Computer Based Training in Spanish

for TB Case Management

QUALITY ASSURANCE PROJECT

Estimated Cumulative Tuberculosis Deaths 1990-1999

Latin America & Caribbean

1,210,000

Africa & Middle East

8,862,000

East Asia & Pacific

7,162,000

South & South-East Asia12,300,000

Total: 30 Million Cases Total: 30 Million Cases WorldwideWorldwide

• Surveillance of trends & drug resistant strains

• Research & implementation of

– Technologies & methodologies for prevention, diagnosis

and treatment of TB

• Strengthen management support services by – Establishing standards & training programs for

• providers &

• laboratory services

Addressing the TB Problem

Addressing the Problem: Training

• Problem: How to train large numbers of health providers & laboratory staff

» Rapid & widely accessible

» Flexible schedule

» Pre-service, in-service & refresher

» Competence based assessment

• Solution: Utilize cost-effective CBT approach

Key Strengths of CBT

• Cost-effective

• Self-paced, personalized instruction

• Consistent quality of instruction

• Interactive and engaging

• Frequent, constructive feedback

• Expands the reach of training

What are the Advantages of QAP’s TB-CBT

• Trains providers in DOTS, most effective treament

• Permits easy adaptation to various settings,

languages, country TB programs

• Developed for providers in LDCs with lower levels

of education and skills

• Used for initial or refresher training, & reference

• Can link to Internet for updates

Cost Comparison

Cost Criteria Traditional Training CBT

Development

Duplication &

Shipping

Equipment &

Facilities

Personnel

Total

THE PLACE OF CBT IN THE LOGIC OF PROCESS QUALITY IMPROVEMENT

• Set sound standards for key processes• Communicate standards to Health Workers (HW)• HW trained to implement standards• HW motivated to implement standards• Basic supplies and equipment available• Compliance with standards monitored regularly• Gaps between standards and actual performance are

identified and analyzed for causes• Process quality improvement activities launched

STEPS TAKEN FOR THE DEVELOPMENT OF THE SPANISH CD ROM IN BOLIVIA

• Advisory comittee: MOH, USAID, PAHO, JHPIEGO, Physicians’ College, QAP, University

• Set up of a Technical steering Committe: USAID, MOH, QAP

• Translation from the english version

• Contents revision by MOH/QAP team

• Approval by MOH TBC National Program

• Images and sound adaptation

• Alpha test

• Beta test

NEXT STEPS• Field test: four groups (physicians, RNs,

auxiliary nurses) tested for changes in knowledge

• Promotion of utilization in a larger scale by MOH, PROSALUD, NGOs.

• OR on cost-effectiveness

• OR on changes in performance linked to knowledge

• IMCI