The aim of the training is to embed the use of the guide into every day clinical practice.
The KTU promotes the use of educational outreach to deliver training to facility staff as teams in their health facilities. Educational outreach is an implementation strategy known to promote the use of guideline recommendations into clinical care. In our programmes this takes place in the form of short (1 -2 hour) training sessions. Delivering these sessions onsite in health facilities every one to two weeks allows for the alternation of learning with practice, thus improving the likelihood of embedding use of the guide in daily clinical consultations. A team approach targeting all cadres of staff working across programmes within a health facility increases coverage and provides opportunities to discuss care coordination within a health facility.
The training uses an interactive methodology to draw on facility staffs’ existing experience and knowledge. It has a curriculum of cases that is carefully structured to explore the features of the guide and its clinical content. To avoid content overload and to allow the training to focus on local priorities, the training curriculum has been divided into four modules – Communicable Diseases, Non-Communicable Diseases, Mental Health and Women’s Health.
Each module consists of a set of cases that moves from basic content and simple guide features to guiding the integrated care of the patient with multiple symptoms and chronic conditions.
Facility Trainers are drawn from the local health system, often based at health facilities, and are trained in a four-day workshop to facilitate on-site sessions and then provide ongoing support for the programme. The programme is scaled up using a cascade training model of training: the KTU equips Co-ordinators or Master Trainers to manage the programme implementation and to train Facility Trainers. The Facility Trainers in turn are responsible for training facility staff (see diagram).