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Appropriately trained and skilled personnel are needed at each level (national, central, district and community) for quality assured and sustainable implementation.
It may be necessary to adapt and elaborate any global and/or regional guidelines on ITMN implementation to meet the specific needs at country, district and local levels. Training and IEC materials should be similarly adapted. Country-specific handbooks, preferably in loose-leaf formats may be prepared with provisions for updating based on experience gained during the implementation, as well as any new developments including techniques. Standards/specifications for the materials, e.g. insecticides, nets and guidance for their use/procedures are expected to be included. They must be widely disseminated and made accessible to all potential users, i.e. the providers (public, private sector, NGOs, other community organizations) and when relevant the net users. All training and educational materials, and other documentation may be translated into local languages. These will require collaboration at all levels.
All training must be task-oriented, and the tasks vary at different levels. The extent to be covered and detailed for a specific training activity depends on expected functions, and the levels of responsibility. Training should cover the concepts, knowledge and skills involved in the technical, operational and managerial elements in each activity area.
Major topic areas to be addressed may include:
· Information management: collection, collation, transfer, analysis, interpretation and feedback;· Planning: at national, district and community levels;
· Specific techniques: e.g. net-treatment procedures including calculations of net surfaces, insecticide and water requirements, impregnation or spraying techniques, vector resistance monitoring, and quality assurance of sprayed nets;
· Logistics management: needs assessment, planning of procurements, storage, distribution, repackaging of insecticides;
· Monitoring and evaluation: operational, technical;
· Supervision skills;
· Community mobilization and intersectoral collaboration; skills in communicating, convincing and harnessing support;
· IEC activities;
· Costing and cost-effectiveness estimations;
· Managerial issues including financial/cost-recovery systems.
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An example of relevant training topics in relation to insecticide resistance is given below: · Mosquito sampling, indicators and parameters for monitoring insecticide resistance; · Insecticide susceptibility test procedures, data recording/reporting, analysis, interpretation and use; · Practical implications of resistance (encountered by WHO test) in relation to field operational use of the relevant insecticides, and making resistance-based decisions on insecticide uses; · Study of resistant mechanisms (more relevant to research); · Cross resistance implications of resistant mechanisms and their relevance for the selection of insecticides. |
All ITMN partners, whether within and outside health services, communities, NGOs, the private sector, or from academic and research institutes, need skills in their respective functions irrespective of the magnitude of the work. The most crucial and first step, however, is the development of a core group of expertise, and of trainers to lead and effect a sustainable programme. They could in turn improve the skills and capacities of other programme implementers.
The training should be structured to cover each major activity area. Approaches may include focus group exercises, individual training, workshops, and seminars, and through training material/documentation. The timing, locations, participation must be detailed and curricula developed for each category of persons and training activity. The training, curricula and the processes themselves must be evaluated.
The locations for training will depend on the type of activity. Some may be permanent, others temporary. For example, the more permanent net impregnation/demonstration sites may be used to train and demonstrate on insecticide-treatments at group or individual levels. National academic/research institutes may be relevant for training on insecticide resistance monitoring techniques; and field-based training is needed on insecticide treatment of nets, on mosquito sampling, and investigations on operational implications of resistance. Some training activities can be linked with those related to other aspects of malaria control.
It may be relevant to consider establishing closely-linked networking programmes involving scientists with the necessary qualifications, experience and expertise, and of institutes having appropriate facilities. These may be at national, regional and global levels, depending on the issues addressed. The networking can contribute to and expedite the development and reinforcement of local and regional capacities. Depending on the needs and capacities at national level, the networking partners may coordinate, assist, participate, or undertake training and monitoring activities, including vector resistance to insecticides, special investigations on resistance, information management and exchange, and operational research.
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