In Section C, we will be looking at

training policy and training functions within an organization.

Part of an organization's personnel management includes having sections or departments,

specifically for that function.

In some countries they're called establishments department,

some places personnel departments,

some places human resource department.

But clearly, employees making up one of

the major resources of an organization do need special attention.

Within that context, we also need

an organizations training or continuing education units,

departments or programs, but unfortunately these are less common.

And as we know, anything that does not have

special units function staff attached to it often doesn't receive attention.

The idea for advancement,

the idea for improving skills as we remember from the previous section is a satisfier,

is a motivating factor for employees to continue the work.

And therefore, it's important for organizations to recognize this need and

institutionalize it in the form of training or continuing education units.

This institutionalizing legitimizes training as not only

a benefit for the employees but a way of keeping the organization efficient,

functioning and up to date.

IST or in-service training and CE,

continuing education, should be part of a training unit within the organization.

That way, these functions will be carried out on a regular basis.

It makes it possible for training to become

a planned component of overall organizational management not just a haphazard thing.

I heard about a workshop,

sent a couple of employees.

No. The training unit,

continuing education unit will continually assess training needs,

organize within the organization training opportunities,

and seek for outside training experiences that are appropriate for the employees.

Again, the idea of making sure that training is

a planned activity not an ad hoc arrangement.

Training is actually a strategy in most community health programs.

The picture we see here,

involves the training of Community Health Committee members.

They are being mobilized for immunization.

Specific skills for these health committee members include; mapping the community,

identifying where people live,

Identifying community leaders and how to convince them of the importance of immunization.

How to explain to parents in the community the benefits of immunization.

And so training is necessary for these committee members to carry out this function.

So, again, training should be

a normal function within the agency or what we call a line function.

When an organization is institutionalizing

a training function there are certain components that are necessary.

There should be a position of a training manager,

a head of a continuing education program within a training department.

This way training will be legitimized not only as an idea,

an organizational policy, a goal but as a practical entitlement for the workers.

Another important aspect of institutionalized training besides

having a special unit or department is setting up a resource center.

So, we mentioned before continuing education includes self-learning.

And if employees know that there's a small library,

a place for pamphlets are kept,

a small reading room where they can go and study and get journals,

and there are many free journals that local health departments can get.

This is an important opportunity for them.

And so again, the training center needs this resource centers.

The resource center is also a place where they can

store videos and films and things that they will need for future.

A training unit has several functions.

The first of course is that of

recognizing and determining the training needs of the organization.

Are there new procedures coming in?

Who has to carry out those procedures?

Are staff losing touch?

Are they forgetting things? How do we know?

Are community members complaining of quality of service?

So, there needs to be a way of determining,

touching base with these needs on a regular basis.

The training unit would of course,

implement staff development and training based on a plan.

There should be a regular plan for not just saying that every employee has

a turn to go for a workshop where they may do more shopping than work but say,

okay, what are we doing in terms of ensuring

that all employees have been exposed to the latest ideas.

If for example, the country is trying to

expand the integrated management of childhood illness procedures and algorithms,

there needs to be a way of phasing in training so that over a period of six months,

a year all staff in the health department

who are working with mothers and children have taken this training.

So, it doesn't need to be planned in

an orderly way to make sure that everyone receives the training.

The training unit itself should have a training director.

There should be people with training responsibilities assigned,

there should be therefore job descriptions for training specialists.

This should be institutionalized.

In addition, the organization may need to on a short-term basis contract with us

consultants training specialists from universities, medical schools, NGOs.

The training unit itself should be aware

that individual employees may have difficulty carrying out tasks

and the opportunity for providing

individualized coaching as needed should be part of the services that the unit offers.

That doesn't mean that every one of the staff in

the training unit can provide coaching on

every aspect of health care that's being delivered but they

can match up employees with mentors to achieve this goal.

Another important function of a training unit

is evaluation and planning a future training.

As we'll talk about often in the course,

continuing education literally does mean continuing.

You organize a training program,

you evaluate it, people go back to work.

They may or may not have difficulty implementing the new skills.

They may come up with additional roadblocks or bottlenecks.

Evaluating what happens as a result of training will help us

plan for future training to keep workers up to date.

As we mentioned, the training unit should

have a specialist in training skills to direct that unit.

And that training specialists does need to organize and carry out

simple operations research about

training functions that work in that environment in that culture.

The person needs to develop overall training plans.

So, we've mentioned for network with outside resources.

The unit may have only a few employees,

but you may need special experts to come in to provide content for certain training.

You may need training specialists who are adept at

certain training techniques and bring them in to assist as trainers.

The training specialist needs to work with the management to carry them

along so that after people receive

training and continuing education that supervision is

appropriate to encourage people to apply the skills they've learned,

to reinforce the skills they've learned and to

identify gaps that will feedback into future training designs.

The training specialists of course, will actually,

administer and run training programs whether it's

lunchtime seminars, retreats, workshops.

Training specialists will also prepare

the training outlines and guides and the learning materials.

Hopefully, during this course,

each of you will have an opportunity to develop a training guide for

a small group within your work setting and see with this skill and function is like.

The training specialists again,

cannot be everything to everyone and therefore,

needs to train supervisors of different section in

teaching skills and instructional skills to improve the quality of supervision.

And of course, an important function of the unit as well as

a training specialist is evaluating through tests,

through observation, through feedback,

the results of training so that additional training can be planned.

Convincing an organization to set up a training unit is one thing,

to make sure it's continually funded is another thing.

Therefore, the training unit or training department needs to be accountable.

If resources are given for training,

the organization will want to know that those resources have been used well,

that in fact, the performance of employees has improved,

that this investment in training has been worthwhile.

Therefore, we need to keep account of the resources used,

the time of staff,

the materials, travel costs,

all the way from designing a training program to follow-up and be able

to thereby use that to compare with training outcomes,

performance changes, and see if in fact the benefit is worth the cost.

Is there a return on the investment for training?

Are patients now, after employees have been

trained in how to manage directly observe treatment for tuberculosis,

are they retaining more patients?

Are more patients completing their treatment successfully?

Therefore, hopefully that means that the training that the health workers

received on this new procedure has been beneficial to the organization.

And therefore, hopefully more

resources will go into training and in continuing education.

Linkage is an important function of the training unit and the training specialists.

The trainees, after being trained, after a workshop,

after a seminar, after a short course,

will hopefully go back and apply the knowledge and skills.

The training may be done on an in-house basis or we may

send employees away sponsored for a workshop.

The question occurs is when they come back,

will they be accepted and will they function?

And so, the training office is important.

One, as I mentioned earlier,

to get the commitment of stakeholders and

management that training is needed to work with and

counsel the employee to find out how he or she is going

to apply the new skills in the work setting where they're needed,

that the employee is located in

the most appropriate position and function and

location in the organization to carry out the new skills,

and that other employees know why the person was selected,

what they're supposed to do.

This may include even at staff meetings have an opportunity for the employee to

share what he or she has learned so that everybody feels part of it and benefits.

So this linking, the training with the actual work setting is

an extremely important function if

the new skills are going to be put into practice and benefit the organization.

Trainers need to liaise with the different departments where the trainees came from,

needs to find out what training needs that department recognizes as important, again,

after training, that the supervisors know what to expect from the trainees,

make sure that job security is maintained.

People may be shifted after training to appropriate or inappropriate places.

They may become redundant.

They want to be sure that not only are they rewarded by attending the training, again,

this is a motivating factor that people

feel self-esteem and importance if they are selected to go for training,

they enjoy the new knowledge,

but the reward should attend back to the workplace where they may

be given promotion or recognition based on having upgraded their skills.

Training should serve certain ideal roles or functions in

an organization when there is a difference or gap

between actual performance and the standard, productivity suffers.

Training can reduce this gap by changing the behavior of individuals.

The individual workers can acquire specific knowledge.

Skills are added to achieve that standard.

Standards may take different forms.

For example, in Nigeria,

new caterers of health workers,

called community health extension workers,

were created several years ago.

And in order to make sure that these staff functioned at appropriate levels,

standing orders, a guide of algorithms,

was developed for them so that it was clear what they would do if a child had fever,

what they would do if a pregnant woman was developing hypertension,

so that there would be standards and guides for them.

So training can ensure that people are

developed to the level of meeting those standards and maintain those standards.

Training is about behavior change.

It's not behavior change in the broad sense that we're used to in terms of

public mobilization to participate in

an immunization program but it's changing the behavior of health workers.

If the health workers behavior has changed,

they will organize better community health education programs

and then hopefully we'll see change of behavior in the community.

But the health workers behavior must be considered first,

and this is the job of training.

Again, an ultimate objective of training is

to achieve the goals of the organization through

the optimum use of human resources so that we

have the best qualified workers in the organization.

The functions the training can achieve include increasing productivity,

people learn skills to manage their time,

new and more efficient techniques to improve the quality of work,

and as a byproduct,

raise morale when people are able to perform better,

getting feedback, accomplishing more.

Training helps develop new skills,

knowledge, understanding, and attitudes.

As the African Medical Research Foundation says,

training can help fight obsolescence or continuing ignorance.

Training helps people use correctly new tools,

machines, processes, methods, and modifications.

As we said before, training may address only 15 percent of

an organization's problems and needs but this is an important 15 percent as we can see.

The new tools, machines, skills,

attitudes are all important for

influencing trainee performance and organizations achieving its goals.

Other functions of training include reducing wastage,

preventing accidents, that people know how to use equipment correctly, reducing turnover.

If people are not performing well,

they get frustrated and leave.

It can even reduce lateness and absenteeism.

When people are satisfied with the work they can perform well,

they look forward to coming for work.

And in the process,

by reducing or preventing these problems,

it can reduce overhead costs.

Training is very important for implementing new changed policies and regulations.

When people are not trained and not involved in changes of policy,

they can fight against the policies,

refuse to implement them.

An example, I recall one of

my former students worked in a very large private hospital in Lagos.

And she was explaining that

the owner of the hospital was concerned that there was a lot of leakage of medication.

And it was not clear at all what was happening, you know,

were they actually being pilfered or were they being inappropriately prescribed,

were they being lost, were they put on trolleys and not given to patients?

What was happening? And so he decided to computerize

the pharmaceutical process and implemented this.

The employees didn't understand the policy.

They didn't know why he was changing this.

They thought he was suspecting them and they got angry and left.

Many of the nurses and doctors left.

And so he had to hire all new staff.

But if he had involved them and trained them on these new procedures,

the need for the policy so they could understand how

to use the new computerized system and why it was important,

then he could have avoided major problems.

Training helps develop replacements because people will leave. They will retire.

Training helps prepare people for advancement and promotion,

improves manpower development, and it

ensures continuity of leadership, continuity of service.

As people move on,

other people have to take their roles,

and so training is a way of ensuring

that the services will continue to be delivered at a quality level.

These are very high expectations.

The question is, can training live up to these?

So sample training activities include orienting employees to the goals,

policies, structure, products, or services of the organization.

Oftentimes, this is done on an individual orientation basis,

counseling by people from human resources about employee, benefits, etc.

It may be done by supervisors.

Depending on the number of new employees that come in at a given time,

it may be done in a formal training setting.

But it's important that even though employees have done basic training,

they have their basic degrees or certificates in nursing,

pharmacy environmental health, but they still need to know

how the particular organization they're working for functions,

what's expected, what is

the unique contribution of that organization to the health of the community?

Again, as we've mentioned,

training is important to orient employees

to new policies and how they're going to be implemented.

Training familiarizes employees with new procedures,

a new record form, new machine,

or modification of existing forms and machines.

One of the problems that we have in

health information systems of health management is

that people do not submit record forms in time.

There are a lot of errors, eraser marks, etc.

You can't read the forms.

Why is that?

It's simply because employees were not trained on how to use the record form,

the importance of the record forms.

And this implies of course that training, hopefully,

can improve the quality of information management

and report writing throughout the organization.

These sample training activities that we've just mentioned show that training,

opportunities, and needs occur all the time in organizations.

That's why we call it continuing education,

which we will talk about in the next section when you return.

Training Policy and Functions (Part 1)

Understanding and Strengthening Health Systems

Meet the Instructors