MASTER Deck Rapid Task Analysis - HRH2030 …...Task Analysis Methodology Task analysis is a...
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Rapid Task Analysis A streamlined approach for matching provider competencies with local health needs Dr. Mariam Reda HRH2030 | Chemonics Dr. Joseph Ichter HRH2030 | Palladium Sarah Sadiq HRH2030 | Amref Health Africa
Transcript of MASTER Deck Rapid Task Analysis - HRH2030 …...Task Analysis Methodology Task analysis is a...
Rapid Task AnalysisA streamlined approach for matching provider competencies with local health needs
Dr. Mariam RedaHRH2030 | Chemonics
Dr. Joseph IchterHRH2030 | Palladium
Sarah SadiqHRH2030 | AmrefHealth Africa
Dr. Mariam RedaHRH2030 | Chemonics Moderator
www.hrh2030program.org
HRH2030 strives to build the accessible, available, acceptable, and high-quality health workforce needed to improve
health outcomes.
Dr. Joseph IchterHRH2030 | Palladium
Assessing Competencies of Community Health Workers in Madagascar’s Andramasina District
Aligning HRH Competencies with Local Health Needs The Rapid Task Analysis Tool: Pilot in Andramasina District, Madagascar
Dr. Joseph IchterHRH2030 | Palladium
Task Analysis Background and Pilot
Review of Task Analysis Methodology and Purpose
Andramasina District Task Analysis Results
Questionnaire Administration
Integration with Existing In-service Training
Education/training – competency based educational systems
Discuss where the rapid task analysis fits into the HRH ecosystem – job descriptions/SOW, licensure, comprehensive training, HRIS
Challenges to Traditional Training
Pre-service education forms the basis to necessary skills and knowledge, but ineffective for longer term knowledge and capacity development
Globally administered workshops can be a mismatch with local public health needs
Comprehensive trainings often remove health care providers from practice creating access to care challenges for populations
Little control over curriculum at the local level
Why the Rapid Task Analysis?
Allows local leadership/management to establish task questions
Tasks asked in a brief format (task options)
Can be used to assess pre- and post-training results
Promoting practice that is safe, effective, and relevant to the country’s health needs
Determining whether members of the workforce are functioning within their designated scope of work or generating new scopes of work for future providers
Creating knowledge and skills assessments and/or licensure tests that are grounded in priority practice areas
Helps prioritize content of training
Task Analysis Methodology
Task analysis is a “systematic assessment of the knowledge, skills, and abilities (professional behaviors) that characterize clinical practice.” (Oshio, Johnson, & Fullerton, 2002)
Supporting the validity of certification processes (Oshio, Johnson, & Fullerton, 2002),
Analyzing the content and relevance of pre-service education (Udaya, Subah, Drake, Ng, & Johnson, 2011) (Dgedge, et al., 2014),
Informing education and regulation leaders for policy and decision-making (Stender, et al., 2013)
Task Analysis Questionnaire ContentFor those health care workers participating in the task analysis, each is requested to make four judgements about the defined tasks. Basic judgements are appropriately worded to the country context but generally include:
Frequency – how often is the task performed?
Criticality – how significant and important is the task for the patient/client?
Location – when and where was the health care worker educated/trained to perform the task?
Performance – what is the perceived level of competence the health worker has over the task? See handouts for sample
questionnaire.
Andramasina Rapid Task Analysis
District chosen by the Madagascar Ministry of Health
Tasks chosen from national and global experts on community health workers’ (CHW) scope of work
Construction of the questionnaire
Data collection training
Data collection period and data analysis
Data dissemination
Andramasina Results Ten Participating Community
Health Centers (Centres Santé de Bases, CSB) Mandrosoa Ankorona Andramasina Ambohimiadana Alatsinainy Bakaro
Ambohibemanjaka Antotohazo Manjaka Ouest Anepoka AlarobiaVatosola
154 total questionnaires returned – 4 sites in red provided interesting insights into variations of training coverage
What made the four CSB sites so insightful?
The same responses across all CHWs under a particular CSB
Initially excluded due to questions surrounding administration methods
Learned in the local dissemination that it was correct, no CHWs had been through training related to the task
National Ministry of Health leadership and provincial leadership surprised at the lack of uniformity in training
Has any training been conducted?
Task #1 - Discuss prenatal visit schedule and its health benefits with pregnant women and caregivers (47.4% have had training)
Task #2 - Provide delivery counseling, including identification of danger signs and a delivery plan with the CSB (48.7% have had training)
Task #3 - Support patients in discussing options of family planning methods (including postpartum IUD) and assist patients in choosing the best options (45.5% have had training)
Task #4 -Voluntary and confidential HIV screening is discussed to raise HIV awareness and reduce stigma (31.2% have had training)
Task #5 - Teach patients from at risk groups how to use, and properly dispose of, condoms (29.9% have had training)
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Task #1 Prenatal VisitSchedule
Task #2 DeliveryCounselling
Task #3 Family PlanningCounselling
Task #4 HIV screening Task #5 Condom Useand Disposal
Confidence in PerformingTask byTraining Received
None On-the-job non-formal Formal in-service Pre-service
0%
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20%
30%
40%
50%
60%
Task #1 Prenatal VisitSchedule
Task #2 DeliveryCounselling
Task #3 Family PlanningCounselling
Task #4 HIV screening Task #5 Condom Useand Disposal
Share of Health Workers Receiving Training, by Task and Training Type
Pre-service Formal in-service On-the-job non-formal
0%
10%
20%
30%
40%
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60%
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Never Rarely Monthly Weekly Daily
Training Coverage (%) byTask Frequency byTraining Type
None On-the-job non-formal Formal in-service Pre-service
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Task 1 Task 2 Task 3 Task 4 Task 5
Confidence in Performing Task by CSB
Ankorona Alatsinainy Bakaro Alarobia vatosola Ambohimiadana Manjaka Ouest Mandrosoa
Several Lessons Learned in Implementation
Conflicting responses included on form (e.g., marking all 8 competency ranges)
Misunderstanding directions in training
Assumptions on meaning and questionnaire use
Designated team to establish rapid task analysis chosen tasks
How can we improve this process in future trainings?
Next Steps for the Rapid Task Analysis
Madagascar Ministry of Health looking to integrate the methodology into wider health provider cadres
Need to explore and ramp up locally accessible training options via the Ministry of Health Training Division
Create a rapid task analysis implementation manual
Lessons learned from further global implementations, getting knowledge back to the Madagascar team
Thank You
Sarah SadiqHRH2030 | Amref Health Africa
Identifying Health Workforce Competency Obstacles to Family Planning in Cameroon
Leadership and Management to Advance FP2020Cameroon experience using rapid task analysis
Sarah SadiqHRH2030 | AmrefHealth Africa
Background
FP2020 represents global, multi-sectoral commitment to increase access to family planning (FP) information, contraceptives, and services to enable 120 million more women and girls to use contraceptives by the year 2020
At health systems level, human resources for health (HRH) integral to provision of FP outreach and services
Shortage of HRH a major barrier to availability, accessibility, and acceptability of quality FP services to achieve FP2020
Host local communities rarely engaged in addressing challenges to health services in general and FP services more specifically
The Intervention
HRH2030 partnered with a local private NGO to implement Phase 1 of the Local Leadership and Management (LLM) approach in Cameroon.
The LLM approach assembles leaders from multiple sectors and strengthens their leadership skills so that they can collaborate to advance a commonly agreed upon agenda to address specific issues that affect the accessibility, acceptability, and quality of FP services in their community.
The approach ensures consistency between national and local priorities, which encourages engagement of leadership at the national level, and it transitions the intervention focus from inside the health sector to multi-sectoral stakeholders at the district level.
Implementation Steps
Local Leadership and Management Approach
Identify an issue that affects accessibility to
or quality and acceptability of FP
services
Confirm the relevance of the issue at district
level
Assemble a team of multi-sectoral district
leaders and build a shared vision
Design, implement, and monitor a shared
district action plan
Evaluate changes in the HRH issue and FP service delivery
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Rapid Task Analysis in Cameroon HRH2030 conducted a rapid task
analysis to measure the capacity of FP providers to provide quality FP counseling.
Each provider self-assessed his/her competency level based on indicators of frequency with which task are performed, confidence with performing the tasks according to standard, and in-service training participation.
Six Gold-Standard FP Counseling Skills
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Help clients make informed and voluntary decisions to choose FP methods based on client preferences and medical eligibility and help them address problems they may experience during use.
Provide personalized, accurate, and organized information on the utilization of the FP method of choice.
Discuss rumors and misconceptions about FP and the method of choice.
Discuss how to handle side effects and plan for follow-up visits.
Use effective interpersonal skills.
Support the client for continued FP method use, including discussing the possibility of switching to another method.
Results (1)
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None 1 Skill 2 Skills 3 Skills 4 Skills 5 Skills All Skills
Distribution of Providers by Number of Standard FP Counseling Skills in Which They Were Trained
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Results (2)
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None 1 Skill 2 Skills 3 Skills 4 Skills 5 Skills All Skills
Distribution of Providers by Number of Standard FP Counseling Skills They Perform at Least Weekly
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of P
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Results (3)
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Helps client tochoose
Providesinformation
Discussesrumors/
misconceptions
Discusses sideeffects
Usesinterpersonal
skills
Supportscontinuous use
All Skills
Distribution of Providers Who Received In-service Training in Standard FP Counseling Skills and Perform Them at Least Once a Week
Num
ber
of P
rovi
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Conclusion Rapid task analysis (RTA) provided proxy of actual
competency on a selected set of benchmark FP counseling tasks
In response, HRH2030 followed up with FP counseling and clinical refresher training in collaboration with the Cameroon Ministry of Public Health
HRH2030 now providing technical assistance to the Cameroon Ministry of Public Health to conduct Phase 2 of the LLM approach
Effort will result in finalization of LLM implementation guidelines for dissemination and use by government entities.
Thank You
Dr. Mariam RedaHRH2030 | Chemonics Moderator
Questions?
