(HRH_PRE) Number of new health workers who graduated from a pre-service training institution or program as a result of PEPFAR-supported strengthening efforts, within the reporting period, by select cadre

Export Indicator

Number of new health workers who graduated from a pre-service training institution or program as a result of PEPFAR-supported strengthening efforts, within the reporting period, by select cadre
Rationale

It is widely acknowledged that the lack of trained health workers is a major barrier to scaling up health services. The lack of a sufficient workforce in countries presents a serious challenge to every area of health. The data will tell us the number of new health workers who are available to enter the health workforce each year as a result of PEPFAR support.

Numerator

Number of new health workers who graduated from a pre-service training institution or program as a result of PEPFAR-supported strengthening efforts, within the reporting period, by select cadre

Denominator

N/A

Calculation

How to calculate annual total:

N/A. Data is reported only once annually at Q4.

Method of measurement

Training under this indicator is defined as “pre-service” training – the training of “new” health workers (see definition below).

Training generally occurs prior to the individual entering the health workforce in his or her new position (with the exception of certain training that may occur on-the job but that prepares health workers to function as a new cadre or with an expanded scope of practice in the health system). A health worker who advances to a higher cadre (e.g., a clinical assistant who completes training to become a clinical officer) shall be counted as a “new” health worker for the purposes of this indicator. The HRH goal is to expand the number of workers in the workforce and increase access to care through the advancement of current workers to higher level cadres through additional training and education.

Pre-service training institutions are university-based or affiliated schools of medicine, nursing, public health, social work, laboratory science, pharmacy, and other health-related fields. Non-professional or paraprofessional training would be any accredited and nationally recognized pre-service program that is a requirement for this cadre’s entry into the workforce.

“In-service” and “continuing education” training should not be included in the count for this indicator but continue to be encouraged. These types of training may be captured by other indicators within program areas (e.g., supply chain).

In order to count, the duration of training must meet or exceed a minimum of 6 months. For example, community health workers who receive a 3-month training course cannot be counted here. The training duration may be a combination of classroom and practical field time to arrive at six months.

A pre-service training program must be nationally accredited, or at the minimum meet national and international standards. The program must also have specific learning objectives, a course curriculum, expected knowledge, skills, and competencies to be gained by participants, as well as documented minimum requirements for course completion. The duration and intensity of training will vary by cadre; however, all training programs should have at a minimum the criteria listed above.

Individuals may be in training over many reporting periods; however, only participants who have successfully completed their training should be counted.

Successful completion of training may be documented by diploma, certificate or other evidence of completion of the program and subsequent eligibility to enter service.

Individuals not meeting these documented requirements should not be counted in this indicator.

“Health workers” refers to individuals involved in safeguarding and contributing to the prevention, promotion and protection of the health of the population (both professional and auxiliary-professionals). The categories below describe the different types of health workers to be considered under this indicator. This is not an exhaustive list of all health workers and position titles may vary from country to country. For the purposes of this indicator, health workers may include the following but is not limited to:
 
• Clinical professionals, including doctors, nurses, midwives, laboratory scientists, pharmacists, medical technologists, and psychologists. They usually have a tertiary education and most countries have a formal method of certifying their qualifications.
 
• Clinical officers, medical and nursing assistants, lab and pharmacy technicians, auxiliary nurses, auxiliary midwives, T&C counselors. They should have completed a diploma or certificate program according to a standardized or accredited curriculum and support or substitute for university-trained professionals.
 
• Workers in a health ministry, hospital and facility administrators, human resource managers, monitoring and evaluation advisors, epidemiologists and other professional staff critical to health service delivery and program support.
 
• Social service workers including social workers, child and youth development workers, social welfare assistants.
PEPFAR support includes funding in the areas of curriculum development, teacher training and support, tuition/scholarships, infrastructure, materials/equipment, and practica/internships. For example, full or partial support of student tuition or scholarships, teacher salaries, and expansion/refurbishment of pre-service training facilities could all count under this indicator depending on the investment.
 
PEPFAR support includes funding in the areas of curriculum development, teacher training and support, tuition/scholarships, infrastructure, materials/equipment, and practica/internships. For example, full or partial support of student tuition or scholarships, teacher salaries, and expansion/refurbishment of pre-service training facilities could all count under this indicator depending on the investment.

 

Data sources: MOH Human Resource Information Systems (HRIS), pre-service training institutions, Ministry of Education, Public Service, and/or private sector HRIS, Ministry of Social Welfare HRIS, professional boards and councils, alumni or graduate networks.

Reporting level:

Above-Site

How to review for data quality:

N/A

Measurement frequency

Annually

Disaggregation

Numerator Disaggregations:

Disaggregate Groups:

1. By Cadre: [Required]
 
Disaggregates:
 
1. • Doctors
• Nurses
• Midwives
• Social Service Workers
• Laboratory Professionals
• Other
 
 
Denominator Disaggregations :
 
Disaggregate Groups: 
 
N/A
 
Disaggregates:
 
N/A
 

Disaggregate descriptions & definitions:

As a service delivery area indicator, the PEPFAR support categories of DSD and TA-SDI do not apply. To report results for this indicator, it is expected that PEPFAR provides support for this activity as defined below.

New health worker graduates of pre-service training institution or program will be counted as PEPFAR supported when PEPFAR is supporting the training of new health worker graduates, including:
 
• Tuition and fees - At least 50% of the students' tuition and fees were or will be provided by PEPFAR for at least six months of their education
 
• Curriculum development - The students received or will receive training where PEPFAR curriculum development was essential to qualify them for their trained role
 
• Infrastructure - The students received or will receive six months or more of education at an institution that could not have supported their education without PEPFAR-supported infrastructure improvements (classrooms, dormitories, utilities)
 
• Faculty support - The students received or will receive six months of more of education at an institution that could not have supported their education without one or more faculty members present and qualified due to PEPFAR support
 
• Practica / internship support - The students would not have received or will not receive adequate practica or internship training without PEPFAR support (including transportation to or sufficient resources at the practicum facility)
 
• Materials / equipment - The students would not have received or will not receive education without materials or equipment (including books and supplies) provided by PEPFAR
 
• PEPFAR educational programs (for non-university-based training institutions) - The students received or will receive their education in a PEPFAR-funded, non-university-based education program for one or more courses without which they would not graduate or be qualified for the intended role
 
• Please refer to the HRH flowchart and worksheet for further information (https://www.pepfarii.net/twg/hrh/SitePages/Home.aspx)
Explanation of the numerator

The numerator is the sum of new health workers from the host country who graduated from a pre-service training institution within the reporting period with full or partial PEPFAR support. Individuals may be in pre-service training over a number of years but can be counted as graduated when they have completed their program. Graduates do not need to attend a formal ceremony – completing the program and receiving documentation is sufficient.

Further information

Indicator changes (MER 2.0 v2.2 to v2.3):

None

PEPFAR Support definition:

No additional requirements needed outside of the standard definition.

Guiding narrative questions:

1. For each cadre, describe nature of education (university, professional school), types of certification/accreditation (e.g., RN, LPN, ADN, BSN, NP, PA).
 
2. For each cadre, describe how training is leading to employment and service gap filling and aligned to reaching HIV epidemic control.