Availability,Utilization and Appropriateness of the Mechanisms for Monitoring and Evaluating Continuing Professional Development at Middle Level Health Training Institutions in Kenya

Abstract

Continuing Professional Development (CPD) training has received global recognition as a tool for improving knowledge and performance of health workers after their basic training, and consequently improving health service delivery. In Kenya, Middle Level Health Training Institutions (MLHTIs) produce the bulk (over 80%) of health workers at CPD training level. However, information on whether monitoring and evaluation (M&E) mechanisms for CPD trainingactivities are available and utilized at MLHTIs in Kenya is relatively scarce and may not berelied on to develop appropriate M&E systems for tracking CPD training. The main objective of this study therefore, ~as·to determine the availability, utilization and appropriateness of the mechanisms for monitoring and evaluating CPD training among public, private and faith-based MiddleLevel Health Training Institutions (MLHTIs) in Kenya. The respondents were 375 tutors from public, faith based and private MLHTIs, selected using a mix of sampling techniques: stratified, purposive, proportionate and simple random. To validate the data, 79 former CPD course participants, 33 heads of department, 34 principal tutors, 28 financial personnel and 5 HMISstaff were included in the study. Data collection was conducted using a questionnaire, key informant interviews, and desk review of CPD .training curricula and reports. Quantitative data wasanalyzed using Statistical Package for Social Sciences (SPSS), while data from desk review wasanalyzed through a process of data reduction, organization and interpretation. Pearson's chisquare test was used to determine the significant differences (P<O.OI) in availability as well as levelof utilization of M&E mechanisms, among institutions in the three categories (public, faith based, private). The variables which showed significant differences were subjected to multivariate analysis using binary logistic regression. The nine-point Rand rating approach was used to make judgment on the appropriateness of the M&E mechanisms. The study found out that there were significant differences.In the availability of M&E guidelines (t=13.921, df=2, P=.OOI); questionnaire (X2=20.326, df~2~' P=.OO); end of course evaluation form (X2=24.222, df=2,P=.OO);and preparation of CPD training progress reports CX2=41.045, df=2, P=.OO).Further analysis showed that M&E guidelines ~ere unlikely to be available among institutions in the public category (OR=0.27, CI-95%(0.07-0.99». There were significant differences in the utilization of the end of course evaluation form (t=24.542, df=2, P=.OO). The appropriate mechanisms for monitoring and evaluation of CPD training among institutions in the three categories were a questionnaire, end of course evaluation form, and computer statistical software. However, analysis of data manually was not appropriate.This study concludes that there were differences in the availability of M&E mechanisms for CPD training at middle level health training institutions in Kenya; the level of utilization of the M&E mechanisms was low; and, most of the available M&E mechanisms were appropriate for use. The study recommends allocation of adequate budget for monitoring and evaluation of CPD training at middle level health training institutions; and capacity building of CPD tutors in M&E. Further research is recommended to determine the factors that influence the differences in the availability and level of utilization of the mechanisms for monitoring and evaluating CPD training at MLHTIs.