INTRODUCTION TO TRAINING NEEDS ASSESSMENT (TNA) CAPACITY BUILDING WORKSHOP

INTRODUCTION TO TRAINING NEEDS ASSESSMENT (TNA) CAPACITY BUILDING WORKSHOP

TNA TRAINING CONTENT OUTLINE • BACKGROUND • OBJECTIVES OF THE WORKSHOP • IMPORTANCE OF CONDUCTING TNA • BASIC QUESTIONS TO ASK WHEN CONDUCTING TNA • TYPES OF TRAINING NEEDS • PRINCIPLES OF TNA

TNA TRAINING CONTENT OUTLINE • PRINCIPAL TNA METHODS • DESIGNING OF APPROPRIATE TOOLS • PILOT TESTING THE TNA TOOLS • SAMPLING • DATA COLLECTION AND ANALYSIS • ENTERING THE COMMUNITY • WRITING THE TNA REPORT • DESIGNING/DEVELOPING THE TRAINING PLAN

Background/introduction • Trainings organized by vertical programmes from MOH do not take into account district priority areas • Health workers are often pulled out of the districts for training, hence affecting their time for effective work at the health facilities • Despite the various trainings conducted, the management of health services has remained weak and quality of health care wanting.

Background/introduction • There is a public outcry that the new graduates from the health training institutions do not perform to the expectation of clients. • There is often a gap between what the health workers learnt during the basic training and the knowledge and skills required to perform the tasks they are confronted with in the field.

Background/introduction • There are emerging technologies for example, new equipment which health workers need to be oriented to their use. • The society is becoming more enlightened and hence demand for some health care needs • There are emerging health conditions that require re-orientation of the Health workers to face the challenges

Background/introduction • There are government policies and priority areas that require re-alignment of the training focus • Training needs were generally designed by trainers based on their own experience, interests and judgment. They were rarely related to the jobs of the trainees and even to the needs of the trainees.

Objectives of the workshop • The overall aim is to develop capacity in districts for systematic, effective and coordinated training programme for health workers Specifically, • Prepare the district staff to carry out TNA • Build capacity of the district staff to develop comprehensive and relevant pre and in-service training plans

Objectives of the workshop • Develop standard TNA methodology and tools for assessing training needs for training programme in the health sector • Guide districts to identify ways of strengthening and sustaining district training activities

Importance of conducting TNA • A training need is knowledge and skills gap that exists in health worker performance and TNA is a method that determines whether a training need exists and the remedial action • Provides basis for course planning to meet the needs of the learners and that of the organization for relevant and effective teaching and learning processes.

Importance of conducting TNA • Provides structure for supervision and performance evaluation • Bridges the gap between the ideal and the actual performance by initiating corrective and remedial measures. • Quite often the condition under which a job is performed differs from the desired one hence need to introduce new approaches and interventions.

Importance of conducting TNA • Ensures relevant training by facilitating need based quality training • Ensures that the training is compatible with the emerging health conditions and change in technology. • To improve productivity in training by maximizing benefits from use of available resources especially if the training is relevant.

BASIC TNA QUESTIONS • What should be assessed and what data will be required? This is to determine which areas needs reinforcement, support, assistance, improvement and change. • How will the data be collected and recorded? This involves deciding on the methods in conducting TNA, categorizing and prioritizing the identified needs, deciding on the corrective measures and communicating the findings.

BASIC TNA QUESTIONS • When will the TNA take place? Decide on the date, time, and duration of the conduct of the TNA. • Where will the TNA take place? Decide on location to carry out the TNA • How much will the TNA cost? • What feedback will be provided?

BASIC TNA QUESTIONS Who should be assessed and carry out the TNA? Identify the staff that will carry out the TNA, whether there is work deficiency or new assignment and if they can be addressed through training Where will the TNA take place? Decide on location and establish the cost and the feedback required

TYPES OF TRAINING NEEDS • Micro - training needs arising as a result of need to change a smaller proportion of the training curriculum as opposed to macro – Training needs where a broad area of the training curriculum requires change • Individual training need for one person versus group Training Needs for a large number of people within the same job classification

TYPES OF TRAINING NEEDS • Pre and in-service training needs • Felt needs and Observed needs • Short term training needs and long term training needs • Performance or gap analysis TNA - This addresses the skill or knowledge deficiency and if training is appropriate way to fix them

TYPES OF TRAINING NEEDS • Needs versus wants analysis - This helps to find out whether training is related to a need • Goal analysis needs assessment • Job/task analysis – This looks at the best ways to perform the task and whether theses tasks can be broken down into teachable parts • Target group analysis - This examines the type of training design appropriate for the trainees • Contextual analysis – The time and requirements for delivering the training.

PRINCIPLES OF TNA • TNA must have explicit purpose/aims • Information required may be qualitative or quantitative depending on the purpose • Are quickly out of date • May focus on an individual or organizational needs

PRINCIPAL TNA METHODS Training needs exists when there is a gap between the ideal and the actual performance Direct observation • A way of gathering data on job performance • Can be unstructured observation to structured checklist • Directly assesses the way a task is carried out

PRINCIPAL TNA METHODS Direct observation • Observe a sample not only just one person • Can be time consuming • Impact of observer on job performance needs to be taken into account

QUESTIONNAIRES • Commonly used • Once developed can be used extensively • Remember to pilot test the questionnaire • Response rate may be low but there are many tricks to improve this • Low response rate can skew the results • Simple to use • Analysis takes time

Key informant consultations/interviews • Process of gathering information from people whose position makes them a key informant • Can be very subjective and biased • Difficult to analyse and interpret information • Simple and easy to conduct

Focus Group Discussions: • A good way to learn about peoples knowledge, attitudes and practices • Prepare questions for the group in advance • Usually has 6 – 8 members • It is best to involve two people. One asks questions and the other notes the responses • Simple to use • Time consuming especially to analyst the data.

Document analysis • Wide range of documents can be accessed such as project reports • Performance appraisal reports • Regular MOH reports for example, various health sector reports • Policy documents • Journal or health bulletins • Out-patient and in-patient register among others

Interviews: • Use a prepared interview schedule so that everyone interviewed is answering the same set of questions. • Has a high rate of completion so you have a better picture of needs • Fairly simple to use • Time consuming and therefore expensive • Easily replicated to wide use

Work samples • Similar to observations • Looks at finished work products, for example, record keeping, reports • Quick • Cheap • Easily available and accessible

NB: Training is not always the answer • Inadequate work conditions • Unclear or absent expectations • Lack of feedback • Triangulation is important

Health workers information • Information from health workers can be generated through: • Critical incident studies (Clinical Audit); an incident where a health worker feels he/she did not do the task well or with unsatisfactory outcome. • Focus Group Discussions (FGDs)

Health workers information • Interviews • Observation • Questionnaires • Test of skills (checklists)

Information from the Health systems Managers Information can be got managers through: • Support supervision reports. • Appraisal reports. • Discussions • Questionnaires.

Information from the Health systems Managers • Health management information system-reports • Human resource inventory • Epidemiological data/Management information system (MIS): - Morbidity and mortality data • Public expressions: - By assessing the customer care and satisfaction

Pilot-testing the TNA tool Labeling: • Was the title clear and unambiguous ? • Could the layout be improved to make the tool use more efficient? Instructions • Do the instructions provide enough guidance to the users? • Is the objective clearly stated? • Is the data collection method appropriate to the objectives?

Target group • Was it easy to identify the required respondents on site? • Was the sample size right? • Did you notice any interviewer effect? • Do you think it produced biased responses? • Could the biases be eliminated?

Getting responses • Did you find it easy to get the necessary responses using the existing questions or checklist? • Did you find the questions/prompts sufficient to keep the focus? • How long did it take to complete the tool? • Were some questions unnecessary?

Getting responses • Were additional questions needed? • Coding responses • Would additional coding on response sheet be helpful? • Would a separate (coded) response sheet be useful?

Analysis • Did the tool pick up the performance gaps? • Did the analysis tool help identify performance gaps • Do you have concerns that some performance gaps were ignored? • Could you provide a summary of the training needs to the district? • Did it provide enough information on which to base

SAMPLING • Sampling is a process of choosing the elements or study units from a larger study population. • Any representative part of the study population is called a sample. It is the planned way of selecting the study units or elements. • It involves selection of a number of study units from a defined study population.

SAMPLING • Study population is the total of all the study units in the study area or defined problem scope. If a sample represents the study population, the findings can be generalized to the entire study population. A representative sample has all the characteristics of the population from which it was drawn. The choice of the sample is influenced by the sampling frame or listing of all the study units.

SAMPLING • A single member of the study population “N” or a sample” n” is called an element or study unit. Data is collected from the basic study unit. • Sampling is choosing a smaller group to include in the survey that will give roughly the same answer as if the whole population has been studied. • The proportion of the sample size that actually participated in the study or the study elements that were actually seen is called the response rate.

Common methods of sampling • Non probability/non-random sampling methods • In the cases where sampling frame is not available, we have to use non- probability sampling such as convenience or quota sampling. • Convenience sampling is a method where the study units that happen to be available at the time of data collection are selected in the sample • Quota sampling: a method where certain number of study units from the different categories with specific characteristic

Common methods of sampling • Probability sampling/random sampling methods • A method where each element in the study population, has an equal or a known chance of being included in the sample. • Probability sampling requires that a listing of all the study elements or units exist or can be compiled.

Reasons for sampling • Inadequate time (moments), Money, Manpower and means of transport

Simple Random Sampling (SRS) • It is a basic probability sampling design. It gives each element in the study population an equal chance of being chosen. This can be done by using the table of random numbers or the lottery method. Make a numbered list of all the items. • Decide on the sample, and then elect the number of required units using a lottery method or a table of random numbers

Systematic sampling • Here the study units are selected at regular intervals from the sampling frame. • A sampling frame is the listing of all the units or elements that compose the study population. • We randomly select a number to tell us where to start selecting individual units from the list. • For example: • If sample is to be selected from 1200 households and the sample selected is 100.The sampling interval is the study frame divided by the sample size.

Stratified sampling • The study should include representative groups of study units with specific characteristic. • It is usually used where the study population has definite strata, class or group whose proportions are known for example, rural/urban, male/female or age groups. • Random or systematic sampling can then be used in each stratum. • Stratification ensures that important variables will be sufficiently represented in the sample.

Cluster sampling • Cluster sampling is the selection of groups of study units (cluster) instead of the selection of study units individually. Clusters can be villages, districts or sub-counties, for example, selection of a village from a list of villages. • Multi stage sampling • Is a method of sampling where sampling may be done in two or more stages, for example, sub-counties parishes and villages.

Bias in sampling • A systematic error in sampling procedures that leads to a distortion in the results of the study. It may be introduced as a consequence of improper sampling procedure that results into sample not being representative. The best known source of bias is non- response. • Overcoming bias in sampling • Pre-testing the data collection tools and follow-up of non- respondents by additional people

DATA COLLECTION AND ANALYSIS Data collection refers to gathering specific information to provide some facts to an issue or problem. This calls for having a clear understanding of the type of data required for the study and a clear vision of the instruments to be used, the target respondents and the selected area. Analysis helps to transform raw data to information from which then can be interpreted to aid decision making.

Data Analysis • Without analysis, TNA data will remain useless and cannot be help to the decision makers. • There is qualitative data, which is information primarily expressed in terms of themes, ideas, events, personalities, whereas quantitative data is expressed in numerical. • It focuses on organising and reducing information and making logical or statistical inferences; whereas interpretation attaches meaning to organised information and draws conclusions.

INTRODUCTION TO TRAINING NEEDS ASSESSMENT (TNA) CAPACITY BUILDING WORKSHOP