Tool to Assess Program Capacity: Adding Services to Manage Reproductive Tract Infections
To assess a program’s capacity to add services to manage reproductive tract infections (RTIs).
The tool is designed to help managers make rational decisions about expanding reproductive health services. The tool consists of four questionnaires which assess staff skills, systems, facilities and commodity requirements for four levels of service: 1) Prevention information and condoms, 2) Syndromic diagnosis and treatment, 3) Expanded clinical examination for diagnosis and treatment, 4) Basic laboratory testing for diagnosis and treatment. The tool provides specific strategies to generate answers to the following questions: 1) What knowledge and skills exist among available staff and what skills need to be added to provide services?, 2) What clients will be targeted for services?, 3) What facilities are needed and available to provide services?, 4) What operating systems exist and what may need to be adjusted?, 5) What commodities are available? The answers to these questions are used to decide what, if any, specific program changes are needed and what level of service to provide.
To apply the tool the following steps are taken: 1) an assessment team composed of staff from the organization or clinic is formed, 2) preliminary data is gathered on the health needs and community demand for RTI services through focus groups, 3) the desired level of services is chosen, 4) the questionnaire is completed and action items are listed, 5) the answers are analyzed and an action plan is developed.
Program for Appropriate Technology in Health (PATH) in 1999.
The primary audience is health program managers who contribute to decisions about how resources are allocated and how services are provided.
Tested in India at the Orissa Institute of Medical Research and Health Services (OMRAH), an NGO which provides maternal and child health services to rural populations. Focus group discussions were used to determine the community's needs and demand for services. Also tested in the Philippines with four NGOs in Cebu City.
The assessment can be completed quickly (1-3 days) and used without an outside facilitator. Instructions and questionnaires are very clear. Use of the tool initiates thought provoking discussion about program capabilities. Throughout the course of the assessment there are suggestions for action items. A wide range of organizations from local to national levels can use the tool. The tool is applied by a team of people rather than a single individual.
Framework does not assess some relevant areas such as finances, and the ability to train and supervise staff who will provide the new services.
Recommendation for Users
Expand the assessment team to include the finance officer, and the human resources and/or operations manager as well as clinical staff. At least one team member should have in depth knowledge of RTI service delivery issues.
Reports and Publications:
A Tool to Assess Program Capacity: Adding Services to Manage Reproductive Tract Infections, Reproductive Health Reports, Number 3, June 1999.