Yesterday was a very long day - we left Pakse in the morning and spent the day following up activities at a district hospital. We had supported training in emergency medicine and laboratory services and the two trainers who organized the trainings came with us to see the results of their training. After summarizing the results with the director of the Dept of Health, we continued on to another district hospital where we'll be doing the same thing tomorrow.
When thinking about development, a lot of people emphasize training. But even more important is this kind of follow-up activity. First, it allows contact between the students and trainers, so if they are having difficulties, the trainers can help them work on solutions on site. Second, It also helps the trainers to see the situation at the district hospital and understand the difficulties so that they can design better training in the future.
The advantage of having district staff train at the province is that they get wider experience because there are more patients and they can exchange ideas with more staff. The down side is that when they return to their hospitals, it's sometimes difficult for them to make changes on their own. We also support trainings at the district level so that the rest of the staff can understand what new skills are available. Any training strategy has to include a combination of on and off-site training, establishing key people at each site, regular monitoring and follow-up, and a strong sense of participation of all the stakeholders.