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PRIME Technical Reports

PRIME II Technical Reports

Most PRIME II Technical Reports detail specific reproductive health care interventions, describing the context, methodology and results of a PRIME project and recommendations from its evaluation. Other reports focus on findings from needs assessments conducted prior to a training intervention or document follow-up studies that ascertain how well health care providers have retained the knowledge and skills they acquired during training. Research studies testing new approaches to service delivery were sometimes published as PRIME technical reports, often with implications for health care policies in particular countries.


Assessment of Health Sub-centers in Jhansi District in preparation for Clinic-based Family Planning (CBFP) Training and Upgrading (August 2000) (214KB)
Report No. 9
This health sub-center assessment was conducted to support PRIME’s training of Auxiliary Nurse Midwives in Uttar Pradesh, India. The report describes the material and physical characteristics of the 255 sub-centers in Jhansi District.

Baseline Survey Report: In-Service Training, Health and Population Sector Program (HPSP), Bangladesh (August 2003) (622KB)
Report No. 40

Capacity and Capability for the Essential Service Package (ESP) Program in Bangladesh: A Review of the PRIME/National Integrated Population and Health Project (NIPHP) Program (July 2002) (453KB)
Report No. 41

Effects of Paramedics Training on Provider Performance and Client Use of Services in Bangladesh (June 2002) (344KB)
Report No. 38

Follow-up Assessment of the Indian Medical Association (IMA) Family Planning Clinical Training Course in Gujarat (September 2000) (147KB)
Report No. 2
PRIME conducted this follow-up evaluation on behalf of the Indian Medical Association (IMA). The study assesses the outcome of a new intermediate-level in-service course for physicians focusing on Intrauterine Device (IUD) services, sexually transmitted infections and infection control. Recommendations are made on the basis of study findings.

Follow-up on Training of Indigenous Systems of Medicine Practitioners in Non-clinical Methods of Family Planning in Uttar Pradesh, India (August 2000) (120KB)
Report No. 8
This report describes an assessment of the Indigenous Systems of Medicine (ISM) program, which provides non-clinical family planning training to homeopathic, ayurvedic, Siddha and Unani practioners working in Uttar Pradesh, India. The program, managed by the State Innovations in Family Planning Services Agency (SIFPSA), was initiated in 1995 with the financial support of USAID and the Innovations in Family Planning Services project. This assessment was undertaken early in the expansion of the ISM pilot project from Sitapur and Jhansi districts to six new districts in Uttar Pradesh. The report discusses changes in access to family planning services, method mix used by clients and skills retention of practitioners following training.

Implementation of the National In-Service Training Strategy for the Essential Service Package: Final Project Review of the PRIME II Bangladesh Health and Population Sector Program (September 2003) (1,749KB)
Report No. 48

Indigenous Systems of Medicine Practitioners (ISMP) Contraceptive Sales Motivation in India (August 2003) (545KB)
Report No. 42

Postabortion Complications and Their Management: A Community Assessment Conducted in Rural Uttar Pradesh, India (June 2001) (2,542KB)
Report No. 23
PRIME provided support for research teams to conduct exploratory research on postabortion care provision in rural Uttar Pradesh. The results show that even though the type of postabortion care provided in rural villages can worsen a woman’s situation, community-based providers are likely to remain the first point of contact for many women with abortion complications.

East & Southern Africa

An Assessment of the Potential of Health Attendants for Family Planning and Reproductive Health Expansion in Tanzania (July 2000) (494KB)
Report No. 3
Details PRIME’s application of a new model of needs assessment, Diagnostic Assessment of Performance and Potential (DAPP), in gauging the suitability of adding health attendants as a new cadre of family planning and reproductive health providers. The assessment also serves as the basis for developing a training strategy.

An Exploratory Study to Determine and Document Factors Affecting IUCD Use in Tanzania (July 2002) (766KB)
Report No. 30

Capacity Building for Training and Human Resource Development: The Case of RH Services in Tanzania (November 2001) (503KB)
Report No. 27
Documents key processes in a ten-year effort by the Ministry of Health and IntraHealth International to develop human resources and training systems to support national improvement and expansion of RH services.

Distance-based Learning to Introduce Primary Health Care Training and Service Delivery: A Case Study in South Africa (February 2000) (525KB)
Report No. 10
A report on PRIME/BASICS’ development of an innovative distance-based training program to assist Eastern Cape province in reorienting training and service delivery from a vertical system to a primary health care (PHC) approach. The goal of the PHC Comprehensive Skills for Trainers Program was to increase the availability and quality of integrated, comprehensive PHC services by developing training capability and capacity.

Expanding Opportunities for Postabortion Care at the Community Level through Private Nurse-Midwives in Kenya (July 2000) (291KB)
Report No. 12
Assesses a pilot project in three Kenyan provinces—Nairobi, Rift Valley and Central—to train private nurse-midwives to include postabortion care in the range of preventive and curative maternal and child health services they offer.

Expanding Opportunities for Postabortion Care at the Community Level through Private Nurse-Midwives in Kenya—Final Report (September 2000) (305KB)
Report No. 21
This report resoundingly demonstrates that trained nurse-midwives can successfully provide safe, quality postabortion care services using manual vacuum aspiration (MVA) at the community level.

Exploring Peer Support Networks for the Provision of High-Quality Postabortion Care by Private Nurse-Midwives in Kenya (August 2003) (358KB)
Report No. 49

Follow-up of Family Planning Clinical Service Providers—Tanzania (October 2000) (181KB)
Report No. 4
A follow-up study of a group of family planning and reproductive health (FP/RH) workers who had previously received either basic or comprehensive FP/RH clinical skills training. The study assesses performance and the factors influencing performance and uses survey, observation and record review methods to demonstrate the positive impact of provider training on volume of service provision.

Performance Needs Assessment of Zonal Training Centre: Capacity to Provide Support for Improving Reproductive and Child Health Services in Tanzania (August 2003) (530KB)
Report No. 39

The Tanzania Family Planning Training Program: The Impact of an Innovative Training Strategy on Reproductive and Child Health Service Performance of Health Attendants in Tanzania (November 2001) (403KB)
Report No. 25
Based on a study implemented in Kasulu and Kibondo districts in Kigoma Region, this report assesses the impact of a pilot training strategy for health attendants in reproductive and child health services. The strategy was developed and implemented by the Ministry of Health with technical assistance from PRIME.

Europe & Eurasia

Reproductive Health Care at the Primary Level in Armenia: Assessment of Providers' Services and the Factors Affecting Performance (August 2003) (816KB)
Report No. 46

Latin America & the Caribbean

An Assessment of Health Promoter Effectiveness in Rural El Salvador (January 2001) (272KB)
Report No. 22
This report describes the results of a national-level evaluation of the effect of rural health promoters in improving health behavior in El Salvador. The study focuses on three key areas: extent of health promoter contact and coverage in the community; health promoter impact on family planning/reproductive health; health promoter impact on child health.

An Assessment of the Sociocultural Factors that Influence Reproductive and Sexual Health among Rural Adolescents in Huancavelica, Peru (September 2000) (376KB)
Report No. 14
The PRIME Adolescent Project was designed in response to evidence that adolescent childbearing, sexual activity and induced abortions are on the rise throughout Latin America, while use of contraception is low. The project investigates existing knowledge and behaviors that influence adolescent reproductive and sexual health in Huancavelica, Peru.

Baseline Survey on Licensing and the Performance of Primary Reproductive Health Care Providers in Region 7—Olancho, Honduras: Primary Provider Performance, Its Factors and Client Perception—Final Report (August 2002) (412KB)
Report No. 29

Capacity Building in Training: A Framework and Tool for Measuring Progress (November 2000) (324KB)
Report No. 16
One of the goals of the PRIME Project is to train and support primary providers of reproductive health care through capacity building. In order to assist project managers and host-country staff with assessments of institutional capacity for training, a new evaluation tool was designed and then tested in several countries. Results of that work in El Salvador are presented in this report.

Dominican Republic Performance Improvement Project Evaluation (January 2000) (488KB)
Report No. 19
Using the Performance Improvement approach, this PRIME Project improved the performance of primary providers of reproductive health care at Social Security Administration (IDSS) health centers in the Dominican Republic.

Follow-up Evaluation of the Effects of Training Primary Health Care Providers in Huancavelica, Peru (June 2000) (133KB)
Report No. 11
This follow-up study assesses the training of primary health care technicians in remote regions of Huancavelica, Peru. PRIME’s training was part of a joint initiative with the Support Program in Reproductive Health (PASARE) of USAID/Lima and the Peruvian Ministry of Health (MINSA) to increase the quality and accessibility of priority reproductive health services provided by MINSA.

Improving the Quality and Availability of Family Planning and Reproductive Health Services at the Primary Care Level: Institutional Capacity Building in the El Salvador Ministry of Health (MOH) (August 2000) (467KB)
Report No. 13
Describes the components and early impact of the first phase of the PRIME/El Salvador project, which trained more than 4,000 people at the department, health unit and community levels over a 12-month period in family planning and reproductive health issues. The program has also strengthened the contraceptive logistics and management system of the MOH.

Results of the Second Follow-up Study of the Dominican Republic Performance Improvement Project Evaluation (November 2001) (408KB)
Report No. 28
Addendum to Technical Report No. 19 with follow-up results and findings focusing on client-provider interaction.

Structural and Individual Factors Related to the Effectiveness of CBD Promoters in Nicaragua (March 2000) (5,819KB)
Report No. 6
PROFAMILIA has provided family planning services in Nicaragua since the early 1970s. Conducted in partnership with PROFAMILIA, this PRIME study examines a variety of factors—at the individual, community, organizational and health system levels—that relate to the effectiveness of health promoters.

Responsive Training & Learning

Evaluation of the Use of PRIME’s Reproductive Health Training for Primary Providers: A SourceBook for Curriculum Development (January 2000) (473KB)
Report No. 18
Assesses the SourceBook, a modular reference for trainers, faculty and curriculum developers intended to help design or revise curricula for training primary providers of client-oriented integrated reproductive health services.

West & Central Africa

An Assessment of the Impact of PRIME interventions on the Training Capacity and Reproductive Health Service Delivery in Ghana (May 2000) (503KB)
Report No. 20
Since 1995, PRIME has initiated a series of interventions in Ghana, including formulation of Health Policy and Standards Protocols, promotion of public-sector collaboration, development of training materials, introduction of a self-directed learning model for service providers in remote areas and decentralization of postabortion care. This study assesses the impact of those interventions.

Assessing the Performance of Pharmacy Agents in Counseling Family Planning Users and Providing the Pill in Benin: An Evaluation of Intrah/PRIME and PSI Training Assistance to the Benin Social Marketing Program (March 2003) (332KB)
Report No. 37

Assessment of Community-Based Distribution in the Republic of Ghana (April 2000) (489KB)
Report No. 5
To assist in developing a national strategy for community-based distribution (CBD), PRIME partnered with the main agencies in Ghana providing CBD services. A detailed overview of current CBD strategies and programs was developed. This descriptive study combines qualitative and quantitative methods to offer recommendations.

Community-based Health Planning and Services (CHPS) Lead District Readiness Assessment Vols. 1 and 2 (October 2002) (840KB)
Report No. 32

Contraceptive Discontinuation and the Client’s Experience of Method Use and Services (December 2000) (865KB)
Report No. 17
Two-thirds of fertile women in Togo want to space births or limit family size. Yet fewer than 10% are using modern contraception. This study seeks a better understanding of the factors that cause women to discontinue contraceptive use.

Diagnostic Assessment of the Performance and Potential of Front Line Health Workers for CBD Supervision in Bazenga Province, Burkina-Faso (September 2000) (155KB)
Report No. 1
The Directorate of Family Health of the Burkina Faso Ministry of Health requested assistance from the PRIME Project in planning a community-based distribution (CBD) pilot program. PRIME applied the Diagnostic Assessment of Performance and Potential (DAPP) approach first used in Tanzania to assess the suitability of several different categories of workers for the CBD role.

Evaluation de la Situation Financière des Centres de Santé et des Hôpitaux Participant dans le Système de Pré-paiement au Rwanda (January 2003) (464KB)
Report No. 33

Evaluation of the GRMA/PRIME Self-Directed Learning, Client-Provider Interaction and Adolescent Reproductive Health Initiative (November 2001) (723KB)
Report No. 26
An evaluation of how well this project implemented by PRIME and the Ghana Registered Midwives Association met its goal of demonstrating that self-directed learning can improve the quality and accessibility of family planning and reproductive health services for adolescents by enhancing midwives’ client-provider interaction skills.

Follow-up of Performance by Pharmacy Agents Trained in Contraceptive Technology Between 1998 and 2001 in Benin (March 2003) (406KB)
Report No. 35

Follow-up of Providers Trained in the Use of Family Health Services Protocols in the Departments of Borgou/Alibori, Atlantic/Littoral, and Mono/Couffo in Benin (November 2003) (540KB)
Report No. 47

Identification des Besoins en Performance des Prestataires de Services en Santé de la Reproduction au Rwanda (October 2003) (1,017KB)
Report No. 43A

Performance Needs Assessment for Reproductive Health Providers in Rwanda (October 2003) (993KB)
Report No. 43

Performance Needs Assessment of Safe Motherhood Regional Resource Teams in Upper East, Upper West and Northern Regions of Ghana (July 2002) (319KB)
Report No. 31

Performance Needs Assessment on Emergency Obstetrical and Neonatal Care Among Providers in the Malanville-Karimama Health Zone of Benin (March 2003) (321KB)
Report No. 36

Study of the Effects of Incorporating Selected Reproductive Health Services on Family Planning Services: A Case Study in the Eastern Region of Ghana (November 2000) (554KB)
Report No. 15
Assesses the effects of training family planning providers to offer a wider scope of reproductive health services, particularly postabortion care and prevention and management of sexually transmitted infections. The study shows that both providers and clients perceived the benefits of these additional services.

Study of the Effects of Technical Supervision Training on CBD Supervisors’ Performance in Seven Regions of Ghana (March 2000) (289KB)
Report No. 7
This follow-up report describes the effects of technical supervision training on community-based distribution (CBD) agents’ supervisors in seven regions of Ghana. The CBD program in Ghana is managed by the Planned Parenthood Association of Ghana (PPAG) and features a varied programs of clinic and non-clinic-based family planning and maternal and child health services. The study shows improved performance by both the CBD supervisors and agents. Training weaknesses and differences between volunteer and paid supervisors are also discussed.

Suivides Prestataires Formés a l'Utilisation des Protocoles des Services de Santé Familiale dans les Départements de Borgou/de l'Alibori, de l'Atlantique/de Littoral, et du Mono/du Couffo en Benin (November 2003) (577KB)
Report No. 47A