Existence of training strategy based on needs assessment to improve quality of service delivery

"Based on needs assessment" refers to use of a systematic collection of information from multiple relevant sources that indicates the areas in which more service providers require training and the type of service providers who should receive training.

The "needs assessment" describes the existing service delivery system and identifies the gaps between desired and actual performance of providers. It examines the components described below under the training strategy and may specifically focus on one or a limited set of services. Alternatively, it can be (though rarely is) an overarching assessment of the health services system.

This indicator does not specifically measure the effectiveness of the strategy at improving quality, but it relates to the objectives of training programs, which are performance improvement and enhanced quality of care.


Evidence of a needs assessment conducted and used in developing the strategy; information from those involved in developing the strategy


Program records; interviews with persons responsible for the strategy


A detailed training strategy is essential for effective training. Although a training strategy does not guarantee an effective result, the lack of a training strategy suggests ad hoc efforts with little attention to priorities or the felt needs within the system.

The training strategy shows an integrated approach to improving reproductive health (RH) service delivery in standardizing and implementing both pre-service education and in-service training, supported by national guidelines/standards. It builds on national RH service delivery needs identified (from government documents and plans) and describes the role of the comprehensive RH training and education system in the context of the sector. In addition to describing the various institutions, organizations and personnel, it includes the sector components of:

  • Licensure/certification of providers;
  • Provider deployment/job assignment;
  • Provider supervision;
  • Qualification of trainers/ trainer development; and
  • Participant selection criteria.

The training strategy may also include components of a pre-service/in-service reproductive health training program:

  • RH curricular component/course schedule;
  • Staff/faculty (classroom instruction, clinical practice);
  • Training materials;
  • Clinical training sites;
  • Quality monitoring system; and
  • Training information systems.

For a training strategy to be effective, it must have local commitment. Ideally, the leading staff from the training organization will play a key role in developing the training strategy, either alone or in collaboration with external consultants. Without this local input, the training strategy will garner little support from the upper levels at the local organization in question. Rather, they will likely dismiss the strategy as irrelevant, erroneous or externally imposed.

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