A system of influence : identifying and addressing factors which determine the transfer of training on sexual and reproductive health in humanitarian settings

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By the end of 2013, almost 80 million people were forcibly displaced worldwide due to persecution, conflict, generalized violence, human rights violations or natural disasters. The sexual and reproductive health (SRH) needs of populations surviving these hazards continue and often increase in their aftermath. In order to meet these needs, competent and engaged human resources are required to deliver lifesaving interventions. However, the development of workforce capacity remains a key challenge in these settings, and is further complicated when training programmes do not facilitate the transfer of knowledge and skills into policy and practice. Effective training is essential to ensure the competence of this workforce and maximise the application of training to benefit vulnerable populations. The gap between training and use of training is referred to as ‘the transfer problem’ and studies have found this to be associated with a range of factors which influence the use of newly developed knowledge and skills in work contexts. Little is known about the transfer problem in training for humanitarian settings. In response to this paucity of knowledge I conducted research to explore the passage of participants in the Sexual and Reproductive Health programme in Crisis and post-Crisis Situations (SPRINT) training course from the training room to their work setting. I sought to identify and understand the factors which enabled and impeded the ability of trainees to transfer their training. I conducted a multi-phase qualitative study in which I interviewed SPRINT trainees, administered questionnaires, carried out observation at regional and national level training events, and reviewed numerous documents including country level and regional monitoring and evaluation reports. Through these data, I discovered a system of factors which operate to determine whether a training participant can and/or will transfer their learning on return to work. These factors operate on and between four distinct layers that include individual level moderators; training design factors; organisational structures; and wider environmental issues. These factors were also found to have an association with a trainee’s intention, and eventual application of knowledge and skills developed during the training course. Identifying and understanding these factors is important, as they can be planned for and addressed to increase the application of new knowledge and skills. This research provides recommendations which will enable training efforts to be optimised and, in so doing, ensure that aid is more effectively applied, and the SRH needs of those living in humanitarian settings are better met.
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