainer helps to
facilitate this step by:

 Asking and helping individuals to summarize what they have learned into concise
statements or generalizations.

 “Pushing back” at people to help make their thinking more rigorous.

 Relating the conclusions reached and integrating them into a theoretical model.

 Making sure, within reasonable time boundaries, that everyone who wishes to share
significant insights gets a chance to contribute.

 Helping the group compare and contrast different conclusions, identifying patterns
where they exist, and identifying legitimate areas of disagreement.
Application

After participants have done some focused work generating generalizations, they are
guided into the application stage. Drawing upon insights and conclusions they have
reached during the previous phase (and other phases), participants incorporate what
they have learned into their lives by developing plans for more effective behavior in the
future. In an ideal educational or training event, participants would be able to apply what
they have learned immediately after the workshop ends. The applications that they plan
may relate to their profession, their personal life, or their student efforts, depending on
the background and needs of specific participant groups.
Techniques used to facilitate the application stage include the following:

 Individual work to develop a thoughtful action plan which puts “thought into action”.

Annex
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82 Data Collection Training for HRH Assessment
Trainer’s Guide

 Participants review each other’s plans, and provide consultation and help as
appropriate to each other.

 Some parts of individual plans might be shared with the whole group in order to
create a sense of synergy.

 Participants identify other learning needs.

One of the ways the trainer assists during this process is by helping participants be as
specific as possible in developing their application plans.

Conclusion

It is important to stress one other point about the experiential model. The exact nature
of each phase of the model is driven by the goals of the training or orientation session/
program. Once the goals are defined, then the session can be designed using the model
as the framework.

In order for this model to be effective, it needs to be rigorously applied, both in the
design and delivery stages. “Experiential training or learning” is a phrase often heard
in the educational and training world; yet, it is frequently misused in practice where it
seems to mean letting people participate in a presentation, having a question and answer
session after a lecture, or a role play or case study by itself without the subsequent
steps in the model. Most frequently, the generalizing and application stages are simply
left out of the design or the program; as a result, the power of experiential learning is
significantly diminished or is negated altogether.

Although the model, when correctly explained, looks very clear, the way it works out in
practice is not always as clear. There are transitions between phases, and occasionally
(especially if the trainer is going too fast), the group will return to a phase until it is
“finished.” Also, individuals in the group may not approach the learning process in such a
linear fashion, and that is perfectly legitimate. The model is meant to serve as a guide for
the trainer or instructor who is trying to design and carry out an educational experience
for a group.
Annex B. Illustrative Example of Data Collection Form
National Action Committee on AIDS

FACILITY STAMP
HERE

Assessment of Human Resources in HIV/AIDS,Tuberculosis,

Malaria, and Maternal and Child Health Services in Nigeria

Health Facility Questionnaire

April 2006
Introduction
The National Action Committee on AIDS (NACA) in collaboration with Partners for Health Reformplus
- a USAID funded Project - are conducting an assessment of human resources in Nigeria’s public and
mission health sector facilities with a focus on HIV/AIDS, tuberculosis, malaria, maternal and child health
services.

The objective of the assessment is to quantify existing and required human capacity, identify type and
distribution of health workers needed to achieve MDGs targets in the health sector. The assessment
thus, will provide NACA, donors, policy makers and other key stakeholders valuable information to use
in planning for scaling up of HIV/AIDS, TB, malaria, maternal and child health services in Nigeria.

We are gathering information from this facility on staffing, type of services offered, days and time spent
in the provision of services. Please note that any information you give will not be divulged to anyone else
and will only be used for the intended purpose.

Survey ID Number: ________________

Data Collectors Supervisor Data Entry Clerk

Name……………......………… Name….……………………… Name…………………………

Name……………….....………

Date: Date: Date:

Annex
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84 Data Collection Training for HRH Assessment
Trainer’s Guide

A. Facility Identification Information

Name of Facility

Region North West.............................................1

(circle number) North East...............................................2
North Central........................................3
South Wes................................................4
South South.............................................5
South East................................................6

State Adamawa..................................................1
(Circle number) Akwa Ibom..............................................2
Anambra...................................................3
Borno........................................................4
Cross River..............................................5
FCT...........................................................6
Imo............................................................7
Kano..........................................................8
Kogi...........................................................9
Lagos.........................................................10
Niger.........................................................11
Ondo.........................................................12
Sokoto......................................................13

Location Urban........................................................1
(circle number) Rural..........................................................2

Type of Facility Federal Medical Center........................1

(circle number) Teaching Hospital...................................2
Specialist Hospital..................................3
General Hospital.....................................4
Comprehensive Health Center..........5
Basic/Primary Health Center..............6
Health Clinic...........................................7
Dispensary...............................................8
Maternity..................................................9
Health Post..............................................10

Facility is funded by: Federal Government.............................1

(circle number) State Government.................................2
LGA...........................................................3
Faith-based Organization.....................4
Persons Interviewed:
Name Title Telephone
1

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86 Data Collection Training for HRH Assessment
Trainer’s Guide

B: Human Resources Status

If this is a Federal Medical Center, please skip question 1 and answer question 2.
All other facilities should answer question 1 and skip question 2.

1. How many staff work in this facility?

If staff type is not available in this facility, enter 0. If information is not available or not
collected, enter 9999.

Number of Number of Current

Staff Type Staff in 2004 Staff in 2005 Number of
Staff in 2006

1a Medical Practitioners
1b Medical Interns (House Officers)
1c Nurses/Public Health RNs
1d Midwives
1e Nurse midwives
1f Laboratory Scientists
1g Laboratory technicians/technologists
1h Radiographers
1i Pharmacists
1j Pharmacy Technicians and Assistants
1k Health Social Workers / Welfare workers
1l Nutritionists
1m Administrators
1n Medical Records Officers (Data Managers)
1o Public Health (Nursing) Officers
1p Environmental Health Officers
1q Community Health Officers
1r Community Health Extension Workers/J-CHEWs

Source(s):_________________________________________________________
___________

Notes:
2. If a Federal Medical Center, how many federal and state staff work in this facility?

If staff type is not available in this facility, enter 0. If information is not available or not
collected, enter 9999.

Number of Number of Current

Type of Staff Staff in 2004 Staff in 2005 Number of
Staff in 2006

State State State

2a Medical Practitioners
2b Medical Interns (House Officers)
2c Nurses/Public Health RNs
2d Midwives
2e Nurse midwives
2f Laboratory Scientists
2g Laboratory technicians/technologists
2h Radiographers
2i Pharmacists
2j Pharmacy Technicians and Assistants
2k Health Social Workers / Welfare workers
2l Nutritionists
2m Administrators
2n Medical Records Officers (Data Managers)
2o Public Health Nursing Officers
2p Environmental Health Officers
2q Community Health Officers
2r Community Health Extension Workers/J-CHEWS

Source(s):_________________________________________________________
___________

Notes:

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88 Data Collection Training for HRH Assessment
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3. In the past year [January 2005 - December 2005], how many health care workers have
joined the facility for the reasons below?

If staff type is not available in this facility, enter 0. If information is not available or not
collected, enter 9999

Incoming
Staff Type Transfer
Transfer-In Other
New –In (within New
(within
Graduates Faith Based Staff
public
sector)

3a Medical Practitioners
3b Medical Interns (House Officers)
3c Nurses/Public Health RNs
3d Midwives
3e Nurse Midwives
3f Laboratory Scientists
3g Laboratory technicians
3h Radiographers
3i Pharmacists
3j Pharmacy Technicians and Assistants
3k Health Social Workers
3l Nutritionists
3m Administrators
3n Medical Records Officers
3o Public Health Nursing Officers
3p Environmental Health Officers
3q Community Health Officers
3r Community Health Extension Workers/J-CHEWs

Source(s):_________________________________________________________
___________

Notes:
 4. In the past year [January 2005 - December 2005], how many health care workers have
left the facility for the reasons below?

If staff type is not available in this facility, enter 0. If information is not available or not
collected, enter 9999.

Outgoing
Transfer Transfer
Leaving Out Out
Staff Type Post Retired Terminated (Within (Within Death
Public Faith Based
Sector) organiza-
tions

3a Medical Practitioners
3b Medical Interns (House Officers)
3c Nurses/Public Health RNs
3d Midwives
3e Nurse Midwives
3f Laboratory Scientists
3g Laboratory technicians
3h Radiographers
3i Pharmacists
3j Pharmacy Technicians and Assistants
3k Health Social Workers
3l Nutritionists
3m Administrators
3n Medical Records Officers
3o Public Health Nursing Officers
3p Environmental Health Officers
3q Community Health Officers
3r Community Health Extension
Workers/J-CHEWs

Source(s):_________________________________________________________
___________

Notes:

Annex
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90 Data Collection Training for HRH Assessment
Trainer’s Guide

C.TYPE OF SERVICES PROVIDED IN THIS FACILITY

5. Which of the following services are provided at this facility?

Are these services provided at this facility?

Services Yes….1
No….2
5a HIV/AIDS
5b Tuberculosis
5c Malaria
5d Maternal Health
5e Family Planning
5f Child Health

If ‘Yes…….1’ is selected for any of the services in Question 5,

please complete the questions in the corresponding sections.
D. HIV/AIDS SERVICES
6. Which of the following HIV/AIDS services are provided by your facility?

Are these services provided at this

HIV/AIDS Services facility?

Yes….1
No….2
6a Voluntary Counseling and Testing (VCT)
6b Antiretroviral Treatment (ART)
6c Prevention of Mother to Child
6d Transmission (PMTCT)
PMTCTplus
6e Tuberculosis (TB) as an Opportunistic
Infection (OI)

7. What is the number of patients seen in the past three months for each of the
following HIV/AIDS services at this facility?

Number of patients seen in the last

HIV/AIDS Services 3 months in this facility

January February March

7a Voluntary Counseling and Testing (VCT)

7b Antiretroviral Treatment (ART)
7c Prevention of Mother to Child
Transmission (PMTCT)
7d PMTCTplus
7e Tuberculosis (TB) as an Opportunistic
Infection (OI)

Source(s):_______________________________________________________

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Trainer’s Guide

8. In this health facility, do the following staff types provide the VCT services listed and if yes, what is the average time each staff member spends
per patient on an average day (excluding VCT services for PMTCT)?

VCT: Pre-test Counseling VCT: Post-test Counseling Laboratory tests

Data Collection Training for HRH Assessment

Does the If Yes, Ideal Does the If Yes, Ideal Does the If Yes, Ideal
Staff current number Staff type current number of Staff current number of
type minutes of listed minutes minutes type minutes minutes
listed spent per minutes provide spent per spent per listed spent per spent per
provide
Staff Type List provide patient spent per the above patient patient patient patient
patient the
the above by each service? by each by each by each by each
by each above
service? staff type staff type staff type staff type staff type
staff Yes…1 service?
member * member * member* member * member*
Yes…1 type No…2 Yes…1
No…2 member*
No…2
8a Medical Practitioners
8b Medical Interns (House Officers)
8c Nurses /Public Health RNs
8d Midwives
8e Nurse Midwives
8f Laboratory Scientists/Technicians
8g Pharmacists/Pharmacy
Technicians and Assistants
8h Health Social Workers
8I Public Health Nursing Officers
8j Environmental Health Officers
8k Community Health Officers
8l Community Health Extension
Workers /J-CHEW

* If staff type is not available or not providing this service, enter 0. If information is not available or not collected, enter 9999.
 9. In this health facility, do the following staff types provide the ART services for adults
listed and if yes, what is the average time each staff member spends per patient on an
average day?

ART: ART Initiation ART: ART Continuing Patient

Does the If Yes, Ideal Ideal If Yes, Ideal

Staff current number of number of current number
Staff Type List type minutes minutes minutes minutes of
listed spent per spent per spent per spent per minutes
provide patient patient patient patient spent per
the above by each by each by each by each patient
service? staff staff type staff type staff type by each
type member* member* member * staff type
Yes…1 member * member*
No…2
9a Medical Practitioners
9b Medical Interns (House Officers)
9c Nurses/Public Health RNs
9d Midwives
9e Nurse Midwives
9f Laboratory Scientists/Technicians
9g Pharmacists/Pharmacy Technicians
and Assistants
9h Health Social Workers
9I Nutritionists
9j Public Health Nursing Officers
9k Environmental Health Officers
9l Community Health Officers
9m Community Health Extension
Workers/J-CHEWs

Ideal number of minutes spent per patient by each staff type member*

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Trainer’s Guide

10. In this health facility, do the following staff types provide the ART services for
children listed and if yes, what is the average time each staff member spends per
patient on an average day?

ART: ART Initiation ART: ART Continuing Patient

Does the If Yes, Ideal Ideal If Yes, Ideal

Staff current number of number of current number
Staff Type List type minutes minutes minutes minutes of
listed spent per spent per spent per spent per minutes
provide patient patient patient patient spent per
the above by each by each by each by each patient
service? staff staff type staff type staff type by each
type member* member* member * staff type
Yes…1 member * member*
No…2

10a Medical Practitioners

10b Medical Interns (House Officers)
10c Nurses/Public Health RNs
10d Midwives
10e Nurse Midwives
10f Laboratory Scientists/Technicians
10g Pharmacists/Pharmacy
Technicians and Assistants
10h Health Social Workers
10I Nutritionists
10j Public Health Nursing Officers
10k Environmental Health Officers
10l Community Health Officers
Community Health Extension
Workers/J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not
collected, enter 9999.
 11. In this health facility, do the following staff types provide the PMTCT services listed and if yes, what is the average time each staff member
spends per patient on an average day?

VCT in PMTCT Setting PMTCT: preventive PMTCTplus

Administration
Does the If Yes, Ideal Does the If Yes, Ideal Does the If Yes, Ideal
Staff current number Staff type current number of Staff current number of
type minutes of listed minutes minutes type minutes minutes
listed spent per minutes provide spent per spent per listed spent per spent per
provide
Staff Type List provide patient spent per the above patient patient patient patient
the
the above by each patient service? by each by each by each by each
above
service? staff type by each staff type staff type staff type staff type
Yes…1 service?
Yes…1 member * staff member * member* member * member*
No…2 Yes…1
No…2 type No…2
member*
11a Medical Practitioners
11b Medical Interns (House Officers)
11c Nurses /Public Health RNs
11d Midwives
11e Nurse Midwives
11f Laboratory Scientists/Technicians
11g Pharmacists/ Pharmacy Technicians
and Assistants
11h Health Social Workers
11I Nutritionists
11j Public Health Nursing Officers
11k Environmental Health Officers
11l Community Health Officers
11m Community Health Extension
Workers/J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not collected, enter 9999.

Annex
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96 Data Collection Training for HRH Assessment
Trainer’s Guide

F.TUBERCULOSIS SERVICES (TB)

12. Which of the following TB services are provided by your facility?

Are these services provided at this

TB Services facility?

Yes….1
No….2
12a Directly Observed Therapy (DOTS)
12b Non-DOTS Outpatients treatment
12c In-patient TB Care

13. What is the number of patients seen in the past three months for each of the
following TB services at this facility?

Number of patients seen in the last

TB Services 3 months in this facility

January February March

13a Directly Observed Therapy (DOTS)

13b Non-DOTS/ Outpatients/ treatment
13c In-patient TB Care

Source(s):_______________________________________________________
 14. In this health facility, do the following staff types provide the TB services listed and if yes, what is the average time each staff member spends
per patient on an average day?

Directly Observed Therapy Non-DOTS Outpatient In-patient TB Care

(DOTS) Treatment
Does the If Yes, Ideal Does the If Yes, Ideal Does the If Yes, Ideal
Staff current number Staff type current S taff current number of
number of
type minutes of listed minutes type minutes minutes
minutes
listed spent per minutes provide spent per listed spent per spent per
spent per
spent per provide
Staff Type List provide patient the above patient patient patient
patient patient the
the above by each service? by each by each by each
by each by each above
service? staff type staff type staff type staff type
staff staff type service?
member * member
Yes…1 member * * member*
type member* Yes…1
Yes…1 No…2
No…2 member* No…2

14a Medical Practitioners

14b Medical Interns (House Officers)
14c Nurses /Public Health RNs
14d Midwives
14e Nurse Midwives
14f Laboratory Scientists/ Technicians
14g Pharmacists/Pharmacy Technicians
and Assistants
14h Radiographers
14I Health Social Workers
14j Nutritionists
14k Environmental Health Officers
14l Community Health Officers
14m Community Health Extension
Workers/J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not collected, enter 9999.

Annex
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98 Data Collection Training for HRH Assessment
Trainer’s Guide

G. MALARIA SERVICES
15. Which of the following malaria services are provided by your facility?

Are these services

provided at this
Malaria Services facility?

Yes….1
No….2
15a Malaria Out-patient Services (Visits due to malaria)
15b Malaria In-patient Services (Admissions due to malaria)
15c Malaria Information, Education & Communication (IEC)

16. What is the number of patients seen in last three months for each of the following
malaria services at this facility?

Number of patients seen in the last

Malaria Services 3 months in this facility

January February March

16a Malaria Out-patient Services (Visits due

to malaria)
16b Malaria In-patient Services (Admissions
due to malaria)
16c Malaria Information, Education &
Communication (IEC)

Source(s):_______________________________________________________
 17. In this health facility, do the following staff types provide the malaria services listed and if yes, what is the average time each staff member
spends per patient on an average day?

Malaria Out-patient Services Malaria In-Patient Services Malaria Information,

Education & Communication
Does the If Yes, Ideal Does the If Yes, Ideal Does the If Yes, Ideal
Staff current number Staff type current number of Staff current number of
type minutes of listed minutes minutes type minutes minutes
listed spent per minutes provide spent per spent per listed spent per spent per
Staff Type List spent per provide
provide patient the above patient patient patient patient
patient the
the above by each service? by each by each by each by each
by each above
service? staff type staff type staff type staff type staff type
staff service?
Yes…1 member * member
Yes…1 member * member* * member*
type Yes…1
No…2 No…2
member* No…2
17a Medical Practitioners
17b Medical Interns (House Officers)
17c Nurses/Public Health RNs
17d Midwives
17e Nurse Midwives
17f Laboratory Scientists/Technicians
17g Pharmacists/Pharmacy
Technicians and Assistants
17h Health Social Workers
17I Nutritionists
17j Public Health Nursing Officers
17k Environmental Health Officers
17l Community Health Officers
17m Community Health Extension
Workers/J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not collected, enter 9999.

Annex
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100 Data Collection Training for HRH Assessment
Trainer’s Guide

H: MATERNAL HEALTH SERVICES

18. Which maternal health services are provided by your facility?

Are these services

provided at this
Maternal health services facility?

Yes….1
No….2
18a Antenatal Care: routine visits, lab tests, and Iron Folic Acid
treatments
18b Antenatal Care: Intermittent Preventive Treatment (IPT)
for Malaria
18c Normal Delivery Care
18d Complicated delivery (C- Section, Vacuum extraction etc)
18e Post-natal Care

19. What is the number of patients seen in the past three months for each of the
following maternal health services at this facility?

Number of patients seen in the last

Maternal health services 3 months in this facility

January February March

19a Antenatal Care: routine visits, lab tests,

and Iron Folic Acid treatments
19b Antenatal Care: Intermittent
Preventive Treatment (IPT) for Malaria
19c Normal Delivery Care
19d Complicated delivery (including
C Section, vacuum extraction, etc)
19e Post-natal Care

Source(s):_______________________________________________________
 20. In this health facility, do the following staff types provide the antenatal care services
listed and if yes, what is the average time each staff member spends per patient on an
average day?

Antenatal Care: routine visits, Intermittent Preventive

lab tests, and Iron Folic Acid Treatment (IPT) for Malaria &
treatments Other Diseases

Does the If Yes, Ideal Ideal If Yes, Ideal

Staff current number of number of current number
Staff Type List type minutes minutes minutes minutes of
listed spent per spent per spent per spent per minutes
provide patient patient
patient patient spent per
the above
by each by each by each by each patient
service?
staff staff type staff type staff type by each
Yes…1
No…2 type member* member* member * staff type
member*

20a Medical Practitioners

20b Medical Interns (House Officers)
20c Nurses /Public Health RNs
20d Midwives
20e Nurse Midwives
20f Laboratory Scientists/ Technicians
20g Pharmacists/Pharmacy
Technicians and Assistants
Health Social Workers
20I Nutritionists
20j Public Health Nursing Officers
20k Environmental Health Officers
20l Community Health Officers
20m Community Health Extension
Workers/J-CHEWs

Ideal number of minutes spent per patient by each staff type member*

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 102

21. In this health facility, do the following staff types provide the delivery-related services listed and if yes, what is the average time each staff
Trainer’s Guide

member spends per patient on an average day?

Complicated Delivery Post-natal Care

Normal Delivery Care
(C Section, vacuum extraction,
etc)
Does the If Yes, Ideal Does the If Yes, Ideal Does the If Yes, Ideal
Staff current number Staff type current number of Staff current number of
type of type
Data Collection Training for HRH Assessment

minutes listed minutes minutes minutes minutes

listed spent per minutes provide spent per spent per listed spent per spent per
Staff Type List provide spent per provide
patient the above patient patient patient patient
the above patient the
by each service? by each by each by each by each
service? by each above
staff type staff type staff type staff type
Yes…1 staff type staff service?
member * member
Yes…1 member * member* * member*
No…2 type Yes…1
No…2
member* No…2
21a Medical Practitioners
21b Medical Interns (House Officers)
21c Nurses/Public Health RNs
21d Midwives
21e Nurse Midwives
21f Pharmacists/ Pharmacy Technicians
and Assistants
21g Health Social Workers
21h Nutritionists
21i Public Health Nursing Officers
21j Environmental Health Officers
21k Community Health Officers
21l Community Health Extension
Workers/J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not collected, enter 9999.
I. FAMILY PLANNING SERVICES
22. Which of the following family planning services are provided by your facility?

Are these services

provided at this
Family planning services facility?

Yes….1
No….2
22a Tubal Ligation
22b Hormonal Injection Contraceptive
22c Intrauterine Contraceptive Device (IUD)
22d Oral Contraceptive Pills
22e Implant Contraceptives
22f Condom Distribution

23. What is the number of patients seen per month for each of the following family
planning services at this facility?

Number of patients seen in the last

Family Planning services 3 months in this facility

January February March

Tubal Ligation Counseling and Procedure

23a Hormonal Injection Contraceptive
Intrauterine Contraceptive Device (IUD)
23b Oral Contraceptive Pills
23c Implant Contraceptives
23d Condom demonstration and distribution
23e

Source(s):_______________________________________________________

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Trainer’s Guide

24. In this health facility, do the following staff types provide the family planning services listed and if yes, what is the average time each staff
member spends per patient on an average day?

Tubal Ligation (time spent on Hormonal Injection Intrauterine Contraceptive

counseling and activity) Contraceptive Device (IUD)
Does the If Yes, Ideal Does the If Yes, Ideal Does the If Yes, Ideal
Data Collection Training for HRH Assessment

Staff current number Staff type current number of Staff current number of
type minutes of listed minutes minutes type minutes minutes
listed spent per minutes provide spent per spent per listed spent per spent per
Staff Type List provide spent per provide
patient the above patient patient patient patient
the above patient the
by each service? by each by each by each by each
service? by each above
staff type staff type staff type staff type
Yes…1 staff type staff service?
member * member
Yes…1 member * member* * member*
No…2 type Yes…1
No…2
member* No…2
24a Medical Practitioners
24b Medical Interns (House Officers)
24c Nurses/Public Health RNs
24d Midwives
24e Nurse Midwives
24f Pharmacists/Pharmacy
Technicians and Assistants
24g Health Social Workers
24h Public Health Nursing Officers
24I Environmental Health Officers
24j Community Health Officers
24k Community Health Extension
Workers/J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not collected, enter 9999.
 25. In this health facility, do the following staff types provide the family planning services listed and if yes, what is the average time each staff
member spends per patient on an average day?

Oral Contraceptive Pills Condom demonstration and

Implant Contraceptives
Distribution
Does the If Yes, Ideal Does the If Yes, Ideal Does the If Yes, Ideal
Staff current number Staff type current number of Staff current number of
type minutes of listed minutes minutes type minutes minutes
listed spent per minutes provide spent per spent per listed spent per spent per
Staff Type List provide spent per provide
patient the above patient patient patient patient
the above patient the
by each service? by each by each by each by each
service? by each above
staff type staff type staff type staff type staff type
Yes…1 staff service?
member * member
Yes…1 member * member* * member*
No…2 type Yes…1
No…2
member* No…2
25a Medical Practitioners
25b Medical Interns (House Officers)
25c Nurses/Public Health RNs
25d Midwives
25e Nurse Midwives
25f Pharmacists/Pharmacy
Technicians and Assistants
25g Health Social Workers
25h Nutritionists
25I Public Health Nursing Officers
25j Environmental Health Officers
25k Community Health Officers
25l Community Health Extension
Workers/J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not collected, enter 9999.

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106 Data Collection Training for HRH Assessment
Trainer’s Guide

J: CHILD HEALTH SERVICES (children under 5)

26. Which of the following child health services are provided by your facility?

Are these services

provided at this
Child health services facility?

Yes….1
No….2
26a Growth Monitoring
26b Immunizations (excluding Campaigns)
26c Information, Education & Communication (children under 5)
26d Out-Patient Care [curative] Services
26e In- Patient care services
26f Nutrition Counseling
26g Nutritional supplement distribution (when available)

27. What is the number of patients seen in the past three months for each of the
following child health services at this facility?

Number of patients seen in the last

Child health services 3 months in this facility

January February March

27a Growth Monitoring

27b Immunizations (excluding campaigns)
27c Out-Patient Care [curative] Services
27d In- Patient care services
27e Nutrition Counseling
27f Nutritional supplement distribution
(when available)

Source(s):_______________________________________________________
 28. In this health facility, do the following staff types provide the child health services
listed and if yes, what is the average time each staff member spends per patient on an
average day?

Growth Monitoring Immunizations (excluding

campaigns)

Does the If Yes, Ideal Ideal If Yes,

Ideal
Staff current number of number of number
current
Staff Type List type minutes minutes minutes minutes of
listed spent per minutes
spent per spent per spent per
provide patient spent per
patient patient patient
the above by each patient
by each by each by each
service? staff by each
staff type staff type staff type staff type
Yes…1 type
member* member* member * member*
No…2 member *

28a Medical Practitioners

28b Medical Interns (House Officers)
28c Nurses/Public Health RNs
28d Midwives
28e Nurse Midwives
28f Health Social Workers
28g Nutritionists
28h Public Health Nursing Officers
28I Environmental Health Officers
28j Community Health Officers
28k Community Health Extension
Workers/J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not
collected, enter 9999.

Annex
107
 108

29. In this health facility, do the following staff types provide the child health services listed and if yes, what is the average time each staff member
spends per patient on an average day?
Trainer’s Guide

Out-patient (Curative) Care In-patient Care Nutrition

Does the If Yes, Ideal Does the If Yes, Ideal Does the If Yes, Ideal
Staff current number Staff type current number of Staff current number of
type minutes of listed minutes minutes type minutes minutes
listed
Data Collection Training for HRH Assessment

listed spent per minutes provide spent per spent per spent per spent per
spent per provide
Staff Type List provide patient the above patient patient patient patient
patient the
the above by each service? by each by each above by each by each
by each
service? staff type staff type staff type service? staff type staff type
staff
Yes…1 member * member
Yes…1 member * member* Yes…1 * member*
type
No…2 No…2 No…2
member*

29a Medical Practitioners

29b Medical Interns (House Officers)
29c Nurses /Public Health RNs
29d Midwives
29e Nurse Midwives
29f Laboratory Scientists/Technicians
29g Pharmacists/ Pharmacy Technicians
and Assistants
29h Radiographers
29I Health Social Workers
29j Nutritionists
29k Public Health Nursing Officers
29l Environmental Health Officers
29m Community Health Officers
29n Community Health Extension
Workers/ J-CHEWs

* If staff type is not available or not providing this service, enter 0. If information is not available or not collected, enter 9999.
ADDENDUM
If notes must be recorded for any questions, please list below.

NOTES:

Annex
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110 Data Collection Training for HRH Assessment
Trainer’s Guide

Acronyms & Definitions

ART Antiretroviral Therapy This is an anti-HIV treatment involving the
use of one class of drugs called non-nucleoside reverse transcriptase
inhibitors (NNRTI) in combination with two other anti-retroviral drugs
called nucleoside reverse transcriptase inhibitors (NRTI) in the long-
term treatment of HIV infection in adults and children.

DOTS Directly Observed Therapy This is a recommended strategy for TB

control, which helps patients take their medicine for TB. If you receive
DOTS, you will meet with a health care worker every day or several
times a week.You will meet at a place you both agree on, such as the
TB clinic, your home or work, or any other convenient location.You will
take your medicine while the health care worker watches. It involves five
strategies namely: government commitment, case detection by smear
microscopy, standard short-course chemotherapy, regular uninterrupted
supply of TB drugs and standardized recording and reporting system
that allows assessment and case finding and TB treatment control overall
performance.

IEC Information, Education and Communication IEC refers to a

public health approach aiming at changing or reinforcing health-related
behaviours in a target audience, concerning a specific problem and within
a pre-defined period of time, through communication methods and
principles such as flyers, leaflets, brochures, booklets, messages for health
education sessions, radio broadcast or TV spots etc.

IPT Intermittent Presumptive Treatment This involves the

administration of curative treatment dose of an effective anti-malaria
drug at predefined intervals during pregnancy, beginning after quickening
( the time at which the fetal movements are first felt by the mother) in
the second trimester.

IUD Intrauterine Contraceptive Device An Intrauterine Device (IUD)

is a small object that is inserted through the cervix and placed in the
uterus to prevent pregnancy. A small string hangs down from the IUD
into the upper part of the vagina. IUDs can last 1-10 years. They affect
the movements of eggs and sperm to prevent fertilization. They also
change the lining of the uterus and prevent implantation. IUDs are 99.2-
99.9% effective as birth control. They do not protect against sexually
transmitted infections, including HIV/AIDS.

NON-DOTS Non-Directly Observed Therapy Although the policy of the Federal

Government of Nigeria is DOTS for all TB patients, DOTS is not
available at all levels of healthcare delivery. Therefore, there are several
different models of TB patient care including outpatient treatment in use
around the country other than DOTS.
NVP Nevirapine This is a class of antiretroviral drugs called non-nucleoside
reverse transcriptase inhibitors (NNRTI) used in combination with other
anti-retroviral drugs in the long-term treatment of HIV infection in
adults and children. Nevirapine is also used on its own in the prevention
of mother to child transmission.

OI Opportunistic Infections Infection with HIV progressively weakens

the immune system, making the individual susceptible to certain
infections and cancers. In early HIV disease individuals can develop
tuberculosis, malaria, pneumococcal pneumonia, shingles (herpes zoster),
staphylococcal skin infections and septicaemia. These are problems
individuals with normal immune systems can also get, but with HIV,
these “ordinary” diseases occur at much higher rates. With advanced
HIV disease “opportunistic” infections (OIs) such as pneumocystis,
toxoplasma, kaposi’s sarcoma and cryptococcal infections develop. OIs
only cause disease in people with weak, damaged immune systems.

PMTCT Prevention of Mother-to-Child Transmission This is a prophylactic

therapy given to HIV positive pregnant mothers to prevent infection to
their infants. Ideally mothers are offered a seven-day intake of zidovudine
(AZT)/ lamivudine (3TC) and infants receive a combination of NVP
and AZT for the same time period. However, these regimens might not
be available or feasible in all settings. In such cases, a single-dose NVP
should be offered for the mother at the onset of labour, and for the
infant within 72 hours of birth.

PMTCTplus Prevention of Mother-to-Child Transmission plus This is an

extension of the PMTCT program described above. Besides providing
prophylactic treatment to prevent transmission of HIV to the child, the
program provides anti-retroviral therapy to women who qualify after the
birth of the child.

TB Tuberculosis A tuberculosis case is a patient with positive culture for

mycobacterium tuberculosis complex. Where culture is not routinely
available a patient with two smears positive results for acid-fast bacilli is
also considered as a TB case.

VCT Voluntary Counseling and Testing HIV testing that is offered to

clients after pretest counseling and in a non-coercive manner.

The End -THANK YOU

Annex
111
U. S. Agency for International Development
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Washington, DC 20523
Tel: (202) 712-0000
Fax: (202) 216-3524
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