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Part I: Policy and economic issues Part II: Pharmaceutical management Part III: Management support systems

Planning and administration


Organization and management
Information management
Human resources management
51 Human resources management and capacity development
52 Designing and implementing training programs

chap ter 52
Designing and implementing training programs

Summary52.2 illustrations
52.1 Objectivesof training52.3 Figure 52-1 Capacity-building framework 52.3
Figure 52-2 The training process for improved
52.2 Developing a comprehensive training performance52.4
program52.3 Figure 52-3 Seating arrangements for various training
Conducting needs and knowledge assessments Selecting applications52.14
subject areas and setting learning objectives Learning
methods Table 52-1 Subject areas, training topics, and target
groups52.5
52.3 Implementing a training program 52.9 Table 52-2 Comparison of training methods 52.8
Strategies Assistance for the design and implementation Table 52-3 Issues to consider when designing training
of training courses Training and presentation skills programs52.11
Monitoring and evaluation
References and further readings 52.16 b oxes
Assessment guide52.17 Box 52-1 Brainstorming: a versatile technique for training,
planning, and problem solving 52.6
Box 52-2 Outline of trainers and participants guides for
workshops52.7

c ountry studies
CS 52-1 Follow-up activities to support a drug and
therapeutics committee course for professionals
indeveloping countries52.10
CS 52-2 Using the MTP methodology in Lao
P.D.R.52.12
CS 52-3 Creating a pharmaceutical management training
network in East Africa 52.13
CS 52-4 Measuring the effect of training on pharmaceutical
supply management at primary health care clinics in
South Africa52.15

annexes
Annex 52-1 Sources of assistance for training programs to
improve pharmaceutical management 52.18
Annex 52-2 Workshop logistics 52.20

copyright management sciences for health 2012


52.2 H uma n resources ma nag eme n t

s u mm a r y
Training is any planned activity to transfer or modify to identify where they may need to make adjustments to
knowledge, skills, and attitudes through learning experi- the training program. At the end of the course, trainers
ences. Personnel may require training for a variety of rea- should collect data on how well the learners achieved
sons, including the need to maintain levels of competence the course objectives and how satisfied they were with
and respond to the demands of changing circumstances the training experience. Whenever possible, the trainer
and new approaches and technologies. Training by itself should follow up with participants after they return to
cannot solve structural, organizational, or policy prob- their work situations to assess the impact of training on
lems within an organization, although supportive super- performance. Data collected during follow-up can help
vision and the use of motivational strategies can help identify the need for additional training or reinforcement
sustain performance improvement derived from training. of newly acquired skills, as well as inform review and
revision of the training materials.
The first step in the design of training involves an assess-
ment of training needs. The assessment comprises In some countries, availability of basic training and con-
tinuous professional development programs is limited;
Observing workers performing normal duties
therefore, many health workers lack access to formal
Interviewing workers and others
training opportunities and new ideas and approaches
Studying routine reports or performance reviews,
that can improve their work performance. Well-designed
along with job descriptions
in-service training programs can help fill this need.
Identifying performance problems
Training should be put into a context of continuous
The second step involves defining the training programs
performance improvement. Changing and improving
learning objectives. The learning objectives, which are
practices require an environment conducive to work,
derived from the needs assessment, specify the observable,
the appropriate learning resources, and the continuous
measurable actions that each learner will be able to demon-
use of motivational strategies. Training should be based
strate as a result of participating in the training activities.
on competencies: the abilities required to do work to the
The third step is the creation and implementation of a standards expected. Therefore, training should result
training program to improve performance, taking into in changes in work behavior that lead to an improved,
account the experience and educational levels of the per- efficiently functioning pharmaceutical management
sonnel and the time and resources available for training. system. At the same time, training alone is unlikely to
Options range from short courses to long-term place- change overall supply system performance unless the
ments in academic institutions in the country, in the environment and supervisory systems support change
region, or overseas, and nonclassroom-based interven- (see Chapter 37) and unless individuals are encouraged
tions, such as on-the-job training, coaching, and mentor- to maintain changes (see Chapter 51).
ing. All options must be weighed against the immediate
Learning requires active involvement. People prefer to
operational needs of the program or institution, because
learn in different waysthrough visual stimuli, verbal
facilities may not have enough personnel to operate
interactions, and learning by doing. Therefore, offering a
when staff members go for training.
variety of training opportunities and training techniques
The learning outcomes that must be achieved, along with is usually more effective than using only one approach.
the training environment, audience characteristics, and Training can be formal or informal, academic or applied,
the experience of the trainer, all determine the mix of guided or self-directed, or provided in public agencies or
learning methods and media that will achieve maximum private institutions.
effectiveness. Methods and media may include lecture,
Training alone is often not sufficient to change behav-
discussion, case study, role-playing, group exercise,
ior or improve performance. Improved performance,
simulation games, brainstorming, and demonstration. If
changed attitudes, and new skills acquired during train-
no published training materialsincluding audiovisual
ing may need to be complemented by and maintained
aidsare available, the trainer must develop them.
through continuing education, supportive supervision,
Development of the training program also includes and adequate motivational incentives. In many cases,
design of the training evaluation, which is carried out structural changes, such as workspace improvements
during the course as well as at its conclusion. During the and increased access to supplies and equipment may be
course, trainers monitor learner progress and satisfaction needed to support improved performance.
52/Designing and implementing training programs 52.3

Figure 52-1 Capacity-building framework

Tools
Performance
capacity
Individual

Skills
Personal capacity

Workload Facility
capacity capacity Staff and
infrastructure
Supervisory Support service
Institutional capacity capacity

Structural Systems Role Structures,


capacity capacity capacity systems, and roles

Source: Adapted from Potter and Brough 2004.

52.1 Objectives of training A countrys national pharmaceutical program alone is


not in a position to handle comprehensive training for
The training of personnel in pharmaceutical management policy makers and midlevel managers; many of their learn-
has four major objectives ing objectives are best handled through general manage-
ment training. However, it is still possible and necessary to
1. Increase knowledge about the special considerations reorient this group on pharmaceutical policies and issues
related to pharmaceutical systems through information exchange, reports, and seminars.
2. Improve attitudes about the importance of pharmaceu- Training for operations-level personnel is critical because
tical management, thus improving the environment they often lack the basic knowledge and skills necessary to
for change be effective at their jobs.
3. Build and strengthen skills in the specific tasks to be Finally, training alone will not result in significantly
completed for efficient functioning of the pharmaceu- improved performance unless it is linked to an enabling
tical system institutional environment. This is illustrated by Figure 52-1,
4. Improve work behavior, so that people function better which is a conceptual framework for building in-country
at assigned activities and fulfill their potential capacity for pharmaceutical management services. It illus-
trates the concept that health structures, systems, and
The goal of these objectives is to increase access to quality roles, staff and infrastructure, skills, and tools must all be
pharmaceutical products and services. addressed to strengthen a countrys ability to effectively pro-
Training should address the needs of three levels of per- vide pharmaceutical services.
sonnel, because it takes all three groups to effect sustainable
change
52.2 Developing a comprehensive training
1. Policy makers, who are responsible for creating the program
environment needed for improved pharmaceutical
management A training program is composed of a schedule of activi-
2. Midlevel managers, who are responsible for planning ties with training goals, learning objectives, subject areas,
and supervising activities required in the management methods, trainers, trainees, methods of assessment, and
and use of medicines locations. A good training program is designed to address
3. Line or operations-level personnel, who are respon- performance problems, such as long delays in getting medi-
sible for carrying out the work of pharmaceutical man- cines from suppliers to the main stores, delays in distribut-
agement ing medicines from midlevel stores to end-user units, or
52.4 H uma n resources ma nag eme n t

Figure 52-2 The training process for improved if all areas of the pharmaceutical supply system are assessed
performance frankly and carefully.
A knowledge and skills assessment evaluates the partici-
PERFORMANCE PROBLEM pants level of prior knowledge, as well as previous training
and experience, in the area of interest. The results of this
assessment are used to develop the training learning objec-
Desired change tives, and ultimately, the content.
Methods for assessing training needs are outlined below.
Training needs assessment The optimal method depends on the goals of the assessment
and the cadre of the individuals being assessed.
A knowledge assessment can be based on observation
TRAINING PROGRAM of a worker performing routine duties. This review uncov-
Learning units ers both strengths and weaknesses, but the presence of an
Courses
observer may influence the behavior observed. For exam-
Practical experiences
ple, a clinical worker examining a patient is likely to be
more thorough than usual if someone is watching. Specific
training needs can be determined more clearly by using
Evaluation
well-established indicators, such as those on performance
monitoring and evaluation described in Chapter 48, and
Change in behavior observation methods, such as those described in Chapter
28.
Interviews with supervisors, administrators, users of ser-
PERFORMANCE IMPROVEMENT vices, and workers can help determine where performance
problems might exist and what skills need to be taught or
improved. If workers fear reprisals from management, reas-
failure to ensure quality of medicines. Figure 52-2 shows surances about confidentiality of information will be nec-
how a training program is developed, proceeding from essary to obtain good data. In some situations, a training
problem identification, through needs assessment, training, needs analysis can be done by conducting a group interview
and evaluation, to a change in behavior that results in better in which the staff are invited to identify competencies in
performance. terms of knowledge, attitudes, and skills. Staff members rate
The key elements of a training program include needs themselves on a graph in relation to each of a set of compe-
assessment, course work, learning tasks, and practical appli- tencies. Exit interviews with workers leaving their jobs can
cation. Facilitators introduce new information to trainees also be useful. Finally, interviews with users of the services
through course work or lectures. Learning tasks or activities, can help in assessing levels of satisfaction.
such as case studies or role-plays, provide individuals with Analyses of job and task descriptions may reveal special
opportunities to work with the new information in a small- training needs. Self-administered, anonymous question-
group setting. Practical experiences and application give the naires for both managers and workers can also be valuable.
trainees the opportunity to apply the knowledge and skills Several types of reports are useful needs assessment
learned in a real-life or simulated situation. tools
The current level of the trainees skills will guide decisions
on developing a training program specifically for the group. Organizational reports, for an overview of the perfor-
For example, the objectives and goals for a program to train mance of the organization and personnel
new employees will differ dramatically from those for a pro- External evaluation or appraisal reports, for an out-
gram geared toward experienced technicians learning a new siders view of the organization and its training needs
technique. (and performance)
Annual or semiannual performance reviews
Conducting needs and knowledge assessments
Selecting subject areas and setting learning objectives
A training needs assessment and a pretraining knowledge
and skills assessment are required to help plan an effective A training needs assessment should indicate which subject
training program. The needs assessment should encom- area, topic, or target group should be given priority (Table
pass the overall working environment, including the super- 52-1). In many countries, some subject areas require more
visory structure and the level of employee motivation. attention than others, but certain basics must be provided:
Pharmaceutical management training will be effective only the selection process needs to be well managed and par-
52/Designing and implementing training programs 52.5

Table 52-1 Subject areas, training topics, and target groups

Subject area Training topics Target groups


Selection Essential medicines lists Policy and decision makers in ministry of health
Public formulary (MOH), ministry of finance (MOF), other ministries
Sources of information Service providers: doctors, nurses
Safety and efficacy Auxiliary personnel
Cost comparisons Pharmacists and dispensers
Levels of use Hospital administrators
Hospital formularies
National pharmaceutical policy

Procurement Procurement cycle Division of planning, MOH


Purchasing methods Division of finance, MOH
Quantification of pharmaceutical needs Division of administration or purchasing, MOH
Scheduling of purchases MOF
Terms of payment Central procurement service (if it exists)
Selection of suppliers Central laboratories, MOH
Payment mechanisms Pharmaceutical quality laboratories
Organization of procurement services Drug regulatory bodies
Quality assurance Senior MOH/MOF officials for policy decisions (such as
Make-or-buy decisions make-or-buy)
Shipment specifications
Contracting

Distribution Distribution cycle Division of planning, MOH


Information system Division of administration, MOH
Port clearing Operations personnel in port and warehouses
Warehouse operations (central, regional, and district)
Packaging and repackaging Transportation
Transportation
Security

Use Promotion of appropriate therapy Program directors


Training of health workers Program supervisors
Dispensing practices Doctors
Patient education Nurses
Information systems Pharmacists
Patient adherence Dispensers
Rational-medicine-use indicators Auxiliary and community health workers
Drug sellers
Patients and clients

ticipatory; procurement officers need training in efficient Pharmaceutical supply systems often run into difficulty
purchasing methods and quantification of pharmaceutical not because they lack staff members with technical expertise
needs; distributionproper storage, efficient transporta- but because they lack staff members who have critical man-
tion, and security of medicinesis a continuing concern; agement skills. Thus, when considering subject areas, think-
and rational use is becoming a major focus of many phar- ing broadly about which skills are most needed to improve
maceutical programs. the performance of the organization is important.
In addition to these basic pharmaceutical management After determining which tasks and competencies are
skills, staff will benefit from training in other areas, includ- required by staff for a particular situation, training goals
ing should be established and learning objectives should be
set. Goals will be broad statements about what the training
General management intends to achieve: for example, This course aims to pro-
Financial management, budgeting, and accounting vide medical stores personnel with the knowledge and skills
Computer systems and information management to accurately estimate quantities of medicines and related
Training program development and management commodities to order.
Training materials development Objectives, on the other hand, should clearly state what
Patient and public communications the participant must be able to do at the end of the train-
Personnel planning and management ing. They must be clear, concise, relevant, easily understood,
Program planning, monitoring, and evaluation and measurablein other wordsSMART (specific, mea-
Proposal development and writing surable, achievable, realistic, and time-bound) (CDC 2009).
52.6 H uma n resources ma nag eme n t

They are, in fact, indicators by which course output and per- Brainstorming: Members of a small or large group are
formance can be assessed. For example encouraged to contribute any suggestion that comes
into their heads on a given subject, initially with no criti-
On completion of the course, participants should cism, but later with a sifting and assessment of all ideas.
be able to (Because brainstorming is such a versatile but sometimes
misunderstood method, it is described in detail in
State the rationale and uses for quantification of Box 52-1.)
pharmaceuticals and other related commodities Case study: A real situation is presented in a brief paper or
Describe the attributes, uses, and limitations of presentation, then analyzed by participants.
various quantification methods Demonstration: The facilitator shows learners how and what
Identify the data required for each of the quan- should be done while explaining why, when, and where
tification methods an action is taken; participants then perform the action.
Discussion: A method in which the participants learn from
Because objectives must be measurable, terms such as one another, usually with guidance from a facilitator.
understand or know are not acceptable. Distance learning: A system designed to build knowledge
and skills of learners who are not physically on-site to
Learning methods receive training. Facilitators and students may com-
municate at times of their own choosing by exchanging
A variety of learning experiences can be used in training, printed or electronic media or through technology that
including allows them to communicate in real time.

Box 52-1
Brainstorming: A versatile technique for training, planning, and problem solving
Brainstorming is a group technique that is useful in Build on other peoples ideas: Although discussion of
training situations. It also helps work groups be more ideas is discouraged, generating new ideas from those
creative in decision making and problem solving. The already suggested is fine.
basic process is easy. The facilitator writes the topic or
questions on a flip chart, whiteboard, or blackboard. After the brainstorming session, ideas are usually typed
Group members are asked to call out their ideas in short up, organized in some way, and brought back to the
phrases that can be written down readily. To keep the group for discussion.
discussion moving, a tight time limit is usually set Although brainstorming can generate many creative
typically, five to ten minutes. The facilitator should be ideas, it is not always successful. Some people may be
prepared to stimulate brainstorming with a few examples discouraged from contributing, and inhibitions may
or prompting questions. exist about raising certain ideas. Brainstorming may also
The creativity of brainstorming is enhanced by giving the be dominated by certain individuals or get stuck on one
group the following short set of guidelines before start- part of the topic. Sticking to the preceding guidelines will
ing help. In addition, methods to make brainstorming more
productive include
No idea is a bad idea: No matter how odd, unconven-
tional, or silly an idea may seem, no idea should be Prepare a broad range of prompts that can be used to
ignored. direct the groups thinking into new areas if sugges-
No discussion of ideas is allowed: Discussion of ideas tions consistently concern one area.
can come later. Grimaces, groans, and other nonverbal Begin by asking each person to brainstorm individu-
judgments discourage creative thinking and should be ally for a few minutes and write down ideas.
avoided. Divide the group into several smaller groups to
Everybody is encouraged to contribute: The facilitator brainstorm on the same topic. Then compile and
should try to get everyone to make at least one sugges- discuss the topics in a larger group.
tion. Limit the number of suggestions by an individual
Go for quantity: This encourages the maximum con- group member. Generally, this degree of directness
tribution and discourages people from screening out should be reserved for situations in which one group
potentially good ideas before suggesting them. member dominates the brainstorming session.
52/Designing and implementing training programs 52.7

e-learning: Participants interact with facilitators through


the use of some of the many electronic, computer-based Box 52-2
learning materials that are now available, ranging from Outline of trainers and participants guides
CD-ROMs to Web-based systems. for workshops
Group exercise: A number of participants undertake an
activity together, followed by a critical analysis of the Trainers guides
process involved. Summary
Lecture: A direct talk with or without learning aids but
Learning objectives and content of the unit
without group participation.
Preparations that the trainer must make
Role-playing: Participants act out the roles of those repre-
Supplementary reading material
sented in a given situation.
Self-paced: Participants are allowed to learn anywhere, any- Unit outline and session plan
time, and at a pace that suits their levels of skills, knowl-
Prerequisites for participation in the session
edge, and aptitudes.
Components of the session and the estimated time
Simulation game: A more advanced version of a case study,
Visual aids to be used
where participants are given more detailed information
on a situation, including data sets to analyze. On the basis Teaching notes
of their analyses, participants develop and defend a plan
Technical background
of action.
Instructions for activities
Worksheet: A step-by-step approach to identifying prob-
lems or solutions through written questions or problems, Visual aids (which can be copied onto transparencies
with space provided for answers. or redrawn on flip charts)
Participants guides
The uses, advantages, disadvantages, and trainers role
for some of these methods are summarized in Table 52-2. Session guide
Some of the methods are more suitable for adult participa- Learning objectives and content of the unit
tory training, and others work well in formal academic set- Basic information the participant must have
tings (such as lectures or seminars). Most people learn better before attending the session
in an active rather than a passive fashion. A combination of Additional reading materials
methods is likely to be more effective than the exclusive use
of one method. Session notes (containing basic technical information,
Sequencing topics. Sequencing means arranging top- including definitions of essential terms)
ics in a logical order during training. In doing so, bear in Session activities (with worksheets and instructions)
mind that most people prefer to learn in easy and progres-
sive stages. Adults, especially experienced trainees, usu-
ally prefer to start with an overview of the whole course
before concentrating on particulars. The best approach is because the workers were not involved or consulted in
to sequence topics to build on previously completed con- developing them. A better approach is to ask knowledgeable
tent and learning experiences. In addition, spiraling the persons to write on one or two topics; circulate drafts among
curriculum revisits the basic concepts repeatedly, while selected end users; and develop the final version in a work-
building on them. The trainer should, however, be aware shop involving end-users, the authors, and national phar-
of training fatigue and not leave the most complex topic maceutical management program officers. This approach
for the end of the course, when learners are likely to be creates a sense of ownership, which leads to increased
more tired. acceptance and use of the materials developed. The topics
Developing teaching materials. Training materials may can be compiled inside one cover or distributed as a series of
not be available for the kind of in-service training that individual modules.
would best suit a particular pharmaceutical management Trainers and participants guides. Training materials
program. Many countries, however, have developed their should include guides for both trainers and participants,
own teaching materials using a number of approaches. as well as audiovisual aids. Some of these materials may be
These materials can be requested and used as is or can be obtained from established programs. Typical contents of
adapted to suit specific needs. Materials from international trainers and participants guides are outlined in Box 52-2.
sources are listed in Annex 52-1. Both provide structured but adaptable notes and exercises
Manuals. Many countries have training manuals that for each unit. The participants guide should contain the
are not being used effectively by their health workers, often technical content for the unit, including definitions of all
52.8 H uma n resources ma nag eme n t

Table 52-2 Comparison of training methods


Method Useful for Advantages Disadvantages Trainers role
Lecture Passing on information and Allows much material to be Learner is passive Provide information
facts delivered in a short time Little of what is said is Answer questions
Giving specific information Handles a large number of remembered
related to occupation, job, participants Lecturer receives little
or task Permits lecturer to be in full feedback
control
Discussion Stimulating interest and Stimulates learners interest Time-consuming Establish small groups early
thought Involves learners actively Requires learners to have in course
Generating possible Allows sharing of learners facts about the topic Help groups select
solutions to problems experiences with others Needs to be well controlled moderators and rapporteur
Consolidating other types to have value Clearly specify tasks for
of learning Can be dominated by a few each group
Developing consensus active persons Assign time limits for each
task and enforce them
Case study Solving problems Involves learners actively Time-consuming to prepare Carefully prepare or read
Changing attitudes Allows sharing of learners Not easy to validate case and relevant material
Building analytical skills experiences with others Discussion may focus on Ask provocative questions
Stimulates ideas and areas different from those to provide key issues for
discussions of concrete intended by trainer discussion
subject Guide discussion to achieve
analysis, possible solution,
recommendations for
action
Role-playing Developing interactive Stimulates interest Time-consuming to prepare Choose a suitable story to
knowledge and modifying Is fun Observers may be passive illustrate key points
attitudes Is active Some key points may not Debrief (discuss insights
Introducing humor and Uses participants be addressed gained from role-playing)
liveliness into training experiences Those engaged in role-
playing may learn more
than observers
Group exercise Team building Facilitates high Trainers skills required to Prepare carefully to ensure
Developing interactive participation of motivated guide the exercise that everything is organized
skills learners Takes time for group to
Studying group dynamics work in harmony
Brainstorming Stimulating creative Promotes active Time-consuming Record suggestions
thinking participation of learners Some learners may be Reorganize into groups
Generating possible Uses learners experiences passive Lead discussion at end
solutions and ideas Requires high-level trainers
Consolidating past learning skills
Providing diversion
Demonstration Showing correct Stimulates a lot of interest Takes effort to produce Arrange for demonstration
procedures and required Can be used for large Good viewing by learners is materials in advance
standards groups difficult in a large group Do demonstration alone
to ensure that everything
works
Observe participant
demonstrations
Correct mistakes promptly
Encourage slow learners
Worksheet Performing quantitative Helps learners relate their Time-consuming Prepare a worksheet based
exercises requiring general learning to some Difficult to prepare on real situations to show
calculations specific area of their work difficulties and successes
Working out solutions for Guide the learners but leave
issues of case studies most responsibility with
participants
E-learning Individual study Allows materials to be Expensive and time- Provide backup support for
Passing on information and passed on quickly consuming to prepare tutoring, coaching through
facts Allows participants to study Participants may not have various means, including
Showing correct at their own locations, at computer equipment or telephone, chat room, and
procedures their own pace communications links Listserv
Working out quantitative Some Web-based systems capable of handling
exercises requiring allow for communication some forms of electronic
calculations between participants platforms (e.g., Web-based)
working on the same
module at the same time
52/Designing and implementing training programs 52.9

essential terms and concepts. The trainers guide should


provide guidance on how the session should be taught.
Audiovisual aids. Audiovisual aids are useful because
they stimulate the trainee and help reinforce the ideas pre-
sented. However, poor visual aids can confuse participants.
Common visual aids include posters, wall charts, chalk-
boards, flip charts, overhead projections, and computer-
projected presentation slides. CDs and tapes are common
audio aids. Videotapes, DVDs, and films are good audio
visual aids, but their expense often makes them impractical.
The equipment and technology support required for some
of these approaches may limit their use in certain settings. If Yes. I just got back today,
relying on equipment or technology that requires electricity, but Im off to another
having a backup option that does not need electricity is an workshop tomorrow
important consideration.

52.3 Implementing a training program The Professional Workshopper

There are two basic approaches to implementing a train-


ing program: one is centered on the trainer, who controls should be trained in the operation of that system rather than
learning contents and experiences; the other is centered on a computerized system that may never be installed.
the learner, with the trainer acting as a guide and provid- Training programs must be feasible. Governments may
ing resources. This approach assumes that people are able not be able to allow a senior official to take an extended
and willing to learn if they are given the proper materials in training leave, regardless of potential long-term benefits.
an atmosphere that is conducive to learning. This method Some officials may not be able to be absent from work for
is preferred because it is participatory, learners experiences more than one week. Similarly, health care providers may
are shared, and participants have more freedom to learn at not be able to be away from the patient population they
their own speed. serve if no backup staff support is available. This factor is of
An important aspect to include in a training package is particular concern in the private sector, where having staff
follow-up support to the participants and evaluation of the away from work will result in facilities losing revenues and
training outcome. This support, which should be included in providers losing income.
in the training budget, may be in the form of supervi- Preservice training is conducted at established training
sion, coaching, mentoring, setting up a network support institutions and is often a prerequisite for hiring. In-service
group, or simply providing a source of ongoing informa- training may be offered in a classroom setting or in the work
tion. Follow-up activities may be conducted in person but environment, either as part of a planned staff development
may also be provided by telephone or e-mail. Country program or after an assessment of deficiencies has deter-
Study 52-1 shows how a follow-up plan is used to track mined what training is needed at the workplace.
participants progress in developing drug and therapeutics Continuing professional development allows cadres of
committees. professionals to maintain and improve their knowledge
and professional competence throughout their careers.
Strategies Professional associations often develop and sponsor con-
tinuing professional development courses and accredita-
Training strategies must be appropriate to the educational tion. A recognized credential can be a powerful incentive for
level of personnel being trained and to the resources avail- seeking professional development; for example, Tanzania
able in the country, feasible in terms of the amount of time created a new cadre of private-sector drug dispenser, who
and travel involved, and relevant to the job. In some coun- may earn a license to work in a government-accredited drug
tries, governments often place officials in jobs that require dispensing outlet after completing a training program and
a higher degree of technical capacity than they possess. In examination.
such cases, managers and trainers need to work together to The decision about the kind of training program to use
close the gap between requirements and ability. depends on the issues raised in Table 52-3, as well as the
Training programs must consider the resources available. criteria of appropriateness, feasibility, and relevance. A
For example, an individual working in a central medical comprehensive training program is likely to include a com-
store that uses a simple card system for inventory control bination of long- and short-term training, observation trips,
52.10 H uma n resources ma nag eme n t

Country Study 52-1


Follow-up activities to support a drug and therapeutics committee course for professionals
in developing countries

Drug and therapeutics committees (DTCs) are effec- people from 70 countries. Follow-up e-mail contact with
tive in promoting rational medicine use, but DTCs have participants showed that they initiated almost 400 activi-
been underused in developing countries. The Rational ties based on the training.
Pharmaceutical Management (RPM) Plus Program and The RPM Plus/SPS process for promoting and support-
World Health Organization (WHO) designed a course, ing DTCs through training and follow-up of course
training materials, and a manual to train health care participants has paid measurable dividends in many
providers and administrators who would be involved countries. The following examples show the wide range
in DTC activities in developing countries. The course of accomplishments by course participants and other in-
includes fifteen training modules and a field trip to hos- country stakeholders
pitals where participants assess the hospital DTCs, con-
duct medicine use evaluations, and review the formulary Reduced the percentage of outpatients receiv-
process. The course ends with each participant making a ing antibiotics at each visit from 90 to 60 percent
workplan for future DTC-related activities. (Kenya)
Established a system that monitors prescribing pat-
A common problem with training courses is that when terns for certain high-use antibiotics (Malaysia)
participants go back to their places of work, they may Developed a generic substitution policy that allows
have difficulty maintaining their new skills without the pharmacy to substitute equivalent products,
ongoing support. The RPM Plus follow-on program, which decreased the average prescription cost by 20
Strengthening Pharmaceutical Systems (SPS), addresses percent (Kenya)
that issue through an innovative follow-up program Created an adverse drug reaction reporting system
designed to help participants carry out their DTC (Pakistan)
workplans and become DTC advocates. The workplans Analyzed cost of pneumonia treatment, resulting in
developed in the training are made available on a DTC institution of new standard treatment guidelines and
Learning Center website. The follow-up program pro- medical records review to assess physician adher-
vides specific technical assistance and support for all ence (Paraguay)
DTC course participants and local organizations to Performed ABC analysis, resulting in changes in
implement a DTC and related activities. Participants the formulary and in the suppliers of several drugs
activities are monitored on the website and through reg- (India)
ular e-mail follow-up and support. Technical assistance
Training courses can promote the use of DTCs and
and support for implementing their workplan activities
related activities in developing countries, but increased
are made available to all participants, and through this
support at the country level plus post-training sup-
post-training support mechanism, participants can share
port and technical assistance are needed to help course
the problems they encounter in their work and brain-
participants achieve their objectives. In addition, more
storm possible solutions.
intensive course follow-up appears to produce enhanced
Between 2001 and 2010, 24 courses were conducted in results in a very short period.
Asia, Africa, Latin America, and Eastern Europe for 945 Source: MSH/SPS 2010.

conferences and seminars, and in-country counterpart engineers, and other technical professionals is most appro-
training. priate here.
Long-term training. Long-term training is often This approach is limited because a pharmaceutical pro-
obtained in an institution of higher learning (sometimes in gram does not have the specific duty to provide basic train-
overseas institutions). Such training, whether in academic ing, and most programs cannot afford to have top personnel
or nonacademic settings, is most useful for highly technical away for a long time. In addition, if personnel fail to return
areas, such as research and development of new drugs, qual- to their job, the costs for training new personnel can be high.
ity assurance, pharmaceutical production, improved manu- Short-term training. Short-term training is usually con-
facturing practices, or advanced areas of patient care. The ducted over a period of one to three months in an academic
provision of fellowships for doctors, pharmacists, industrial or nonacademic setting. To work effectively, the trainee
52/Designing and implementing training programs 52.11

Table 52-3 Issues to consider when designing training programs

Audience Mode Length Location Funding source


Trainers to be trained Preservice training Seminar (two weeks or Local college or Government
Senior government On-site job training, less) university Private organizations
officials counterpart training Short-term course (two National management Industry
Administrators in Classroom (off-site, weeks to three months) institute (where one University
government ministries in-service training) Long-term course (six exists) Self
Managers of Tours, observational to twenty-four or more International sponsor Donors
donor programs, trips months) (for example, WHO, International
nongovernmental Workshops and seminars UNICEF, USAID, Danida, organizations
organizations Courses (short or long SIDA, KfW, and GTZ) National government
Managers of facilities in term) Business donor agencies
decentralized settings Independent private Foundations
Line or operations-level group Private charity, such as
personnel Government agency a church group

needs to be separated from everyday work responsibili- A number of institutions have developed training materi-
ties. Sometimes, when staff members have difficulty getting als and can provide training at the regional or international
away for an entire week, training may occur on a series of level. Some private nongovernmental institutions in the
Saturdays. United States, such as Management Sciences for Health,
This approach is appropriate for most training needs in and quasi-governmental institutions, such as the Eastern
pharmaceutical management, especially for top- and middle- and Southern African Management Institute in Arusha,
level personnel. Prerequisites for effective short-term train- Tanzania, offer training in individual countries. In addition,
ing include some institutions are beginning to develop regional train-
ing centers in management; Country Study 52-3 illustrates
A sufficient supply of people with appropriate back- a regional approach to technical assistance and capacity
ground or education building in East Africa.
Courses available in the language of the participants Observation trips. Countries that do not have formal
Course design that uses training modules to allow training programs but have successfully implemented essen-
for flexible curricula to meet the needs of target tial medicines programs can offer useful and practical exam-
groups ples for personnel from other countries. In addition, some
Intensive, practical training so that participants multinational and national pharmaceutical manufacturers
gain a good mix of information and skills in a short have regional or local warehouses, manufacturing plants,
time and laboratories that are good sites for visits. Observation
Adequate follow-up of graduates, including provision trips work best when combined with short-term training,
of continuing education programs, to ensure that they to reinforce in a practical way the skills learned. Such pro-
continue to function effectively grams can benefit both the visitors and the institution vis-
ited, especially if the trainer accompanies the trainees.
In addition to training the target groups outlined in Table Conferences and seminars. Standardized curricula pre-
52-1, this type of program is suitable for the training of pared by an international institution can be used to present
trainers (often referred to by the acronym TOT) who will at regional conferences and seminars. This approach works
return to their jobs and train others in the techniques and well for focusing on particular components, such as phar-
skills they have learned. Thus, short-term training should maceutical distribution or use. It is also an effective way
include pedagogical and leadership skills and provide some to promote longer training programs, information sharing
institution-building capacities. Annex 52-2 provides further among developing-country personnel, desire for improve-
information on workshop logistics and evaluation. ment, and general sensitization of policy makers to the
An example of an innovative type of training is the importance of pharmaceutical management.
monitoring-training-planning (MTP) methodology, which In-country counterpart training. An outside consultant
puts into place an ongoing process to deal with individ- with expertise in an aspect of pharmaceutical management,
ual training issues in the short term. MTP puts the tools such as computerized inventory, can train counterparts by
and responsibility for training into the hands of local staff, working on-site for a period of weeks or months. Short-term
who tackle specific problems in concise, monthly sessions. consultancies work best when they are focused on a specific
See Country Study 52-2 for an introduction and example activity (for example, a pharmaceutical packaging process
of the MTP methodology being used in the Lao Peoples or the development of an operations manual). Longer peri-
Democratic Republic (P.D.R.). ods (from two to four years) are required for overall systems
52.12 H uma n resources ma nag eme n t

renovation. Meaningful improvements in pharmaceutical Lack of appropriate institutional capacity building: The host
management systems can be made using long-term, on-site country may not be able to continue innovations after the
consultants. The major limitations are departure of the consultant.

Expense: International agencies characteristically spend a Assistance for the design and implementation of
significant amount of money a month to support an in- training courses
country consultant.
Lack of regional effect: Only the individual country bene Ideally, training courses are best developed by educators
fits, although participants in a program could train oth- skilled in instructional design who have a solid background
ers. in and knowledge of the topic areas. However, the skills

Country Study 52-2


Using the MTP methodology in Lao P.D.R.
The monitoring-training-planning methodology uses module flows into the monitoring section of the next.
a sequence of steps involving techniques to implement For example, if an organization launches a program to
a sustainable health project or program. MTP places improve warehouse management at the local level, the
the tools and responsibility for programs in the hands program designers may organize a session on evaluat-
of local staff, who learn how to mobilize their own ing storerooms, one on improving storage conditions,
resources, carry out the MTP program, and improve and another on inventory control. Each session begins
pharmaceutical management in their health facilities. with a report on the planned activities from the previous
Central- and regional-level managers accompany and month; contains a concrete product, such as an evalu-
monitor the staff as they implement the new pharmaceu- ation, correct storage practices, or an operating inven-
tical management programs. tory system; and ends with participants knowing their
responsibilities and tasks for the next month.
The MTP tool relies on the following principles
The Lao P.D.R. National Drug Policy Program promotes
The program is continuous, stepwise, and imple- rational medicine prescribing in hospitals through the
mented in a structured fashion. activities of Drug and Therapeutics Committees; how-
Every implementation step is planned in advance ever, when some problems did not respond well to that
and detailed in the instructions and materials. approach, MTP was implemented to handle small-scale
The programs lead to concrete products that are training issues. The use of the MTP approach in the
shared among peers. Lao P.D.R. involved a series of small-group discussions
Because MTP participants are usually volunteers, among prescribers in individual hospital departments.
the institution should recognize their efforts. After being trained in the MTP methodology, these
Work is spread among the team of participants so groups defined their problem of interest, selected tar-
that everyone takes part. gets they wanted to achieve, applied a problem-solving
Supervision by all participants of each others approach, and monitored indicators to observe the
responsibilities and tasks increases accountability response. By using MTP, groups frequently met defined
and improves problem-solving skills. targets within two to three monthly training cycles.
Sessions must be short and punctual so time and For example, within three months, Vientiane Hospital
travel commitments are minimized. reduced postoperative antibiotic prescription from 60
Materials and approach should allow for adaptation percent to 49 percent, close to its goal of 45 percent;
to the particular needs of each locale. Mittaphap Hospital reduced intravenous fluid use for
MTP is unique in that it incorporates monitoring, gastritis from 78 percent to 46 percent and antibiotic use
training, and planning into a single monthly session from 40 percent to 20 percent; and Oudomxay Hospital
that achieves tangible results. For one day or less on a reduced antibiotic use in outpatients from 60 percent to
monthly basis, participants first review achievements 45 percent. Initially implemented in eleven provincial
from the previous session, analyze information about hospitals, the MTP methodology has been extended to
their own situation, study how to take action, and then fourteen provincial and fourteen district hospitals and
plan short-term activities. Each segment sets the stage will be extended to all hospitals in the country.
for the succeeding segment; the planning segment of one Source: Sisounthone, Luanglath, and Phanyanouvong 2004.
52/Designing and implementing training programs 52.13

Country Study 52-3


Creating a pharmaceutical management training network in East Africa
As a result of major global funding initiatives, countries supply, management, and use of medicines in their coun-
in Africa have experienced a tremendous increase in the tries. The country groups then take a regional lead in a
volume of pharmaceuticals and health commodities to specific area and offer assistance to other groups related
manage. However, the weakness in the regions pharma- to this area of expertise. In addition, the groups consult
ceutical management has required interventions to help with ministries of health and other stakeholders regard-
build in-country and regional capacity to support the ing research activities and the monitoring and evaluation
scale-up of treatment programs. of pharmaceutical management initiatives.
With help from the Rational Pharmaceutical The RTRCs first activity was to assess management of
Management (RPM) Plus Program, the Makerere HIV/AIDS pharmaceuticals and commodities in each
University in Uganda began coordinating a network of the four countries. The assessments identified many
of institutions from Uganda, Kenya, Tanzania, and problems, among them inadequate human resource
Rwanda to develop capacity for pharmaceutical manage- capacity to handle the basic functions of pharmaceutical
ment. The idea behind the Regional Technical Resource management, such as selecting, quantifying, and dis-
Collaboration (RTRC) for Pharmaceutical Management tributing AIDS-related commodities, including rational
initiative is to create a collaborative group that offers prescribing. As a result, the RTRC has placed priority on
regional and country advisers with expertise in the sup- training health care workers on how to manage AIDS-
ply, management, and use of antiretrovirals and other related pharmaceuticals.
medicines. Each country core group is multidisciplinary
As a next step, RPM Plus developed generic HIV/AIDS
and includes pharmacists, social scientists, and represen-
pharmaceutical training materials that can be easily
tatives from academic institutions, ministries of health,
adapted to train pharmacists, pharmaceutical technolo-
and nonprofit organizations. In the long term, the RTRC
gists and technicians, pharmacist assistants, nurses, and
plans to incorporate institutions from other countries,
storekeepers. The training materials were developed with
such as Ethiopia and Zambia.
a diverse audience in mind, with content that is neither too
Each countrys core group assumes a role in the coun- complicated nor too basic. The training process is as prac-
trys national pharmaceutical management activities. tical as possible to help trainees apply the lessons learned
For example, by conducting national assessments of the in their daily work. The RTRC countries are also incor-
pharmaceutical sectors, each group identified key areas porating the monitoring-training-planning approach in
in which to develop and consolidate specific skills in the their training programs (see Country Study 52-2).

involved in designing and implementing a training pro- est priority. Training programs have usually been estab-
gram can be learned by observing good trainers and paying lished on an ad hoc basis to fulfill a specific need rather
attention to how they use different methods. Many phar- than in a systematic and comprehensive way. But some
maceutical programs rely on outside organizations, such as programs address specific areas for a particular level in the
Management Sciences for Health, i+Solutions (previously supply system or for multiple levels in a vertical disease
the International Dispensary Association), and WHO to control program.
help them develop local training programs or provide train- Annex 52-1 lists selected organizations that have practical
ing opportunities for staff (see Annex 52-1). Training-of- experience in the design or implementation of training pro-
trainers courses are also frequently offered by local, regional, grams, or both. These organizations are invaluable resources
or international training institutes. for the development of many types of training programs.
Another valuable resource for a training program is the
practical experience of organizations and institutions in Training and presentation skills
the pharmaceutical supply process. Among these are inter
national organizations, governmental and nongovernmental A trainer is expected to be knowledgeable, possess excellent
organizations, universities, developing-country institutions, communication skills, and be able to communicate at the
and programs already operating in developing countries. level and in the language of the participants (consecutive or
With few exceptions, however, these organizations have simultaneous translation may be appropriate for certain sit-
made technical assistance rather than training their high- uations). To be effective, the trainer should take into account
52.14 H uma n resources ma nag eme n t

Figure 52-3 Seating arrangements for various training applications

COMMUNICATION IN SMALL GROUPS (510 PEOPLE)

PREFER THIS NOT THIS

COMMUNICATION AND PRESENTATION IN LARGER GROUPS (1030 PEOPLE)

screen screen
flip chart flip chart

Presentation

screen screen
flip chart flip chart

Presentation
+
Large group discussion

screen screen
flip chart flip chart
Presentation
+
Large group discussion
+
Small group
exercise

Source: Adapted from McMahon et al. 1992.


Key: H = Trainer or presenter.
52/Designing and implementing training programs 52.15

Country Study 52-4


Measuring the effect of training on pharmaceutical supply management at primary health care
clinics in South Africa

Training in pharmaceutical supply management was such as organization of supplies, record keeping, order-
introduced as part of the Essential Drugs Program in ing and stock control, labeling of medicines, but also
Mpumalanga province in South Africa. To study the rational-medicine-use indicators, such as patient knowl-
effect of the training, a pre- and post-intervention study edge and advice received from staff and appropriate use
was conducted comparing six randomly chosen primary of the essential medicines list. The results of the evalua-
health care clinics that received training to six primary tion showed significant improvements across the range
health care clinics that did not receive training. The of outcome measures in the intervention group, and
three-day workshop was part of a provincial pharmaceu- the improvements were sustained and even increased
tical supply management training cascade. in some instances from the first to the second post-
The evaluation included a pre-intervention survey, the intervention survey. The pharmaceutical supply man-
training workshop for staff of the study group clinics, a agement training not only affected the pharmaceutical
post-intervention survey one month after the training, management indicators, but also improved patient care
and a second survey three months after the training. The and raised the level of use of the essential medicines list.
study measured not only supply management outcomes, Source: Summers and Kruger 2004.

the nature of the target group or audience (who are they? are its main points. These main points are then expanded using
they senior or line managers?) and their level of knowledge the chosen learning methods. At the end of the session, the
and skill (have participants been trained in the subject to be trainer should always summarize the discussion, making
presented or related subjects?). sure to allow time for questions and clarification.
Preparation. Time used in preparation is time well spent. In developing visual aids, the following points should be
On average, the amount of time spent preparing the first kept in mind
presentation of a course or training session by a person
knowledgeable on the topic equals four times that spent pre- Use only one idea per visual aid to avoid crowding.
senting it. So a one-week course would require four weeks Use large letters and clear drawings.
of preparation. After looking up information and consulting Do not include too much information on one slide
manuals and other resources that are relevant to the subjects (seven lines with seven words per line is a maximum
(identified in the needs assessment), the trainer chooses guideline).
appropriate learning methods and puts together a session Do not use multiple fonts, sizes, and colors.
plan. He or she takes steps to acquire or prepare appropri- Allow plenty of time for preparing the visual aids and
ate participants guides and audiovisual aids well in advance time for obtaining and testing the equipment.
of the targeted training date. The trainer should have the Test the materials in a rehearsal before the session,
draft materials peer reviewed by someone who is technically preferably in front of critical colleagues.
competent in the subject area. Also, if possible, the trainer
should rehearse the presentation before colleagues, keeping When using visual aids, the trainer should take care to
in mind issues of time and clarity.
Presentation. The trainer should always come to the Check the visual aids and equipment a few minutes
training venue and the session early to check out the room, before the session begins.
the seating arrangements, and the audiovisual equipment Always face the audience, without obstructing their
(Figure 52-3). A friendly chat with participants before the view, and use a pointer.
session creates a more comfortable environment. Switch off the equipment during discussions.
Formal introductions should take place at the beginning
of the first session. One way to do this is to ask pairs of par- Trainers personal style. Personal appearance and style
ticipants to interview each other; then each presents the can make a difference in keeping participants interest
other to the group or records the information on a wall chart during a session. The trainer should maintain eye contact
for all to see. with the group and make sure that his or her voice is clear
The actual session should begin with the trainer present- and can be heard by everybody. When interest appears to
ing the objectives of the course or session and summarizing be flagging, the trainer needs to be flexible and willing to
52.16 H uma n resources ma nag eme n t

change the schedule, perhaps by introducing a role-play or 14. <http://www.ajpe.org/view.asp?art=aj730114&pdf=yes>


arranging a short field visit or by inserting an unscheduled Klatt, B. 1999. The Ultimate Training Workshop Handbook. New York:
break to allow participants to stretch or get refreshments. McGraw-Hill.
Lucas, R. W. 2005. Conducting a Training Needs Assessment, Developing
A good story or joke can help revive interest. In a session an Annual Training Plan, Assessing Trainer Competency, Contracting
in which participants are divided into small groups, having Out for Training. In Human Resource Management Resource Kit.
the trainer move from group to group stimulates interest. <http://erc.msh.org/mainpage.cfm?file=2.8.0.htm&module=hr&la
During a long course, allocating time for dinners and other nguage=English>
social activities is important. . 2003. Creative Training Idea Book: Inspired Tips and
Techniques for Engaging and Effective Learning. New York: American
Management Association.
Monitoring and evaluation McMahon, R., E. Barton, and M. Piot. 1992. On Being in Charge: A
Guide to Management in Primary Health Care. 2nd ed. Geneva:
Monitoring and evaluation to assess the performance and World Health Organization.
H MSH/RPM Plus Program (Management Sciences for Health/
progress of the participants is one of the trainers key roles.
Rational Pharmaceutical Management Plus Program). 2009. A
These assessments should be done as formative evaluations Guide for Implementing the Monitoring-Training-Planning (MTP)
while the course is in progress (for midcourse adjustments Approach to Build Skills for Pharmaceutical Management. Arlington,
and fine-tuning), as summative evaluations at the end of Va.: MSH/RPM Plus. <http://www.msh.org/Documents/upload/
the course (to make the course better in the future), and MTP-Tool-for-Pharma-Mgmt.pdf>
as periodic follow-ups after the training is over to moni- MSH/SPS Program (Management Sciences for Health/Strengthening
Pharmaceutical Systems Program). 2010. Promoting Rational
tor outcomes and assess the continuing performance of Medicines Use and Drug and Therapeutics Committees. Arlington,
the trainees. The training outcomes should be measur- Va.: MSH/SPS Program.
able, performance-based, and directly related to the objec- H Nimmo, C. M. 2000. Staff Development for Pharmacy Practice.
tives of the training program. For example, if the goal of Bethesda, Md.: American Society of Health-System Pharmacists.
the training is for the participants to be able to institute Pike, R. W. 2003. Creative Training Techniques Handbook: Tips, Tactics,
and How-Tos for Delivering Effective Training. 3rd ed. Amherst,
a post-exposure prophylaxis program in their workplaces, Mass.: HRC Press.
a relevant outcome measure would be the completion of Plaza, C. M., J. R. Draugalis, M. K. Slack, G. H. Skrepnek, and K.
this activity within a reasonable time frame. Curriculum A. Sauer. 2007. Curriculum Mapping in Program Assessment
mapping is a method to evaluate the links between course and Evaluation. American Journal of Pharmaceutical Education
content and outcomes (Plaza et al. 2007). 71(02):20. <http://ajpe.org/view.asp?art=aj710220&pdf=yes>
Potter, C., and R. Brough. 2004. Systematic Capacity Building:
Country Study 52-4 details a study designed to assess the Hierarchy of Needs. Health Policy and Planning 19(5):33645.
effect of pharmaceutical management training on clinics in Sisounthone, B., S. Luanglath, and A. Phanyanouvong. 2004. Using
South Africa. Monitoring-Training-Planning (MTP) to Reduce Irrational Use of
In training, formative assessment is important, because Drugs in Hospitals in Lao PDR. Abstract, International Conference
the aim of the course is to improve performance, not to on Improving Use of Medicines 2004, March 30April 2, Chiang
Mai, Thailand.
grade the participants. The trainer can help them learn more H Stolovitch, H. D., and E. J. Keeps. 2002. Telling Aint Training.
quickly and more completely by providing them with con- Alexandria, Va.: American Society for Training and Development.
structive criticism during the course. The trainer can also Summers, R. S., and C. H. Kruger. 2004. Impact of Training in Drug
use the feedback from evaluations to adjust the content and Supply Management (DSM) on DSM, Dispensing Practices, and
methods of the training to better meet participants needs. n Patient Knowledge and Care at Primary Health Care (PHC) Clinics.
Abstract, International Conference on Improving Use of Medicines
2004, March 30April 2, Chiang Mai, Thailand.
Trap, B., C. H. Todd, H. Moore, and R. Laing. 2001. The Impact of
References and further readings Supervision on Stock Management and Adherence to Treatment
Guidelines: A Randomized Controlled Trial. Health Policy Planning
H = Key readings.
16(3):27380.
WHO/EMRO (World Health Organization Regional Office for the
Abbatt, F. R. 2004. Teaching for Better Learning: A Guide for Teachers Eastern Mediterranean). 2006. Training Manual for Community-
of Primary Healthcare Staff. 2nd ed. Geneva: World Health Based Initiatives: A Practical Tool for Trainers and Trainees. Cairo:
Organization. WHO/EMRO. <http://www.emro.who.int/dsaf/dsa736.pdf>
H Bienvenu, S. 2000. The Presentation Skills Workshop: Helping People
Create and Deliver Great Presentations. New York: American
Management Association.
CDC (U.S. Centers for Disease Control and Prevention). 2009.
Writing Smart Objectives. Atlanta: CDC. <http://www.cdc.gov/
HealthyYouth/evaluation/pdf/brief3b.pdf>
Ho, S., D. Kember, C. Lau, M. Au Yeung, D. Leung, and M. Chow. 2009.
An Outcomes-Based Approach to Curriculum Development in
Pharmacy. American Journal of Pharmaceutical Education 73(01):
52/Designing and implementing training programs 52.17

a s s e s s me n t g u ide

Training programs Sites and institutions


Was a needs assessment conducted before the train- Which institutions provide training for staff working
ing programs were developed? in the pharmaceutical sector?
Were performance indicators established? If so, how Over the past two years, where has training
were they established and who was involved? occurred? For whom?
Do the performance indicators include process, out-
Trainers
put, performance, and impact indicators? Are they
both quantitative and qualitative? At each of the institutions identified, how many
What training programs have been held? trainers are there?
How many people of each target group have been How many of these people have been formally
trained? What percentage is that of the total target trained as trainers?
number? In the courses undertaken, what were the evaluation
What methods were used for the training? ratings of the trainers?
What feedback did the participants give on the
Materials
training?
What were the evaluation results for knowledge What training materials were used for the training
change? Work performance change? courses?
How much money has been spent on training activi- Where and how were the materials developed?
ties (if possible, compare budget to actual expen- When were they last updated?
ditures)? What percentage of the overall program How widely available are the training materials?
budget is this? Do the training materials correspond with current
policies?
52.18 H uma n resources ma nag eme n t

Annex 52-1 Sources of assistance for training programs to improve pharmaceutical management

The following organizations and institutions offer training fax: 44 20 7572 2508; e-mail: admin@commonwealth
in selected activities relevant to the pharmaceutical supply pharmacy.org; website: www.commonwealthpharmacy.org
process. This listing is not exhaustive, nor is it an endorsement of
Offers the Management of Pharmaceutical Supply, a distance
these training programs. For details, these organizations should
learning program for all pharmacist and nonpharmacist
be contacted directly.
managers involved with pharmaceutical supply procurement
International organizations are listed first, followed by national and management, especially at the regional level. The course
and private organizations and institutions. Also included is a does not require the student to take leave from his or her
list of short courses on pharmaceutical policy, pharmaceutical employment.
management, rational medicine use, and related subjects.
Crown Agents, St. Nicholas House, St. Nicholas Road, Sutton, Surrey,
SM1 1EL United Kingdom; telephone: 44 20 8710 6771; fax: 44 20
International organizations
8770 0479; e-mail: TrainingEnquiries@crownagents.co.uk; website:
World Health Organization (WHO), 20 Avenue Appia, CH 1211 http://www.crownagents.com/Training/CrownAgentsTraining.aspx
Geneva 27, Switzerland; telephone: 41 22 791 21 11
Crown Agents offers a number of short courses on general
Department of Essential Medicines and Pharmaceutical Policies; management and finance topics and in procurement and supply
website: http://www.who.int/medicines management, including a Certificate in Health Supply Chain
Management. Courses are held in the United Kingdom and in a
Assists member states in the development and implementation
number of other countries, including some in Africa and Asia.
of pharmaceutical policies, the supply of essential medicines of
good quality at the lowest possible cost, and the development Fdration Internationale Pharmaceutique/International
of training in the rational use of medicines. Works closely with Pharmaceutical Federation (FIP), P.O. Box 84200, 2508 AE, The
WHO collaborating centers on pharmaceutical regulation and Hague, The Netherlands; telephone: 31 70 302 1970; fax: 31 70 302
quality assurance and control. Provides training in product 1999; e-mail: fip@fip.org; website: www.fip.org
registration and computerization of drug regulatory data, as
Provides contact information on more than 900 pharmacy
well as good manufacturing practices (GMPs), analytical control,
schools worldwide as well as an extensive list of organizations
and preparation of chemical reference substances.
offering continuing education and online and distance learning
WHOs medicines department provide training programs courses on pharmacy topics. The FIP Foundation for Education
to support policy makers, ministry of health officials, and Research provides a certain number of scholarships,
nongovernmental organizations (NGOs), professional fellowships, and grants every year to assist in the development
associations, and other stakeholders in managing medicines of individuals or groups in the fields of pharmacy practice and
supply and rational pharmaceutical management. WHO pharmaceutical science.
participates in regional and national training courses for drug
Eastern and Southern Africa Management Institute (ESAMI), P.O.
regulators.
Box 3030, Arusha, Tanzania; website: http://www.esami-africa.org
WHO/EMP maintains a list of training resources on its website at
A regional institution that was designated by the UN Economic
http://www.who.int/medicines/training/en.
Commission for Africa as the African Centre of Excellence in
United Nations Childrens Fund (UNICEF), Supply Division, UNICEF Management Development, ESAMI has nine program areas,
Plads, Freeport, 2100 Copenhagen , Denmark; telephone: 45 3527 including training in general financial management and health
3527; fax: 45 3526 9421; website: www.unicef.org/supply management. Clients come from governments, parastatals, the
private sector, NGOs, and national and regional institutions in
The Supply Division conducts training on vaccine forecasting
Africa.
at regional immunization meetings and has developed
a complete suite of training modules on supply chain i+Solutions, Westdam 3b, 3441 GA Woerden, The Netherlands;
management. Through its Procurement Services, the Supply telephone: 31 34 848 9630; fax: 31 34 848 9659; e-mail: info@
Division can arrange for training in procurement and supply iplussolutions.org; website: http://www.iplussolutions.org
upon request.
i+Solutions is a not-for-profit organization specializing in
United Nations Institute for Training and Research (UNITAR), pharmaceutical supply chain management for low- and middle-
International Environment House, 1113 Chemin des Anemones, income countries. i+Solutions offers a variety of courses and
CH 1219 Chatelaine Geneva; telephone: 41 22 917 84 00; fax: 41 22 training programs in pharmaceutical management.
917 80 47; website: http://www.unitar.org
Mahidol University, Faculty of Pharmacy, Sri-ayudhaya Road,
Conducts training and workshops on many areas, including Rajadhevi, Bangkok 10400, Thailand; telephone: 66 02 644 8677
social and economic management, although not specific to 91, ext. 1301; fax: 66 02 354 4326; website: http://www.pharmacy.
pharmaceuticals. Offers a number of online training courses. mahidol.ac.th/eng
Offers short courses on pharmaceutical management, including
National and private organizations and institutions
use of essential medicines, GMP training, and pharmaceutical
Commonwealth Pharmacists Association, 1 Lambeth High Street, economics. Organizes professional meetings, conferences, and
London SE1 7JN, United Kingdom; telephone: 44 20 7572 2364; symposia as a means of professional continuing education.
52/Designing and implementing training programs 52.19

Management Sciences for Health (MSH), 784 Memorial Drive, an advanced therapeutic knowledge base and the necessary
Cambridge, Mass. 02139-4613 USA; telephone: 1 617 250 9500; fax: practical skills to ensure rational prescribing.
1 617 250 9090; website: www.msh.org
Swiss Tropical and Public Health Institute, Course Secretariat,
Center for Pharmaceutical Management, 4301 North Fairfax Drive, Socinstrasse 57, CH 4002, Basel, Switzerland; telephone: 41 61 284
Suite 400, Arlington, Va. 22203 USA; telephone: 1 703 524 6575; fax: 82 80; fax: 41 61 284 81 06; website: http://www.sti.ch
1 703 524 7898; e-mail: cpm@msh.org
Offers the two-week course Rational Management of
Offers short-term courses in multiple languages on rational MedicinesA Focus on HIV/AIDS, Tuberculosis and Malaria.
medicine use and other aspects of pharmaceutical management Conducted in English. Other courses in international health
and on other topics, including pharmacovigilance, management include Health Care and Management in Tropical Countries.
information systems, and disease-specific pharmaceutical
University of Heidelberg, Institute of Public Health, Course
managementsuch as HIV/AIDS, malaria, and tuberculosis. In
information: Im Neuenheimer Feld 365, 69120, Heidelberg,
more than thirty years, thousands of health professionals have
Germany; telephone: 49 62 21 56 50 48; fax: 49 62 21 56 49
participated in MSH courses in the United States and other
18; website: http://www.klinikum.uni-heidelberg.de/Short-
countries.
Courses.109912.0.html
Robert Gordon University, School of Pharmacy, Schoolhill,
Offers short courses in international health. Most of the courses
Aberdeen AB10 1FR, Scotland, United Kingdom; telephone: 44 1224
are post graduate, advanced level, one- and two-week long
262 502; website: www.rgu.ac.uk/pharmacy
programs conducted in English. The institute also offers a one-
The School of Pharmacy offers postgraduate distance learning year masters of science in international health.
courses and certificates for health care professionals to develop
52.20 H uma n resources ma nag eme n t

Annex 52-2 Workshop logistics

Workshop and support checklist Break room(s) or area(s)


Groups of approximately equal size
Advance planning
Overhead and slide projector check: screen that all
Goals participants can see, projector proper distance and angle
Objectives, expected outcomes from screen, sufficiently long electric cord, extra bulb
Needs assessments Transparencies and pens
Content, topics, session Flip charts and pens available for plenary and small groups
Length, time frame
Daily preparation of meeting room
Number of participants
Implementation approach (e.g., small-group interaction Projectors: position, cord, spare bulb, transparencies, pens
versus large-group presentations) Blackboard or whiteboard: cleaner, pens
Materials, including prereading for the participants, Flip charts: location, paper, pens
participants and facilitators guides, handouts
Workshop administration checklist
Participant list
Short-term consultants, facilitators or presenters (choosing Upon arrival at the training site, make sure that the
the best people to present each topic) conference room is arranged properly and note any
Budget, including materials, travel, accommodations changes that need to be made. Find out if additional
Venue: reservations, deposit, other concerns rooms are available for small-group discussions. Set up a
Invitations to participants and follow-up phone calls registration desk near the entrance and a working table
where appropriate. Arrange the handouts on a separate
Workshop material
table where they are readily accessible.
Ruled writing pads, pens, pencils with erasers Set up the projector and test it. Make sure that the
Document binders projection screen can be seen easily by all participants.
Flip charts, pens, and markers Put the writing pads, pens, and programs into document
Blank overhead transparencies and pens binders and place them on the tables.
Masking tape and transparent tape Inform the management of the site about all the practical
Stapler and staples arrangements.
Hole punch Put up a signboard at reception displaying the location of
Photocopying paper the conference room and registration time.
Computer paper, printer ribbon, blank diskettes, multiplug Using the list of participants, prepare the name tags and
adapter spread them out on the registration desk so that the
Letterhead stationery and envelopes participants can collect them as they register. This step can
Paper clips, scissors, Post-it pads, rubber bands, Wite-out, be done either the evening before or in the morning before
glue registration begins.
Calculator Give a copy of the program to the management so that
Name badges they know when to serve tea or coffee and meals.
During the introductory session, make administrative
Workshop support responsibility
announcements: when allowances will be paid (night-
Logistics: supervision of conference site, meals, breaks, and out allowances are normally paid at the end of day one;
accommodations reimbursements for travel expenses are normally paid at
Finances: payment of cash food allowances, paperwork, the break on the last day, upon presentation of receipts as
and reimbursement for transportation expenses documentation).
Secretary for word processing As soon as the last person has registered, type out the
Vehicle and driver participant list and start preparing the receipts for
Messenger and photocopier participants to sign when receiving allowances. Use a
duplicate receipt book with a carbon. Mark the receipt
Workshop support facilities
number against the participants name on the list to make
Telephone access (incoming and outgoing) for facilitators paying easier.
On-site (or easily accessible) photocopy machine (with Type out a separate list for reimbursing transport expenses
toner and paper) for low-volume copies and make out payment receipts. Fuel and other travel
Photocopy service site for high-volume copies receipts can be collected on day one when paying out
Computer and printer allowances.
Overhead projector, extra bulb, extension cord of adequate Give a copy of the participant list to hotel management,
length indicating the participants who are not staying at the
LCD projector and projection screen site so that they know how many extra teas and lunches
Sound system and microphones (if needed) to charge for. Also, give management the names of
the people who are settling their own bills (facilitators,
Setup of main meeting room
secretaries) so that they will not be included in the main
Opening session and plenary sessions: horseshoe versus bill.
classroom-style seating with extra chairs On the last day, have the hotel management prepare the
Tables for small group work detailed bill and check it against the participant list.