Training & Supervision

The Standard Days Method® (SDM) is an information-based method, and while it is not difficult to provide and does not require any special procedures or equipment, the accuracy of the client screening and the quality of the counseling are critical to successful method use. Successful SDM introduction involves training not only the providers who will offer the method, but other personnel who will inform clients and supervise service delivery. To ensure that providers are competent, programs can rely on existing training resources that can be easily adapted for different levels of providers. Basic guidelines on how to organize and conduct the training also are included in these resources.
Key Actions for Training in the SDM
1. Orient policymakers and program decision makers to the SDM
Before providers are trained, conduct orientations to familiarize policymakers and program managers with the SDM. This will help build political and programmatic support for the method and is an integral part of the overall training plan. These can be meetings of 2-3 hours in duration, where the scientific basis of the SDM is presented, and experiences of introducing the SDM elsewhere are discussed. An orientation package which includes a PowerPoint presentation is available and can be adapted to local situations.
2. Identify primary and secondary providers of the SDM and determine training activities for them

In most programs, there will be both primary and secondary providers of the SDM. Primary providers are responsible for SDM screening for medical and behavioral eligibility and for counseling clients on how to use the SDM. There may be clinically trained staff offering other methods of family planning, or they may be community-based providers with limited family planning experience and counseling skills. Secondary providers often are community motivators or health educators who offer general information and support to clients, but do not screen or counsel clients on the SDM. Nevertheless, they need to know enough about the SDM to be able to answer basic questions about the method and who can use it.
3. Determine appropriate training approaches for the population to be trained

The learning objectives for training providers are standard, but the length and content of the training will depend on the trainees’ counseling skills. Well qualified personnel experienced in family planning counseling may require a brief 2 hour training. Other types of providers, such as non-health personnel and community-based workers, may need up to two days of training to acquire the knowledge and skills needed to appropriately counsel clients. Training of secondary providers may consist of formal training or more informal briefings during meetings or workshops.
While it may not be feasible to train all levels of providers at once, the overall implementation of training activities will be easier if the population to be trained is identified, the appropriate training approach is determined and a schedule to complete the training events is established.
Different approaches for training providers in the SDM have been tested and are available along with corresponding support materials. These approaches range from traditional class room training to online and distance learning packages. The different training approaches and available resources can be downloaded below.
Supervisors and senior clinical personnel should be included in the training. Knowledge of the SDM will enable them to support providers, and assist in the integration of SDM. In addition, policy makers and program managers should be briefed on the SDM to build their support for SDM introduction.
4. Match curriculum and training design to skill level of trainees

A variety of materials have been developed for training providers in the SDM. They vary in the level of skills they intend to achieve, and training length and methodology. In cases where providers have little experience and skills in family planning counseling the curriculum must address key family planning content and provide opportunities for practicing new skiils and receiving feedback. Consideration also should be given to incorporating SDM into pre-service curricula to impart an understanding of SDM to nursing and medical school students.
5. Incorporate SDM job aids and tools in training exercises

Provider job aids have been tested, adapted and used in diverse programs. To ensure that providers are familiar with these job aids —and eventually use them in their work sites— the trainers should make these available and use during training exercises, role plays, and general discussions. Peer-feedback and self-evaluation tools also are effective strategies for strengthening counseling skills.
6. Assess the capacity of participating organizations to support and conduct training and sustain follow-up activities

Follow-up actions should be considered as an integral component of the training effort. When training of trainers (TOTs) are conducted for example, plans should be developed to training providers and ensure that resources, such as a dedicated cadre of trainers, are available for the training. Although cascade training, (training trainers to train providers) offers a potentially efficient approach to in-country SDM training, it only works where there are training professionals who devote most of their time to training. Where a cadre of trainers does not exist, personnel will need to be drawn from the ranks of providers, thus burdening the service delivery system. When providers are trained, plans should be made for addressing the factors necessary to support service delivery, such as provider and client materials. The availability of personnel trained in SDM must be accompanied by organizational commitment to offering SDM, and systems in place to support SDM services. These systems include IEC to inform women about the availability of a new family planning option, SDM materials for providers and clients, an adequate supply of CycleBeads, and policies and procedures for incorporating SDM into the service delivery system.
7. Establish mechanisms to assess the effectiveness of training activities

Effectiveness of SDM training can be assessed through immediate evaluation of changes in knowledge and skills, and evaluation of the training room the participants’ perspective. SDM training curricula include a pre- and post-test and a participant evaluation. Responses should be analyzed after the training to determine whether the training met the objectives and participants are competent to provide the method to clients. The training evaluation can also help identify areas where reinforcement or adjustments are needed as well as:
  • Providers’ acceptability of the SDM
  • Provider competence in offering the method
  • Whether providers find the service delivery tools appropriate and can use them correctly
The Knowledge Improvement tool (KIT), located in the Quality Assurance tab of this toolkit  can be used by supervisors to identify areas of SDM counseling that need to be strengthened. The KIT consists of a series of questions about the SDM that assesses provider knowledge, skills and practices in offering the SDM. The use of the KIT reinforces knowledge and provides immediate, individualized feedback during follow-up visits.