Family medicine training program evaluation project

Abstract

Having analyzed the system of health financing, expenditures, health needs and indicators, in 1996 the Government of Armenia developed a new health policy, adopted a Primary Health Care strategy. Based on that, the World Bank’s credit was obtained to launch the Project of Primary Health Care development. Introduction of family medicine is an important part of the Project, aiming at improvement of access to, and quality of, PHC services for the general population. In line with the World Bank supported project’s objectives, a Family Medicine training program was developed at the National Institute of Health dealing with continuing medical education of physicians and nurses. This project aims at evaluating the Family Medicine Training Program, which will first start in the autumn of 1999. The goal of the Family Medicine Training Program is to prepare general practitioners (family doctors) from currently practicing rural therapeuts and pediatricians, enabling them to provide a broad range of services to the general population at the PHC level after undergoing the 9-month training inherent in the job description. Hence, the trainees are pediatricians and therapeuts from rural ambulatories that will be rehabilitated and supplied with medical goods and equipment. Evaluation of the training program aims at assessing whether the program has made an impact on the multidisciplinary knowledge and skills of trainees, increasing their competence and broadening the range of services they provide to the general population on the PHC level. To that end, the training program’s objectives are increased knowledge by 40% and increased range of services by 30%. The evaluation program aims at detecting this change and making a causal inference. T-test of differences in means for 95% significant level will be used. The pre-and post-tests of the training and control groups, or a the quasi -experimental study with non-equivalent controls, will be used to carry out the evaluation of the training program. The formative evaluation will provide insight into the training process – educational strategies and methods used, organizational aspects, etc. The measurement instrument was designed and piloted, then a pre-test was carried out in the intervention group. Time-table and analysis plans were developed, methodology and logistical issues have been addressed. The whole evaluation project’s time frame is 18 months. The evaluation will provide a basis for recommendations to be made to the MOH authorities and implementers of the training for further improvement and effectiveness.