Traditional Practitioners as Primary Health Care Workers
(1995; 146 pages) View the PDF document
Table of Contents
View the documentI. EXECUTIVE SUMMARY
View the documentIII. OBJECTIVES
View the documentIV. METHODOLOGY
Open this folder and view contentsVI. DESCRIPTION OF PROJECTS
View the documentVII. RESULTS
View the documentSTEP I: Planning for the Training
View the documentSTEP II: Determining Content for Training
View the documentSTEP III: Determining the Training Methods
View the documentSTEP IV: Selecting Training Materials
View the documentSTEP V: Training the Trainers
View the documentSTEP VI: Evaluating the Training
View the documentREFERENCES
View the documentAPPENDICES

STEP VI: Evaluating the Training

The evaluation process can be very rewarding to all who participate in it. One might regard it as an opportunity to gauge progress in meeting the goals of your programme.

Purpose of evaluation in training programmes

Evaluation is intended as a way to assess success in achieving training programme goals. As health professionals, it is our mission to provide the best service possible. Evaluation also allows us to see where we can improve our efforts.

Who benefits from evaluation?

Evaluation is most often performed for the benefit of trainees and training staff. But other groups benefit as well.

Trainers and programme staff need to know how effective their training methods are and how effectively the THPs are performing the skills they were taught. Doctors, nurses and others who collaborate on referrals can identify problems in the system from evaluations. Feedback from the THP trainees can provide valuable information for the trainers and programme staff to assess the effectiveness of the training.

Administrators need adequate data to determine programme effectiveness and to justify continued use of public monies to keep their programmes going. They are more likely to continue supporting training activities if they have adequate data to show how effectively the programme is actually working.

THP trainees benefit greatly from knowing how well they are doing. Evaluation data can help them to correct mistakes and improve performance during the training. Evaluations can help staff to identify the most competent THPs to help supervise and train others.

Community members can provide very useful information about the nature and quality of health services they are receiving. By asking them to participate in evaluation, you will increase community awareness and understanding of the project and facilitate their accepting more responsibility for health promotion and disease prevention activities.

Funding agencies always need positive evidence that a programme is worth their money. Having good evaluation data fulfils a major requirement for being accountable for spending project monies and greatly enhances one's chances for continued funding.


Progress evaluations

Progress evaluations can take place at many different stages during training on a daily or weekly basis by assessing performance of trainees and staff.

Assessment is accomplished by conducting exams or observing students at work. It also enables trainers to evaluate their programmes.

A good assessment must be practical, economical, accurate, easily understood by trainees and give feedback on the success of your teaching methods.


Informal testing can be done inside or outside the classroom. Remember to make questions clear, precise, easily understandable, easy to answer in brief. Encourage students to participate in the process, taking care not to embarrass any student.

Formal testing or examination can be accomplished by having a trainee demonstrate his or her ability at a certain task; or through oral tests by probing a trainee's knowledge through questions and answers.

Continuous observation is more effective than a final exam. Staff members can routinely observe the performance of trainees and identify their strengths and weaknesses. This type of assessment is more reliable because it enables a trainer to keep a continuous check on the trainees performance and can correct errors as they occur.

Self assessment is when a student evaluates his or her own performance. You must set clear standards and make sure the trainee understands how to assess their own progress. One advantage of this is that it gives the THP experience in evaluating his or her self and they can continue this evaluation process independently after the programme is ended.

Peer assessment means that students assess each other. It is a good learning tool but not a final evaluative method. Again, you must give good instructions and set clear standards. Peer assessment can give greater meaning to field experience and have more relevance than more formal tests.

Assessing the performance of trainers is important too. Trainers can obtain information about their effectiveness in the following ways: Self-evaluation; peer evaluation; and evaluation by the trainees themselves. Trainer evaluations should take place daily or weekly, as well as at the end of the course. Trainers should develop a set of standards by which these evaluations should be performed.


These are usually performed at the end of a project cycle, such as after one, two or three years. These evaluations attempt to measure outcomes of the training programme, such as the knowledge, attitudes and skills gained by the trainees, the types of health services delivered by the healers, the type and frequency of referrals made between healers and health agency staff, and changes in health behaviours and health conditions of community members.

Outcome evaluations can be performed internally by the agency's own staff members; externally, by hiring outside consultants; or a combination of the two methods. An advantage of the combined internal and external method is that it lends itself to a participatory type of evaluation that includes all groups involved.

The value of a participatory evaluation allows those who participate in a project to play an active role in evaluating themselves and the results of their project. This type of evaluation shifts the control of project knowledge back to the participants and the community. This process enables local communities and organizations to assess information, make decisions, and take responsibility for improving their own health programmes, thereby promoting greater self-reliance among the participants.

Various levels of project staff, government personnel, THPs, and male and female community groups can be involved. Programme elements which have been evaluated this way have included: the process for selecting THPs; training content and methods; trainers; referral systems; collaboration with other agencies; health impact on the community; and cost effectiveness.

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