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Capacity-building in family health

Innovative in-service training program for teams in Latin America

Silvia Takeda, MD MSc
Research Associate at Serviço de Saúde Comunitária do Grupo Conceicao in Porto Alegre, Brazil.

Monica Riutort, MEd
Lecturer and Manager of International Programs at the University of Toronto.

Onil K. Bhattacharyya, MD PhD CCFP
Clinician Scientist at the Li Ka Shing Knowledge Institute of St Michael’s Hospital in Toronto, Ont, and an Assistant Professor in the Department of Family and Community Medicine and the Department of Health Policy, Management, and Evaluation at the University of Toronto.

Correspondence: Dr Yves Talbot, Department of Family and Community Medicine, University of Toronto, 263 McCaul St, 4th Floor, Toronto, ON M5T 1W7; telephone 416 978-3763; fax 416 946-3147; e-mail y.talbot{at}utoronto.ca

PROBLEM BEING ADDRESSED Brazil, Chile, and Canada are among the countries where development and deployment of human resources have been central to health reform; however, it is unclear how the education and training of primary care workers is best accomplished.

OBJECTIVE OF THE PROGRAM To implement a model of in-service training in primary health care for interdisciplinary teams of primary health care professionals from Brazil and Chile.

PROGRAM DESCRIPTION This 5-module program targeted primary care providers from various disciplines who had at least 3 months of front-line experience. The program was offered in 2 formats: intermittent "in-country" training or an intensive course taught in Canada. In Brazil, the in-country training took place over a period of 8 to 12 months, during which 5 modules of 2 to 3 days each were interspersed with 2-month "action periods." The intensive course taught in Canada was delivered to Chilean participants in Toronto, Ont, where 3 modules were offered to a group of 12 to 20 primary health care professionals over a 6-week period. The educational methodology combined short didactic presentations, whole group learning exercises, and small group problem-based learning sessions, including team projects that were completed in between each module and presented at the beginning of the next one. During the course, the participants learned how to perform computer database searches and assess the best evidence in the management of common problems.

CONCLUSION Pretests, posttests, and evaluations of student projects demonstrated that participants had increased knowledge, as well as increased capacity to use the best evidence to address common problems in their communities. This is a promising model, adapted to the context of primary care reform in Latin America, with strong potential to support health human resource development and multidisciplinary care by front-line providers in other countries.