Lessons from Further Afield…Thinking about Needs and Outcomes


Specialty organizations play a pivotal role in disseminating knowledge and establishing best practices. Many also provide the means for capacity-building, via training programs and tools, mentorship opportunities, and evaluation processes. This is as true in limited resource settings as it is in more developed ones.

But lessons can also be learned from international organizations such as Jhpiego, an affiliate of Johns Hopkins University with nearly 4 decades of reproductive and family health field work in more than 150 countries. Health interventions that are “innovative, effective and low-cost” are supported by a framework for “training competent health care workers, strengthening health systems and improving delivery of care” (http://www.jhpiego.org/en/content/who-we-are).

Field-based and field-driven planning ensures a practical and adaptable basis for health development work in limited resource settings. In their efforts towards achieving sustainability, organizations such as Jhpiego, and their partners, have also amassed unique technical and process expertise which can inform on future interventions.

The Canadian Radiation Oncology community may refer to a basic distillation of these experiences in

– “Training Works! What You Need to Know about Managing, Designing, Delivering and Evaluating Group-Based Training”  (available in English/French/Spanish, viahttp://www.hrhresourcecenter.org/node/137)

–       “Standards-Based Management and Recognition: A Field Guide”  (described athttp://www.hciproject.org/improvement_tools/improvement_methods/approaches/standards_based_management_recognition; available in English/French/Spanish/Portuguese viahttp://reprolineplus.org/resources/field-guide-standards-based-management-and-recognition-learning-resource-package)

These resources, as simple examples of the kind of toolkits developed and refined by established non-profit organizations working in international health (and available online), offer a glimpse into the successes of development work, the philosophies that shape these, and the mechanics of moving such projects forward.

Rather than focus on the content and nature of a proposed health application, methodologies are highlighted for designing and implementing a systems intervention involving any given health solution (which could be a new treatment algorithm, a new diagnostic tool, a new workflow, etc.). Training of health care workers or volunteers is featured prominently in such a process. Key considerations arise in the planning and preparation ahead of training, in the actual training delivery, and finally in the evaluation of training outcomes and subsequent on-the-job performance. Along the way, attention to the organizational or community setting, the clinical or practice standards upon which training should be based, the specific training needs diagnosis and the makeup of the training audience itself can better tailor a health systems-level intervention. It may also increase uptake and eventual cascade of training. This goes hand in hand with a pared-down method for improving performance and quality of health services, via simple ground-based standardization and monitoring, which is outlined in these documents as a means to quickly and practically manage local needs-based change in most limited resource settings, with measurable results.

Formalized in this manner, field-tested methodologies can be easily reproduced, and applied in the context of international oncology work. Tools like these can help bridge the gap in global cancer control, and ultimately support the important mission of organizations such as IAEA/PACT, UICC, IARC, and many others.

(Originally posted January 27 2013, 3:34 PM  by CIC workgroup)

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