Bangladesh: Supporting Urban Primary Health Care …...3 Loan Agreement (Special Operations) (Urban...

1

Technical Assistance Consultant’s Report

Project Number: 42177-013 June 2013

Bangladesh: Supporting Urban Primary Health Care Services Delivery Project (Financed by Asian Development Bank)

Prepared by: Monica Burns

This consultant’s report does not necessarily reflect the views of ADB or the Government concerned, and ADB and the Government cannot be held liable for its contents.

2

Government of the People’s Republic of Bangladesh

Ministry of Local Government, Rural Development and

Co-operatives

Local Government Division

Urban Primary Health Care Services Delivery Project

Project Management Unit

Nagar Bhaban, 5 Phoenix Road, Dhaka 1000

Training and Capacity Development Strategy

25.06.13

3

Contents

Page

Abbreviations used 3

1 Introduction 4

2 Background 5

2.1 Context for urban primary health care services 5

2.2 Migration 5

2.3 Training needs 6

2.4 Staff retention 6

3 Training and capacity development strategy and Logframe 7

4 Background to capacity development objectives 16

4.1 Links to project outputs, targets and sustainability 16

5 Background to guiding principles 16

5.1 Strategic co-operation between MOHFW and MOLGRD&C 16

5.2 Sustainability 17

5.4 Gender equity 17

6 Training topics / areas 17

6.1 Range 17

6.2 UNFPA 18

6.3 Save the Children 18

7 Target groups 18

7.1 Identification 18

7.2 Overlaps in target groups 19

7.3 Inclusion of MOHFW in selected capacity building interventions 19

8 Training action plan parameters 20

8.1 The TCU structure in place to co-ordinate training delivery 20

8.2 The resource envelope 21

8.3 Sources of training (institutes / providers) 22

8.4 Training modalities / format 23

9 Monitoring and Evaluation 24

Annex 1 Roles and responsibilities of the Training Co-ordination Unit 26

4

Abbreviations ADB Asian Development Bank

ASRH Adolescent Sexual and Reproductive Health

BIAM Bangladesh Institute of Administration and Management

BRAC Bangladesh Rural Advancement Committee

CME Continuing Medical Education (for all health officials)

CRHCC Comprehensive Reproductive Health Care Centre

DLIs Disbursement-linked indicators

DMF Design and Monitoring Framework (RRP Appendix 1)

DPP Development Project Proposal, Urban Primary Health Care Services Delivery Project,

Government of the People’s Republic of Bangladesh, Ministry of Local Government,

Rural Development and Co-operatives, June 2012

ENC Essential Newborn Care package

ESD Essential Services Delivery

HBBGDA Helping Babies Breathe Global Development Alliance

HMIS Health Management Information System

ICMH Institute of Child and Maternal Health

IT Information Technology

k.a.s.e Knowledge, Attitude, Skills and Efficiency

LGD Local Government Division

M&E Monitoring and Evaluation

MDG(s) Millennium Development Goal(s)

MFSTC Mohammedpur Fertility Service and Training Centre

MMR Maternal Mortality Ratio

MOHFW Ministry of Health and Family Welfare

MOLGRD&C Ministry of Local Government, Rural Development and Cooperatives

MOU Memorandum of Understanding

MTR Mid Term Review

NGO Non-government Organisation

NIPORT National Institute of Population Research and Training

NIPSOM National Institute for Prevention and Social Medicine

OGSB Obstetric and Gynaecology Society of Bangladesh

PA Partnership Agreement/Area

PA-NGO Partnership Agreement Non-government Organisation

PHC Primary Health Care

PHCC Primary Health Care Centre

PIU Project Implementation Unit

PMU Project Management Unit

PSTC Population Services Training Centre

QA Quality Assurance

RRP Reports and Recommendations of the President (June 2012)

SIDA Swedish International Development Agency

SNL Saving Newborn Lives

TCU Training Co-ordination Unit

ULB(s) Urban Local Body(ies)

UNFPA United Nations Population Fund

UPHCSD Urban Primary Health Care Services Delivery

UPHCSDP Urban Primary Health Care Services Delivery Project

USAID United States Agency for International Development

WHO World Health Organisation

5

1 Introduction

1.1 The purpose of the Training and Capacity Development Strategy is provide the

context for and guidance for providing training and capacity building to those involved in

the Urban Primary Health Care Services Delivery Project. The Strategy addresses

training needs to support establishment of good clinical, managerial and governance

practices which will facilitate delivery of good quality primary health care through public

private partnerships which are managed professionally and transparently using reliable

and accepted information. The Training and Capacity Development Strategy is grounded

in the formally agreed documents relating to the project, such as the RRP, DPP and the

PAM. It also links with the National Urban Health Strategy 20121 which identifies the

key health challenges for urban population and ways to address those. The Strategy is

used as the basis for the detailed Implementation Plan and regular revisions of that Plan

1.2 The Urban Primary Health Care Services Delivery Project (UPHCSDP), which

runs from December 2012 until December 2017, offers support to provide good quality

primary health care services to those living in specified urban areas through public

private partnerships. Funded by Asian Development Bank (ADB), Swedish International

Development Agency (SIDA) and the Government of the People’s Republic of

Bangladesh (GOB), the project continues a long-standing commitment to primary health

care development, focusing on achievement of Millennium Development Goals (MDGs)

4, 5 and 6.

1.3 Bangladesh has made huge progress in reducing child mortality and in improving

maternal health. The neonatal mortality rate has reduced from 52 in 1993 to 32 in 2011;

infant mortality has reduced from 87 to 43, child mortality reduced from 50 to 11 and

under-5 mortality from 133 to 53 for the same period2.

1.4 In addition to continuing the very necessary thrust towards achievement of MDGs

4, 5 and 6, the project focuses on adolescent health issues which pose a particular

challenge for such a relatively young and mobile population, with a high preponderance

of young adults moving to urban areas in search of work and better conditions.

1.5 The project is under the overall management of the Ministry of Local Government,

Rural Development and Co-operatives (MOLGRD&C), which also manages the Urban

Health Project of UNFPA which has closely aligned objectives for primary health care

development.

1.6 The approach of the project is to provide primary health care services through

public private partnerships between MOLGRD&C and PA-NGOs, delivering services to

government-specified standards. The scope of the project covers all City Corporations

and selected Municipalities and is specifically pro-poor in its targets, with a focus on

women, children and adolescents.

1 Government of the People’s Republic of Bangladesh, National Urban Health Strategy 2012, Ministry of

Local Government, Rural Development and Co-operatives, Local Government Division in collaboration

with Ministry of Health and Family Welfare 2 Bangladesh Demographic and Health Survey, Preliminary Report 2011

6

1.7 The UPHCSD Project started officially on 3rd

December 2012 and will run for

five years. The Training and Capacity Development Strategy is developed to cover the

lifetime of the project, to build skills and knowledge which will support ongoing

implementation of urban primary health care service delivery into the future. In order to

get maximum benefit from training inputs, most training and skills development activities

are planned to take place between June 2013 and June 2016. This will ensure that training

inputs are appropriate for the achievement of project outputs, that learning can be

successfully applied during the lifetime of the project, and that quality primary health

care services are delivered to urban populations across the lifetime of the project, with in-

built capacity for sustainable continuation.

1.8 The Training and Capacity Development Strategy is developed in the context of

the key project components3, which are:

Component 1 Strengthening institutional governance and capacity of local governments

Component 2 Improving urban PHC service delivery system through public-private

partnerships, and

Component 3 Project management support.

2 Background

2.1 Context for urban primary health care services

The key responsibility for health policy and strategy, and international and national

reporting of health statistics, within Bangladesh rests with Ministry of Health and Family

Welfare (MOHFW). Urban primary health care is the responsibility of the Urban Local

Bodies, under the jurisdiction of the Local Government Division of Ministry of Local

Government, Rural Development and Co-operatives (MOLGRD&C). The separation of

responsibilities for national health issues across two ministries poses numerous

challenges, not least of which is the limited institutional co-ordination between the two

Ministries and their respective Divisions.

2.2 Migration

Migration to urban areas is steadily increasing, with a high proportion of young people

among the internal migrants. Rapid urbanisation through inward migration creates a

number of challenges for health care, family welfare and nutritional security. It is a huge

challenge to provide quality health services within existing resources. Targeting of those

resources to ensure good quality primary health care services will ensure improved

uptake of the necessary immunisations and vaccinations, and provide illness prevention,

health promotion and treatment for most chronic and minor illnesses and diseases, as well

3 Loan Agreement (Special Operations) (Urban Primary Health Care Services Delivery Project) between

People’s Republic of Bangladesh and Asian Development Bank, dated 26 September 2012, BAN42177,

Loan Number 2878-BAN(SF), Schedule 1, Description of the Project, Page 10

7

as ante natal, delivery and post natal care. Delivery of a quality primary health care

service will enable the relatively young population to remain healthy and so contribute to

national productivity and economic development.

2.3 Training needs

The Design and Monitoring Framework4 describes the performance targets (and

indicators with baseline) for the outcome and outputs of the project. The skills required to

achieve these outputs are described in the Project Administration Manual, Annex 9,

which proposes to provide knowledge and skills development in three key areas: (i)

management skills, (ii) clinical skills and (iii) skills in health management information

system and basic IT. The proposed training inputs are further expanded in the Indicative

HRD Plan in the same Annex and are based on reviews and reports5 from the preceding

UPHC II project and a training needs assessment undertaken at the start of the project

which helped to identify and confirm gaps and priorities previously documented.

Focusing on these three key areas will channel skills and capacity development inputs to

achieve the project targets and establish the systems which will continue into the future.

2.4 Staff retention

2.4.1 In previous urban primary health care projects retention of staff has been a major

challenge. Staff employed under NGO contracts are paid less and have fewer benefits

than health personnel employed in the public sector. Frequent movement of staff is a

widespread challenge in all sectors in Bangladesh. Despite this, training and capacity

development is still necessary for clinical, management, and leadership skills, to ensure

achievement of the project objectives and to build a trained and qualified cadre of

personnel who can develop the public private partnerships for the future, to ensure

sustainable delivery of primary care services.

2.4.2 Staff working in government Divisions, Ministries, Municipalities and City

Corporations are subject to being reassigned on a frequent basis. The MOLGRD&C’s

commitment to the Urban Primary Health Care Services Delivery Project offers some

reassurance that key personnel will not be moved during the lifetime of the project,

except through promotions. This offers some stability in personnel for skills development

- and application of those skills - over the lifetime of the project.

2.4.3 Mitigation of the adverse effects of high staff turnover will be supported through

the incentives of access to high quality professional capacity building programmes and

opportunities to undertake certificated training programmes. Those who acquire

additional skills and knowledge will be able to apply them in the field of primary health

care and health management generally, even when they move position.

4 RRP, Appendix 1, pp11 - 13

5 Including Final Report on Management and Support with Recommendations, M S & T Firm, December

2011; Report of the mid-term review independend consultant team, Loan 2172-BAN(SF) / ADB Grant

0008-BAN/Sida Grant 0009/DFID Grant 0010: Second Urban Primary health care Project, March 2009

8

3 Training and capacity building strategy

The training and capacity development strategy is presented in succinct format below.

Sections 4 – 7 of this document provide background details relating to principles, training

topics, target groups, the TCU structure, the resource envelope and modalities.

The training and capacity development strategy reflects the lessons learned from previous

projects, specifically the training inputs and identification of capacity gaps. In identifying

the most effective training and capacity building inputs for this project, the various types

of training (interactive, international exposure, group learning, individual learning and

other methods) were considered. The subjects for training and capacity building were

based on previous experience and documented reports and reviews of earlier projects.

The numbers of training and capacity building inputs were also considered, with

reflection on how to achieve maximum coverage of all personnel involved in and

responsible for successful implementation of urban primary care services.

Training and capacity development strategy

Guiding principles

The guiding principles of the training and capacity development strategy are the national

objectives and international commitments relating to achievement of MDGs 4, 5 and 6,

the goals, objectives and project outputs of the UPHCSD project. Encouraging strategic

co-operation between MOHFW and MOLGRD&C, building sustainability and

incorporating gender equity into the training and capacity development are key

principles. The Training strategy provides capacity building interventions to support pro

poor targeting for delivery and sustainable development of primary health care services,

focusing on women, children and adolescents.

Mission

The mission of the strategy is to support managers and clinical personnel and users of

primary health care services to achieve improved health status through good quality

services provided through public private partnerships

Objective

The training and capacity building objective is to support the designated personnel

responsible for planning, monitoring and delivery of the services under the UPHCSD

project to undertake their roles and responsibilities with the necessary skills and

competencies.

Priority interventions

A number of priority training and capacity building interventions have been identified to

support project personnel in the successful achievement of the project outputs. These are

presented in more detail in the Implementation Plan and are listed below:

Orientation of all relevant LGD, ULB, PIU, CRHCC, PHCC personnel in the

goals and objectives of the project

Management skills training and development for LGD, ULBs, PIU and PA-NGOs

9

to facilitate good practice for execution of public private partnership agreements,

including human resource management, supplies management

ULB and PIU accounts staff to be trained in financial management, accounting,

reporting, auditing

LGD, ULBs, PIU to have project management skills training, including reporting,

financial planning, procurement, billing, contracting

LGD, ULB and PIU personnel to have enhanced leadership and management

training and capacity development in public private partnerships for urban

primary health care

ULB, PIU, and PA-NGO personnel to have capacity building for quality

assurance monitoring (clinical and managerial)

Orientation and capacity development on gender issues in health, sexual

reproductive health rights, cancer screening, diagnosis and treatment of STIs for

PHCC and CRHCC staff (doctors, nurses, midwives)

Training for clinical staff of CRHCCs and PHCCs to support improved ante natal

services, including observation and monitoring of vital signs, BCC to support

better nutrition during pregnancy, advocacy, use of cell phone technology to

maintain contact with pregnant women, identification and interventions relating to

complications of pregnancy

Training for clinical staff of CRHCCs and PHCCs to support improved maternal

delivery and post natal services, including safe delivery, emergency obstetric care,

maternal and newborn health and nutrition

Training and capacity building for clinical and BCC staff of CRHCCs and PHCCs

to encourage informed uptake of family planning options and to provide the full

range of available interventions (clinical and non-clinical)

Training and capacity building for clinical and BCC staff of CRHCCs and PHCCs

to support improved child health, including early newborn care (ENC), Keeping

Babies Breathing (KBB), child nutrition and growth monitoring

Orientation and capacity building of clinical and BCC staff of CRHCCs and

PHCCs to provide adolescent sexual and reproductive health services

Logical Framework

A Logical framework is presented below. This reflects the links to the Design and

Monitoring Framework of the RRP. Additional columns have been inserted to (a) identify

capacities required to support achievement of the components, and (b) skills and capacity

building to be provided to support the achievement of the components.

Implementation of the strategy

An Implementation Plan has been developed to support the strategy and is available as a

separate document. The Implementation Plan includes details of training and capacity

development to be provided in-country and abroad (including numbers of participants

and duration of programmes), budget planning for implementation, selection of training

providers, and training evaluation and assessment forms for monitoring and evaluation

and quality assurance of training inputs.

10

Logical framework for training and capacity development Design summary

6 Performance targets and

indicators with baseline

Data sources and

reporting

mechanisms / OVIs

Capacities required to

support achievement

of outputs

Training and capacity

building inputs to support

achievement of outputs

Assumptions and

risks

Impact

Improved health

of the urban

population,

particularly the

poor, women, and

children

By 2020, for urban population:

MMR is reduced from 194 to

143 per 100,000 live births

U5MR is reduced from 63 to 48

per 1,000 live births and gender

disparities eliminated (<5%

difference)

Proportion of underweight is

reduced from 28% to 21% and

stunted children reduced

from 36% to 27% and gender

disparities reduced (<5%

difference between sexes)

TFR is maintained at 2.0

Differentials in MMR, U5MR,

TFR, and child malnutrition

between the lowest wealth

quintile and the highest wealth

quintile in urban areas is

reduced by 15%

BMMS 2010, MDG

and

future BMMS reports

BDHS 2007, MDG and

future BDHS reports

BDHS 2011, MDG and

future BDHS reports

BDHS 2011, MDG and

future BDHS reports

Assumption

The government and

partner institutions

remain committed to

health as a priority for

inclusive growth and

reducing poverty.

Risk

The priorities and

programs of the

Government of

Bangladesh change.

Outcome

Sustainable good

quality urban PHC

services are provided

in the project areas

and target the poor

and the needs of

women and children

By 2017, in project areas:

60% of births are attended by

skilled health personnel

(baseline: 26.5% BMMS 2010)

At least 80% of growth

monitoring and promotion

performed on under-5 children

(baseline: 43.3% UPHCP II

2008)

For all indicators:

Project baseline and

endline

surveys (household,

facility-based, and

qualitative)

ISI

UHS

ULB annual

Assumption

The government

implements

investment programs

and strategies for

strengthening the

delivery of pro-poor

urban PHC services

effectively.

6 Labels and strategic performance targets used from RRP, Appendix 1 Design and Monitoring Framework

11

Design summary6 Performance targets and


Data sources and

reporting

mechanisms / OVIs


support achievement

of outputs




Assumptions and

risks

At least 60% of eligible couples

use modern contraceptives

(baseline: 53% UHS 2006)

At least 80% of poor

households are properly

identified as eligible for free

healthcare (baseline: 67%

UPHCP II 2008)

At least 80% of the poor access

project health services when

needed (baseline: 64.7%

UPHCP II 2008)

At least 90% of project clients

express satisfaction with project

services (baseline: 76%

UPHCP II 2009)

development

plans

Risks

Governance and

corruption risks are not

minimized. Citizen

demands for greater

participation,

transparency, and

accountability are not

met.

ULBs lack sufficient

funds to implement

programs and

strategies for

strengthening pro-poor

urban PHC services

Outputs

1 Strengthened

institutional

governance and local

government capacity

to sustainably deliver

urban PHC services

Governance and capacity

Permanent and functional inter-

agency coordination structure

for urban health is established

by December 2013

All project ULBs have a

functioning health

department with at least 1 staff

in each health department

trained in PPP contract

management and core project

management skills by 31

December 2013

Gender-responsive data

collection and analysis are

computerized through HMIS in

80% of partnership areas by 31

December 2014

Sustainability and commitment

At least 50% increase in overall

For all indicators:


endline

surveys (household,

facility-based, and

qualitative)

Project joint review

missions

Project training

program

evaluation

Project quarterly

progress

Reports

Post training

assessment reports

Course completion

reports

Leadership to support

interagency collaboration

Management of PPP

contracts

Project management

HMIS implementation

Financial planning for

urban primary health care

Management of urban

primary health care service

planning and delivery

Clinical management for

obstetric care

Management of

Overseas

1 Masters in Primary Health

Care Management, ASEAN

Institute for Health

Development, Mahidol

University, Thailand (x 2 pax)

2 Masters in Public Health,

Department of Public Health,

Mahidol University, Thailand

(x 2 pax)

3 Certificate course (12 weeks)

on public procurement (x2 pax)


on social health insurance (x 1

pax)

5 Study visits on Leadership

and Management related to

urban primary health care (x 27

pax / 3 batches)

6 Study visits on options for

financing urban primary health

Assumption

All participating ULBs

are adequately funded

and are committed to

delivering urban PHC

services.

Risks

Political pressures at

the ULB level divert

resources and efforts

away from the delivery

of PHC services.

Recurrent

expenditures are

inadequate to sustain

services of partnership

agreement NGOs after

the project ends.

12



Data sources and

reporting

mechanisms / OVIs


support achievement

of outputs




Assumptions and

risks

allocation to the urban primary

health care sustainability

fund compared to UPHCP II

(2011 baseline: Tk38.5M)

At least 5% per annum increase

of ULB annual development

plans and block grants allocated

for PHC and public health

related services (2011 baseline:

No)

Mid term review

Quality Assurance

reports

reproductive services

(women, men and

adolescents)

Pro-poor targeting

Clinical waste

management

care (x 8 pax )

7 Study visit on urban primary

health care with responsibilities

split between health and local

government ministries (x 8

pax)

In-country

1 Orientation Workshop,

Project Interventions (x 100

pax)

2 Comprehensive ESD+,

Referral, QA (x 100 pax)

- Orientation workshop on

project deliverables, effective

pro-poor targeting, and

referrals from PHCCs and

CRHCCs to secondary care

- ASRH

3 ESD Training-Clinical (x

1,620 pax) UNFPA

- Safe delivery

- Emergency obstetric care

orientation

- Post abortion and maternal

reproductive health

- Reproductive health (ante

natal, post natal and essential

newborn care)

- Maternal, newborn and child

health (ante natal post natal,

ENC, IMCI)

- Essential Newborn Care

(TOT)

4 Effective pro-poor targeting

(x 2,200 pax)

- Identification of poor

- Promotion of service uptake

13



Data sources and

reporting

mechanisms / OVIs


support achievement

of outputs




Assumptions and

risks

5 Medical IT-Cellphone

Technology, IT based

Advocacy (x 2,200 pax)

6 Innovative approaches (e.g.

health financing, DLIs, ESD,

medical IT, resource

mobilisation) (x 30 pax)

7 Community Engagement

(Orientation) (x 2,200 pax)

8 Outreach & Community

Participation (Targeting ) (x

2,200 pax)

9 Referral System & Linkage

with secondary care (TOT and

direct training) (x 3,614 pax)

10 Medical / Non-medical

Training on Health

Management (x 10 pax)

- Gender issues in health

- Sexual reproductive health

and rights

- Clinical waste management

- Violence against women

11 Medical Training (x 1,650

pax) UNFPA

- Infection prevention and

control

- Counselling of patients of

appropriate family planning

methods

- Management protocols for

Emergency obstetric care

(UNFPA)

- Diagnosis and treatment of

STIs/ RTIs

- Cervical cancer (VIA

methods) and breast cancer

screening

14



Data sources and

reporting

mechanisms / OVIs


support achievement

of outputs




Assumptions and

risks

- Clinical contraception

- Post-partum tubal ligation

and post partum IUD

- Severe acute malnutrition

12 BCC/ Counselling related to

Family Planning, Reproductive

Health, Nutrition, Violence

Against Women, Adolescent

Sexual and Reproductive

Health (x 264 pax)

2 Improved

accessibility, quality,

and utilization of

urban PHC services,

with a focus on

women and children,

through PPP

By midterm review and

sustained until project

completion:

Accessibility and utilization

At least 30% of each of the

major project healthcare

services (including caesarian

section) is provided free-of-

charge to holders of

government-issued red cards

that identify them as poor.

At least 80% of facilities

planned for construction and

upgrading are functioning

normally within 3 years of loan

effectiveness

(12 CRHCCs and 26 PHCCs)

Quality

At least 80% of children

consulting project PHC services

for acute respiratory infection

receive correct treatment.

At least 80% of children

consulting for diarrhea receive

correct treatment.

PPP performance and

accountability

For all indicators:


endline

surveys (household,

facility-based,

qualitative)

ISI

Patient satisfaction

survey

(as part of project

baseline

and end-line survey)

Project HMIS

Post training

assessment reports

Course completion

reports

Mid term review

Quality Assurance

reports

Management of public

private partnerships for

urban primary health care

Clinical service delivery

for ante natal services,

deliveries, postnatal

services, family planning

and reproductive health

Clinical service delivery

for neonatal care in an

urban primary care setting

Using QA and M&E

indicators to improve

service delivery

Advocacy for pro-poor

service delivery

Child development and

nutrition, treatment of

childhood illnesses

Management of PPP

contracts for urban

primary health care

Overseas

1 Study visits on public private

partnerships for urban primary

health care (x24 pax / 2

batches)

2 Study visit on Medical IT

related to urban primary health

care (x 8 pax)


on reproductive health (x 1

pax)


on Medical IT (x 2 pax)

In-country

1 Leadership and management

training (x 30 pax)

2 Project Orientation &

Management Training (x 50

pax)

3 Management Training /

Strategic Planning / Budgeting

(x 767 pax)

- Strategic management,

governance, planning and

budget management

- Management of public private

Assumptions

Social and cultural

factors do not bar the

poor and women from

accessing facility based

PHC services.

NGOs and the

government are

committed to

accountability and

performance in PPP

contract management.

Risk

Procedural problems

arise in contracting

process, because

relations between

ULBs and contracted

NGOs do not remain

smooth or NGO

partners are not

supervised effectively

15



Data sources and

reporting

mechanisms / OVIs


support achievement

of outputs




Assumptions and

risks

100% of partnership area

NGOs achieves internal quality

compliance (financial

management, updated clinical

registers, clinical waste

management, inventory

management).

Clinical waste

management

Financial management and

controls

General clinic

management

partnerships

4 Health Management (QA

systems) (x 163 pax)

- Quality assurance

- Stock control for medical

supplies

- Clinic management and

organisation

5 Introduction to the use of GIS

Mapping (x 110 pax)

6 HMIS & Financial

Management Systems (x 150

pax)

- Orientation

- Implementation

7 HMIS Implementation (163

pax)

8 FMS Implementation(x 163

pax)

9 Monitoring & Evaluation (x

163 pax)

- Financial monitoring

(budgets, expenditure, billing,

receipts received)

- Establishing M&E process as

part of management of PHCCs

and CRHCCs

3 Effective support

for decentralized

project management

A fully functional PMU with at

least 20% of the staff female is

established by loan

effectiveness and PIUs are

established in ULBs within 3

months of loan effectiveness.

Computerized FMIS is

functioning fully in

partnership areas by 31

December 2014, streamlining

accounting procedures and

Project HMIS

Project joint review,

ADB

missions

Project quarterly

progress

Reports

Post training

assessment reports

Monitoring and evaluation

processes

Project management

(planning, monitoring,

reporting)

Financial management and

planning

Information management

22 Project Tracking (x 134

pax)

- Monitoring and evaluation for

routine PPME and ISIs

23 Project Management

Systems (x 134 pax)

- Procurement, disbursement,

accounting and reporting

Assumptions

Qualified counterpart

staff and government

counterpart funding

are available on time.

Adequate staffing is

available to enforce

internal controls and

sound financial

management.

Risk

16



Data sources and

reporting

mechanisms / OVIs


support achievement

of outputs




Assumptions and

risks

processes at all levels of project

implementation

(PMU, PIUs, and partner

NGOs).

Project monitoring and

evaluation surveys, follow-up

on findings, data collection, and

quarterly progress reporting are

implemented on schedule.

Course completion

reports

Mid term review

Quality Assurance

reports

Turnover of

counterpart technical

staff is high due to

resignations,

promotions, or

assignments to other

government or private

offices.

17

4 Background to capacity development objectives

4.1 Links to project outputs, targets and sustainability

Building capacity under the UPHCSDP will contribute to the achievement of the project

deliverables. In addition, the building of capacity establishes the knowledge and

competency base to build sustainable systems which will outlive the project interventions.

Sustainable good quality urban primary health care services will be constructed through

the introduction and establishment of strengthened institutional governance and local

government capacity to deliver services, through improved accessibility (particularly for

the poor, women and children), and through increased utilisation of those services.

Sustainability of service delivery will be predicated on the establishment and growth of

public private partnerships, and with effective support for decentralised management. The

capacity development objectives are to support the Local Government Division, the

ULBs, the PA-NGOs, and the staff of the PHCCs and CRHCCs to achieve these goals.

In order to achieve the epidemiological performance targets, governance and

management targets specified for the project, and establish best practice for continued

sustainability, capacity building will address a number of skills and knowledge gaps.

These were identified through MTR and consultant reports from UPHCP II, the Project

Administration Manual, Annex 9, the reports and recommendations of the training firm

assigned to provide training and capacity building under the earlier UPHC project, and

subsequent training needs assessment undertaken at the beginning of the current project.

The identified training needs range from clinical skills, procurement and financial

management skills, to project management skills, as iterated in the PAM Annex 9,

Indicative Training Plan and further described in Section 5 below.

A Logical Framework has been produced to reflect the training and capacity building

interventions proposed, to support achievement of the three components of the project.

The Logical Framework takes the same format as the Design and Monitoring Framework

of the RRP, putting the proposed training interventions into the context of each of the

project components (See Section 3). The framework includes the numbers of people who

will be provided with training and capacity building for each of the main topics of

training. The framework is further expanded in the Implementation Plan to reflect the

target groups for each type of training and potential training institutions or agencies who

may be invited to bid for delivery of the training (See tables in sections 2.1 and 2.2 of the

Implementation Plan).

5 Background to the guiding principles

5.1 Strategic co-operation between MOHFW and MOLGRD&C

Fostering and maintaining strategic collaboration between higher level personnel across

MOLGRD&C, Local Government Division, MOHFW, Directorate of Health Services

and Directorate of Family Planning will be help to establish the smooth operation

(including clinical referrals) and the robust reporting of improved health status for urban

primary health care recipients and will help to ensure that continuing professional

18

development, based on MOHFW standards and curricula, is provided to service delivery

personnel working in project PHCCs and CRHCCs.

5.2 Sustainability

The training and capacity development inputs are designed to support both the successful

implementation of the project and the establishment of sustainable clinical, management

and financial practices which will function well into the future. Building a strong

management basis to support public private partnerships to deliver primary health care in

urban areas will also contribute to sustainable economic growth as access to good quality

care improves.

5.3 Gender equity

The Gender Action Plan7, which was prepared to support explicit integration of gender

equity in programme outputs and outcome areas, is a basic principle of the project.

Gender equity principles as per the PAM (Section 3.1, p32) indicates the recruitment of at

least 20% of women for PMU, PIUs, PA-NGOs management, technical and support staff.

The Gender Action Plan also encourages the selection of women for promotion and

training opportunities which is reflected in the Implementation Plan.

6 Training and capacity development topics

6.1 The range of training topics is predicated on the identified skills, competency and

capacity needs identified in the PAM and in the Design and Monitoring Framework of

the RRP. It should be noted that under the preceding UPHC II project (and earlier PHC

projects) many training inputs were provided which are similar to those identified for this

project. The previous experiences will be built on in this project to support technical and

managerial skills development into the future. Recommendations from the final report of

the consulting firm contracted to provide training inputs under the preceding project8

were consulted in the development of this strategy and plan. The topics to be covered are

designed to fit with available resources and are focused on achievement of the three

project components while targeting the three major training areas of management, clinical

skills and HMIS/IT. The detailed Implementation Plan indicates the specific (sub)topics

for the training and skills development modules which will be delivered.

The following are the topics for training and capacity building

Clinical training and re-training, clinical refresher training, continuing

professional development for maternal and child health and adolescent health

(also see 5.2 and 5.3 below)

7 Gender Action Plan, Urban Primary Health Care Delivery Services Project (RRP BAN 42177)

8 Final Report on Management and Support with recommendations, Management Support and Training

Firm, 31 December 2011

19

Behaviour change and communication: as well as target groups of professionals

(both clinical and non-clinical) this issue is also targeted at communities and

potential recipients of primary health care services.

General management (human resource management, public private partnerships,

office management, management of clinics, supplies management, clinical waste

management)

HMIS / IT

Financial management (accounting systems, reporting and audit)

Project management (reporting, finance, purchasing/procurement, billing,

financial flows, contracting and MOUs with suppliers (PPP and training agencies)

6.2 Clinical topics covered by UNFPA

Clinical training topics which will be addressed by the UNFPA project are identified in

the PAM, Annex 9, table A9.2: these are based on identified training needs to support (i)

improved contraceptive and family planning care, (ii) screening for cancers, and (iii)

midwifery training to support safe delivery. The proposed training inputs by UNFPA

address basic and refresher training as part of a continuing medical education programme.

All of the training to be provided by UNFPA addresses training needs identified to

achieve Output 2 of the project.

6.3 Clinical topics covered by Save the Children

In direct response to the challenge of MDG4 the Helping Babies Breath Global

Development Alliance (HBBGDA), the American Pediatric Association, USAID, and the

Saving Newborn Lives (SNL) programme of Save the Children, in collaboration with

WHO, have developed a training programme specifically targeted at saving newborn

lives – a key feature of MDG 4. An updated Essential Newborn Care (ENC) package will

be available from January 2014, with all associated teaching and learning materials (hard

copy and e-learning). This skills training fits neatly into skills needs identified for

achievement of Output 2 of the Project. In addition to making the training materials

available, the Saving Newborn Lives programme of Save the Children will also provide

hands-on training in ENC through a Training of Trainers programme, and periodic

monitoring to ensure the learning is being applied.

7 Target groups

7.1 Identification

Target groups for training and capacity development were identified with direct reference

to the project components and outputs, as described in the PAM and the RRP, in addition

to observation visits to providers, and discussions with PA-NGOs and experienced

training providers. While the main objective of the project is to improve primary health

care services delivery in urban areas, successful achievement of the project goals and

20

objectives cannot be met by focusing exclusively on clinical training and capacity

development. The scope of the project – and the challenge for sustainability - is very

wide and crosses numerous jurisdictions: health, local government and urban

development.

The target groups for training and capacity development include:

Doctors working in PHCCs and CRHCCs

Nurses working in PHCCs and CRHCCs

Midwives working in CRHCCs

Paramedics working in PHCCs and CRHCCs

Laboratory technicians working in PHCCs and CRHCCs

Administrative and non-clinical staff in the 168 PHCCs and CRHCCs

PA-NGO management staff from the 30 participating NGOs

PA-NGO staff

Municipality staff (4 municipalities)

City Corporation staff, specifically Health Officers (11 City Corporations)

Urban Local Body (ULB) officials

Officials from Local Government Department,

MOHFW officials

LGD officials

Communities in the catchment populations of the 168 PHCCs and CRHCCs

(women, men, children, adolescents and youths, community leaders)

The Implementation Plan indicates the relevant target audiences for each of the proposed

training inputs.

7.2 Overlaps

There is some overlap between and across the target groups, offering opportunities to

share training and capacity development activities and so build common understanding of

issues between groups and create a platform for sustainability of provision of primary

health care services into the future.

7.3 Inclusion of MOHFW officers in selected capacity building interventions

The inclusion of MOHFW officers (specifically from the Directorates of Health Services

and Family Planning) in some of the training and capacity development programmes is

important for a number of reasons. It is widely accepted that the separation of

responsibility for delivery of primary health care from the MOHFW to MOLGRD&C

poses a number of major challenges in terms of linking policies, clinical capacity

21

standards, information reporting, and referrals to the secondary health care services. By

including MOHFW in training and capacity building programmes this will help to build

collaborative links between health and local government officials: it will also facilitate

better understanding about the Government of Bangladesh’s national and international

responsibilities for reporting on achievements in the health sector in terms of maternal

mortality, neonatal, infant and under-five mortality, uptake of immunisation and

vaccination, uptake of family planning services, childhood illnesses and diseases, and

other epidemiological data.

7.4 Selection of participants

The selection of participants for training and capacity development will be determined

based on identified needs for training, absorption capacity for the organisation,

receptiveness to lifelong learning and continuing professional development. Selection

criteria for different types of training and capacity development – clinical, general

management, project management, and leadership – have been determined by the PMU

and the criteria will be applied for all training inputs including courses, workshops and

study visits.

8 Training action plan parameters

8.1 Training Co-ordination Unit structure in place to co-ordinate training delivery

8.1.1 Role of the Training Co-ordination Unit

Implementation of the Training Strategy will be managed by the Training Co-ordination

Unit (TCU) located in the Project Management Unit (PMU). Under the direction of the

Deputy Project Director (Administration and Training) the Training Co-ordination Unit

will comprise a National Training Specialist (for 36 months), an Urban Primary Health

Deputy Project Director Training and Administration

International Human Resources

Development Specialist 8 months

National Training Specialist

36 Months

Overall

supervision

and

guidance by

Project

Director

National Urban Primary Health Care

Specialist 48 months

22

Care Specialist (for 48 months) and an international Human Resources Development

Specialist (for 8 months), and will be supported by the Deputy Project Director (Service

Delivery) for clinical training inputs, the Programme Officer (Administration and

Training), and the MIS and Data Management Officer. The roles and responsibilities of

the Training Co-ordination Unit and the job descriptions of the core TCU team are

described in detail in Annex 2.

The Training Co-ordination Unit is responsible for the scheduling of training modules

and sessions, and is responsible for liaison with the PA-NGOs, local government

departments and Ministries to identify appropriate personnel for the training opportunities.

Criteria for selection of training participants are included in the Implementation Plan and

will be followed by the TCU in identifying and selecting appropriate training recipients.

The training and capacity development inputs will be delivered to appropriate

participants in an adult-friendly way.

8.2 Resource envelope

8.2.1 The overall project package comprises US$81 million, through an ADB loan

amounting to the equivalent of US$50 million, a SIDA grant of US$20 million, and

Government of Bangladesh contribution of US$11 million9, plus US$3 million parallel

financing for the UNFPA urban health project. The training budget within the UPHCSD

Project amounts to US$1.7 million: US$500,000 is available for training, study visits and

fellowships abroad10

, while US$1.2 million is allocated for local training, workshops and

capacity development within Bangladesh.

8.2.2 Flexibility to meet future training and capacity development needs

To allow for changing circumstances over the lifetime of the project an amount of

US$0.2 million will be set aside (not specifically allocated) from the in-country training

budget, to be used for additional training inputs to be provided in-country, based on

assessed need and on documented justification. Disbursement of the US$0.2 million will

be made on production of evidence of the need for training which is not already provided

under the Training and Capacity Development Strategy or in the Implementation Plan.

Disbursement of this residual amount will be available for clinical or management issues

but it should not be made available for disbursement before 2016. Decisions about

allocation of the residual fund will be made by the Project Management Unit.

8.2.3 UNFPA training resources

The UNFPA Urban Health Project, which runs from 2013 – 2016, with a grant of US$3

million, has allocated US$1 million to clinical training relating to maternal and

reproductive health services11

: these training inputs dovetail with some of the training

needs and target groups identified under the UPHCSD Project, specifically relating to

clinical contraception, midwifery training, cervical screening, breast cancer screening,

post partum family planning, and capacity building for delivery of Adolescent Sexual and

Reproductive Health (ASRH) services. Under the umbrella of the overall UPHCSDP

9 RRP, Section II, D

10 DPP Page 29, Sub component 3.4 Training Co-ordination, footnote 1 and PAM Page 105, Annex 9

11 PAM, Annex 19, as agreed during project preparation phase

23

UNFPA is providing equipment to CRHCCs, as well as direct training to the staff, to

support increased capacity to provide essential services. This resource allocation has been

taken into account in the Implementation Plan, reflecting the skills and competency

training inputs at minimal cost to the UPHCSD Project training budget.

8.2.4 PA-NGO training resources

Under the contracts issued to PA-NGOs for the delivery of primary health care services

in the project PHCCs and CRHCCs an allocation is available for training and capacity

development. This allocation is in addition to the US$1.7 million separately allocated

within the project budget for training and capacity development. The actual amount of the

allocation for training varies from one PA-NGO to another. In total the budget amounts

to BDT 6,051,372 (approximately US$ 76,131.10 equivalent) under 21 contracts. With

co-ordination and good management, these resources could be used most effectively if

they were pooled by the PA-NGOs to achieve economies of scale in purchasing

necessary skills and competency training. A number of the PA-NGOs are experienced in

and well placed to provide appropriate clinical training to other PA-NGO service staff

and this would also ensure consistency of clinical training across the PHCCs and

CRHCCs. Utilisation of the training allocation by PA-NGOs will be monitored and

evaluated by the Training Co-ordination Unit, in terms of effectiveness and meeting

project priorities. Training planned by the PA-NGOs has been catalogued by the Training

Co-ordination Unit and is attached to the Implementation Plan.

8.2.5 Save the Children training resources

The Helping Babies Breath Global Development Alliance (HBBGDA), the American

Pediatric Association, USAID, and Saving Newborn Lives (SNL) programme of Save the

Children, in collaboration with WHO, have developed a training programme specifically

targeted at saving newborn lives – a key feature of MDG 4. An updated Essential

Newborn Care (ENC) package will be available from January 2014, with all associated

teaching and learning materials (hard copy and e-learning). In addition to making the

training materials available, the Saving Newborn Lives programme of Save the Children

will also provide hands-on training in ENC through a Training of Trainers programme,

and periodic monitoring to ensure the learning is being applied. SNL Save the Children

will assist the Training Co-ordination Unit to determine and establish appropriate

monitoring indicators to assess the effectiveness of the ENC training and newborn care

practices. The training available under this resource is indicated in the Implementation

Plan. Save the Children have generously agreed to provide training of trainers to PHCC

and CRHCC staff in a number of urban areas which overlap with UPHCSDP districts, at

minimal cost to the project (transport and allowances of participants only).

8.2.5 Other potential capacity building resources

In addition to the training budget allocated for the project, other aspects of the project

budget have training and capacity development resources attached to them. These include

BCCM, PPM&E, ICT and HMIS. The allocations for training under these aspects of the

project will be identified as contracting is undertaken and the training and capacity

development inputs associated with each will be reflected in the overall reporting of the

the training and capacity development associated with the project. This will provide a full

24

picture of inputs and achievements, in terms of building capacity and human resources to

sustain primary care services delivery

8.3 Sources of training

Training and capacity building will be provided from a wide range of institutes, agencies

and resource persons, as appropriate for the type of training. MOUs and Agreements of

Co-operation will be developed with those agencies chosen to deliver training inputs. An

indicative list of the proposed agencies follows:

Institute of Post-Graduate Medicine and Research (IPGMR)

Obstetrics and Gynaecological Society of Bangladesh (OGSB)

Save the Children

James P Grant School of Public Health

EngenderHealth

Mohammadpur Fertility Services and Training Centre

icddr,b

National Academy for Planning and Development

Bangladesh Institute of Management (BIM)

Bangladesh Computer Council (BCC)

BRAC University

NIPORT

NIPSOM

Institute of Child and Maternal Health (ICMH)

This list is not exhaustive. Other agencies, institutions and resource persons may be

identified by the PMU during the course of the project and can be invited to submit bids

for delivery of training services for which they are suitably qualified.

8.4 Training modalities / formats

The UPHCSD Project aims to exploit all available formats for training and capacity

development. These formats will include but are not restricted to:

face to face training for small groups which are particularly effective for clinical

training, technical skills training for financial management, and behaviour change

management

workshops and seminars for larger groups to disseminate orientation on project

components and outputs, good practice (management and clinical), and

information

conferences to support good clinical practice and good management and

governance practices

e-learning, using materials from a variety of sources. Existing programmes and

modules will be used, where possible, thus avoiding the additional significant cost

of development.

Overseas study visits of up to two weeks, and international conferences,

addressing the following subject areas relating to primary health care,

management and leadership12

:

12

See Indicative Training Plan, Annex IV of the DPP, pages 78-79

25

Leadership management related to urban primary health care

Pubic private partnerships for delivery of urban health care

Financial options for urban primary health care

Medical IT related to urban primary health care

Primary health care delivery with responsibilities split between health and

local government ministries

Where possible, there will be a focus on addressing the challenges of linking local

government and health authorities, where delivery of primary health care services

have been tasked to local government.

Academic training (Masters, diplomas and certificates) in-country and abroad will

be supported for ULB health officials and service delivery personnel in each year

of the project13

14

Some of the training provided will be new skills training, while other training inputs will

be refresher training (both clinical and management). Participants in training modules

provided by accredited institutions will be encouraged to build credits towards

certification, which will improve their work opportunities for the future.

Given the limited resources, the wide range and the large numbers of potential target

groups for training, where possible and appropriate, training will take the form of

Training of Trainers, with appropriate training materials supplied, so that workplace-

based cascade training can then be provided to many more people.

Details of the overseas academic programmes and study visits and the planned in-country

training, are included in the Implementation Plan of Overseas and In-country Training

Programs under UPHCSDP.

9 Monitoring and Evaluation 9.1 Monitoring and evaluation indicators will be developed by the PMU against

which training inputs will be measured. Using (a) the Design and Monitoring

13

As indicated in Project Administration Manual, Project Number 42177, June 2012, Bangladesh: Urban

Primary Health Care Services Delivery Project, Annex 1: Detailed Project Components, Section 4, para 6;

also indicated in DPP subcomponent 3.4, footnote 1 14

There are currently no personnel within MOLGRD&C with specific responsibility for urban primary

health care, thus reducing the potential pool of personnel available for academic training. The current pool

of physicians working in the Project City Corporations either already have MPH degrees or are ineligible to

undertake such programmes due to Government regulations about eligibility of personnel for long term

academic training. Appropriate shorter and medium term diploma and certificate programmes will be

sourced for these key personnel. When the Urban Development Wing of MOLGRD&C is established

appointed personnel responsible for urban primary health care planning and management will also be

eligible for shorter and medium term training programmes, as well as more intensive Masters programmes.

26

Framework15

for the strategic indicators, and (b) the Measurable Target Indicators16

for

the indicators identified for PA-NGOs delivering urban primary care as the bases,

indicators will be developed for each type of training input. These indicators, together

with the QA indicators being developed in the PMU, will be used to assess efficacy and

appropriateness of training inputs.

In developing the indicators for clinical training inputs, close liaison with MOHFW will

be necessary, to ensure (a) that reporting meets national and international reporting

requirements and (b) that clinical training and capacity building inputs at least meet

MOHFW curricula standards.

The TCU will also liaise with other agencies such as UNFPA and Save the Children, the

agencies providing additional clinical training inputs, in the development of appropriate

monitoring and evaluation indicators for those inputs.

9.2 The Monitoring and Evaluation process will include inputs from training recipients

who will be required to assess the value of the training inputs through completion of post-

training assessment forms and follow-up monitoring by the TCU. The following

documents have been prepared by the PMU to assess training inputs

Post training assessment form

Training event report

Training observation checklist

Counselling checklist

These are attached to the Implementation Plan and will be used as additional monitoring

and evaluation data sources by PMU.

9.3 The Training and Capacity Development Implementation Plan will be reviewed

annually and updated or amended, as necessary. An annual timetable of training events

for each year of the project will be produced by the Training Co-ordination Unit.

9.4 The Training and Capacity Development Strategy and the Implementation Plan

will be reviewed during the project’s Mid-term Review (MTR) to assess continued

applicability and appropriateness in what is inevitably a dynamic situation which spans

five years. Adjustments will be made where necessary, following the MTR.

15

RRP, Appendix 1, pp 11-13 16

Bidding Documents for Delivery of Primary health Care Services under Partnership Agreement, May

2012, Appendix VI-B

27

Annex 1

Roles and responsibilities of the Training Co-ordination Unit

Roles & Responsibilities

1. Review in detail the Training Requirement of UPHCSDP

2. Identify k.a.s.e. development strategy for ULB to continue to ensure

delivery of PHC services through partnership agreements with NGOs

3. Organize and implement the training / orientation programs in

collaboration with relevant GOB agencies, training institutions, training

providers and reputable institutes overseas

4. Update the Human Resource Development Plan & Training Plan in line

with the objectives, vision and mission of UPHCSDP

5. Design and develop training guidelines (training implementation plan,

modules, lesson plans, session hand-outs, training materials for ULBs)

for implementation of the overseas and in-country training programs of

UPHCSDP

SCOPE OF WORK IN DETAIL:

1. Identify and prioritize training needs, programs and strategies in order to offer

high quality overseas & in-country training and state-of-the-art instructional and

measurement techniques and subject matter to ensure training efforts are

maximized

2. Establish a training map of who has received what training or capacity

development in all PHCCs, CRHCCs, LGD, PIUs, and PMU and any other

agency linked with delivery of the UPHCSDP

3. Develop MOUs and contracts, as appropriate, for all training institutes and

agencies, including those who are providing training at no cost to project.

4. Supervise the training teams, facilitators, instructors, subject matter experts and

participants.

5. Establish monitoring and evaluation indicators to measure the success or

otherwise of training and capacity development inputs. These indicators will

include measurable as well as qualitative indicators, using participant response

forms and observation visits, follow up visits to participants to assess application

of skills learned. For aspects of the clinical training, Dg health, Dg Family

Planning, Save the Children, UNFPA and Bangladesh Academy of Family

Physicians will be consulted to assist with development of monitoring and

evaluation indicators

6. Serve as liaison to trainers & GOB officials to develop cohesive working

relationships and facilitate information sharing related to overseas & in-country

training of UPHCSDP

28

7. Identify trainers, facilitators, subject matter specialists for training programs;

mentor new trainers, facilitators, subject matter specialists to develop an on-going

resource pool of skilled trainers for UPHCSDP

8. Select and determine appropriate learning resources, training programs and

delivery methods and techniques to meet identified needs of PMU, PIU & PA-

NGOs

9. Develop, modify and update program curricula and/or content and materials

10. Develop additional training-research instruments, questionnaires or surveys to

provide the methodology to collect information to determine training needs and

trends.

11. Identify liability risks in agency training programs and provide information on

proven strategies, programs and documentation to aid in risk management and

prevention

12. Coordinate and facilitate meetings of trainers, facilitators or subject matter

specialists from various GOB agencies / institutes to review the effectiveness of

past programs and revise for future training inputs and updated course context, as

required

13. Write and disseminate UPHCSDP training standards, strategies and activities;

review and supervise the production and distribution of training materials related

to UPHCSDP

14. Develop program performance and learning objectives to provide a standard

against which program content/curriculum and delivery may be measured for

effectiveness of training (monitoring and evaluation indicators)

15. Consult with reputed training facilitators to monitor training activities, issues of

UPHCSDP needs and requests

16. Prepare documentation or reports for management on the effectiveness of course

instructors, training methodologies, quality of course content, program delivery &

training related statistical data

17. Brief management on existing and proposed training programs to ensure the

expectations and the needs of the UPHCSDP are met

18. Evaluate formal proposals for overseas training management contract awards and

negotiate training and related services terms and conditions of participants

travelling abroad

19. Determine eligibility of training participants prior to nomination

20. Respond to inquiries concerning training

Training Interventions: 03 major areas

1. Leadership and Management

2. Clinical Skills

3. Skills related to HMIS & IT

29

Below are the job descriptions of the National Training Specialist, the National Urban

Primary Health Care Specialist and the International Human Resources Development

Specialist (as per DPP, pages 94-95,100- 101), the lead officers in the Training Co-

ordination Unit of PMU.

National Training Specialist (36 months)

Terms of reference:

1 Support the Training Co-ordination Cell (TCC) established within PMU in preparing

the design and conduct of a training needs assessment (TNA) for LGD, ULBs, and PA-

NGOs

2 Assist TCU in designing a comprehensive master training plan for various target

training beneficiaries based on the findings of the prior TNA; and

3 Support TCU in managing the implementation of the project’s capacity building

program including identification of training participants, selection of trainers / resources

persons, and preparing training reports

National Urban Primary Health Care Specialist (48 months)

Terms of reference:

1 Act as the focal point for all technical matters relating to PHC service delivery

2 Co-ordinate with relevant government agencies and development partners on project

related programs and issues

3 Assist the Project Director in administering the PA-NGO contracts and addressing

technical problems related to service delivery and quality assurance

4 Co-ordinate with the HMIS consultant team on the design, development, and

operationalization of HMIS

5 Provide technical support to the HRD Unit in designing training programs for

enhancing staff skills at the PMU, PIU and PA-NGO levels, and

6 Assist the Project Director in overseeing and evaluating the findings of the PPME

program of the project, make initial assessment of performance of each PA0NGO,

identify and advise any corrective measures, if needed, particularly for ensuring quality

30

service and poverty targeting

International Human Resources Development Specialist (8 months)

Terms of reference:

1 Assist designing and conducting a training needs assessment of the LGD/ULB/ PA-

NGO staff involved in the project

2 Assist in development of strategies, plans and programs for HRD and management,

including career development plan and non-salary incentives

3 Review the HRD training program and adapt as required

4 Prepare guidelines for initial training programs, and for continuous training program for

health workers, managers of ULB health departments, LGD staff

5 Prepare detailed short term training programs and study tours in-country or in

neighbouring Asian countries for (i) LGD and ULB officials, (ii) staff of ULB health unit

and ULB departments, and (ii) NGO personnel

6 Organize trainings and workshops as required

7 Prepare guidelines for e-training

8 In collaboration with MOHFW, PMU officers and other collaborators develop modules

for e-training and in collaboration with ICT specialists, develop and implement e-learning

and assessment

Date post:	23-May-2020
Category:	Documents
Upload:	others
View:	7 times
Download:	0 times