title: Options for maintaining quality family planning counseling: strategies for refresher training.
abstract: OBJECTIVE
  To maintain knowledge over time, new family planning providers require refresher training and support, which can be costly and time consuming. The Knowledge Improvement Tool (KIT), guides family planning supervisors to ask recently trained providers a list of questions, reinforce correct answers and address knowledge gaps regarding provision of the Standard Days
  
  
  METHODS
  (SDM).This study compares the cost and effectiveness of the KIT to other methods of reinforcing SDM knowledge.
  
  
  METHODS
  An experimental design was used.
  
  
  METHODS
  Several departments around Guatemala City and in the highlands of Guatemala.
  
  
  METHODS
  Providers belonging to PROREDES, a network of non-governmental organizations (NGO) funded by the United States Agency for International Development.
  
  
  METHODS
  Providers received either: (i) individual KIT, (ii) group KIT, (iii) 2-h refresher training or (iv) no refresher training.
  
  
  METHODS
  Total provider scores on pseudo-simulated client counseling session and costs associated with each refresher type.
  
  
  RESULTS
  All groups who received refresher training scored well overall (over 70%), compared with only 42% for the group with no refresher training. Providers who received individual KIT retained more knowledge over time, but it was the most costly.
  
  
  CONCLUSIONS
  Some type of reinforcement is needed following initial training. Programs must consider what is most practical in terms of existing supervision systems and budgets. Individual application of KIT is primarily appropriate for programs that already conduct routine supervisory visits of individual providers and can integrate KIT. Group KIT or traditional refresher training produce slightly lower results at significantly less cost.
authors.affiliation: International Training and Education Center for Health, University of Washington, Seattle, USA. irhsujata@gmail.com
authors.forename: Sujata
authors.initials: S
authors.lastname: Naik
authors.forename: Telma
authors.initials: T
authors.lastname: Suchi
authors.forename: Rebecka
authors.initials: R
authors.lastname: Lundgren
mesh_terms: D005193:Family Planning Services / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D016544:Patient Simulation; D011361:Professional Competence; D011787:Quality of Health Care / Q000458:organization & administration*