LHW Systems Review - Oxford Policy Management

LHWP – Systems Reviewavailable. This information is updated monthly and enables the Programme to judge howmany trainers need training in order to meet recruitment plans and refresher training.There have to be two trainers present before training can be conducted at a health facility,and one of these must be female. The central PSP database provides information on theavailability of trainers, but not on their gender (Table 5.4). However, this information ispresented at quarterly review meetings at the federal and provincial levels. In 2003, theProgramme was operating in 3,880 facilities and had a ratio of three trainers per facility. In2008, there were 4,721 health facilities with LHWs, so the ratio had fallen to 2.6 trainers perfacility. The analysis by province/area indicates that Sindh could not possibly have hadsufficient trainers at this time, and neither could FANA if they were planning to conductrefresher training.Table 5.4 Number of facility trainers per facility, by province, June 2008June 2008 Punjab Sindh NWFPBalochistanAJK FANA FATA ICTNumber of facility trainers 5,962 1,482 2,027 396 254 114 215 50Number of facilities 2,628 846 743 200 126 94 65 19Average number of facilitytrainers/facility 2.3 1.8 2.7 2.0 2.0 1.2 3.3 2.6Source: PSP database January 2009, LHWP, MoH.Was the Programme able to provide 9,000 trainers? There is no record of how manytrainers were trained under this PC-1. There is a trainer training budget estimated in the PC-1 (of Rs. 145.260 million). The PSP database records a net increase of 482 District MasterTrainers from 475 in 2003 to 957 in 2008. The number of Facility Master Trainers increasedby 463 from 10,037 to 10,500 during the same period. The database does not tell us howmany trainers were recruited, lost through attrition, or trained (Table 5.4). 34Overall training budget The Programme had a budget of Rs. 735 million for all capacitydevelopment for the period June 2003–June 2008. Of this, Rs. 711 million had been spentby June 2008. The training budget is only 3.76 percent of Programme expenditure. It is themain area receiving support from development partners, particularly with regard to pilottraining and printing.Table 5.5Comparison of number of trainers available, by level andprovince, June 2003 and June 2008Province/ AreaDistrict Master Trainer2003 2008Increase/decreaseFacility Master Trainer2003 2008Increase/decreasePunjab 183 479 296 5,419 5,962 543Sindh 89 146 57 1,505 1,482 -23NWFP 93 145 52 2,107 2,027 -80Balochistan 53 113 60 423 396 -27AJK 28 27 -1 212 254 42FANA 4 17 13 107 114 7FATA 18 26 8 198 215 17ICT 7 4 -3 66 50 -16Total 475 957 482 10,037 10,500 463Source: PSP database January 2009, LHWP, MoH.34The PC-1 indicated that, by 2003, there were 8,000 trainers who had been trained by the Programme. The numbers heresuggest there were significantly more, with 14,518 at the district and facility level.24