Critical review of training process towards strengthened service delivery in Dagoretti sub-county.

Abstract

Human resources are the most important assets of any health system. Training is one of the principal means by which health professionals such as Nurses and Clinical Officers maintain, improve, and broaden the knowledge and skills required. Despite progress in developing more effective training methodologies, training initiatives for health workers continue to experience common pitfalls that have beset the overall success. To improve the quality of healthcare services, the shortage of healthcare workers must be addressed by giving quality training and education needed to fill the gap to increase the output of qualified healthcare workers. The study area was in Dagoretti Sub County and 7 facilities were selected owned by the Ministry of Health and the County Government namely Mbagathi District Hospital, Dagoretti Sub County Hospital, Riruta Health Center, Waithaka Health Center, Ngong Road Health Center, Chandaria Health Center and Woodly Clinic. The sample size was 170 Nurses, 50 Clinical Officers, 6 Facility in Charges and 14 Sub County Managers. The research study examined the training process: Selection criteria; Follow up mechanism; and Coordination of activities and how this could strengthen service delivery. The study followed a descriptive cross sectional study design. A survey method using structured questionnaires for facility in charges, nurses and Clinical Officers and a key informant interview was conducted for the sub county managers. Sampling technique used was convenient sampling method. The reaction to the study was positive with a questionnaire response rate of 75.1%. Data analysis included identifying and comparing findings using Statistical Package for Social Scientists software. Data was presented using APA tables, pie charts and bar graphs. The results of the study showed that selection criteria could influence training process by 44.6% at a significance level of 0.03, follow up mechanism could influence training process by 58.4% at a significance level of 0.01 which is very significant and coordination of training activities could influence training process by 43.1% at significance level of 0.03. The findings revealed disconnect between sub county managers, facility in charges, nurses and Clinical Officers on how the training process is carried out. The study concluded that selection criteria is not need based; there is no data base of trainings held. Follow up mechanism is not in place and action plans are not implemented. The activities coordinating training are not well defined since there is no information on trainings available. Based on the conclusions, the recommendations made are improving Human Resource Information System; establishing a training schedule; and a system to evaluate service delivery. This would strengthen the Human Resources for Health pillar and the service delivery pillar in Health system strengthening.