title: Evaluating the impact of healthcare provider training to improve tuberculosis management: a systematic review of methods and outcome indicators used.
abstract: BACKGROUND
  Developing human resources capacity is vital for tuberculosis (TB) control in low- and middle-income countries. Although investments in TB healthcare provider (HCP) training programmes have increased, it is unclear whether these are robustly evaluated. The objective of this systematic review was to synthesize the methods and outcome indicators used to assess TB HCP training programmes.
  
  
  METHODS
  A systematic scoping review of publications reporting on evaluations of training programmes for TB HCPs - including doctors, nurses, paramedics, and lay health workers - was conducted through a search in three electronic databases, Google Scholar, and five websites of non-profit organizations. Data on the study location, population trained, outcomes assessed, and evaluation approach were extracted.
  
  
  RESULTS
  After screening 499 unique publications, 21 were eligible for inclusion in the analysis. The majority of evaluations were conducted in Africa. The most common evaluation methods were a review of patient records (n=8, 38%) and post-training interview with trainees (n=7, 33%). In terms of outcomes, more than half of the studies (n=12, 57%) evaluated knowledge acquisition of trainees, with only six (29%) assessing on-the-job behaviour change.
  
  
  CONCLUSIONS
  Even though more funds have been invested in TB HCP training, publications from robust evaluations assessing the impact on quality of care and behaviour change are limited.
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Shishi
authors.initials: S
authors.lastname: Wu
authors.affiliation: Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK.
authors.forename: Imara
authors.initials: I
authors.lastname: Roychowdhury
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Communicable Diseases Policy Research Group, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK. Electronic address: mishal.khan@lshtm.ac.uk.
authors.forename: Mishal
authors.initials: M
authors.lastname: Khan
mesh_terms: D003906:Developing Countries; D006282:Health Personnel / Q000191:economics / Q000193:education* / Q000592:standards; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D015397:Program Evaluation; D058996:Quality Improvement / Q000191:economics; D019984:Quality Indicators, Health Care; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*
keywords: Healthcare providers; Review; Training; Tuberculosis