This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.
PIP: Lot Quality Assurance Sampling (LQAS) was used to evaluate the technical competence of two cohorts of family planning service providers trained with a new six-week curriculum developed by the Kenyan Ministry of Health Family Planning Training Program. This was the first application of LQAS, originally developed to assess industrial production, to an evaluation of the quality of family planning service provision. One cohort (n = 11) had completed the training within two months of the evaluation; the other (n = 19) had been trained one year earlier. The 30 providers were rated on 101 tasks in a series of six client interactions. The cohorts did not differ significantly in the total proportion of tasks needing improvement. In both, the number of counseling tasks needing improvement was significantly greater than the number of physical examination tasks. Performance was least adequate among caregivers who were not currently providing services. 17 of the 18 instances in which cohorts needed skills improvement were contributed by nonproviders. These findings suggest that continuous use of skills learned in training is more predictive of skill retention than time elapsed since training. This study helped identify task categories (e.g., counseling) in which the new curriculum needs strengthening.