Implementation, Monitoring and Evaluation of a Novel In-Service Training Strategy of Public Health Staff: Evidence from Colombo Regional Directorate of Health Services, Sri Lanka

Introduction: Continuous in-service training sessions help in updating and upgrading the competency of the public health field staff. Implementation of these sessions with the uniform delivery of the quality assured content has been a challenge in the Sri Lankan well-established preventive healthcare system.

Aim: To describe the implementation, monitoring and evaluation of a novel in-service training strategy of public health staff including Pubic Health Inspectors (PHI) and Public Health Midwives (PHM) conducted in the Colombo Regional Directorate of Health, Sri Lanka from January to June 2018.

Methods: A consultative meeting and a workshop was conducted with the participation of all stakeholders in reviewing the existing in-service training methodology and in recommending the strategies of overcoming the limitations of it. A novel strategy was developed for the implementation of in-service sessions with multi-level implementation and evaluation components. The in-service training sessions were conducted to improve the knowledge and quality of service provision by Public Health Inspectors, Public Health Midwives and other public health staff. Four evaluation indicators were defined. Descriptive statistics and the Wilcoxon signed rank test were used in the evaluation.

Results: By the consultative meetings and workshops, four main weaknesses of the existing in-service training system were revealed, and three characteristics of an ideal system were defined. Two process indicators have shown a coverage of the intervention of 100% while the median satisfaction scores were observed to be 85% or above. Two output/outcome indicators have shown that the interventions have yielded significantly higher post-intervention scores compared to the pre-intervention scores as perceived by the staff members (p<0.05), while the reception of feedback reports was 100%.

Conclusions and Recommendations: The novel strategy is seemingly effective in relation to the four evaluation indicators used. Possibility of implementing similar strategies in other areas must be explored with the view of disseminating quality assured content with uniformity among the public health field staff categories in the monthly in-service sessions.