Identifying training needs to improve the quality of Depo-Provera services in Nicaragua. Volume 1. Project report results and recommendations. Final report.

An assessment of the technical competence of Depo-Provera (DMPA) service providers and distributors was conducted to measure the level of training of service providers identify potential method biases and identify topics and areas that require further training. Information was collected in 71 service delivery points including Health Centers and Health Posts. Findings indicated that the average level of knowledge of DMPA procedures among 86 service providers interviewed was 61.8 points in a 100 point scale. Knowledge tests showed large differences between trained and untrained personnel. While trained personnel scored 65 points in the knowledge scale untrained personnel scored 59 points. In approximately half of the case studied the service provider used some kind of printed materials. On the average service providers inquired about 13 items or 65% out of the possible 20 items included in the observation guide. These consultations with acceptable and high levels of completion of institutional service provision norms. In 22 consultations (20% out of the 11 consultations observed) service providers inquired about less than 10 items. There was a small fraction (6 cases) in which the service provider complied with 6 of the 20 required items or less. These were cases which provided extremely poor information. Important recommendations are also provided in this paper.