Participatory training techniques WORKSHOP “OST in Developing Countries: A Primer”

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Participatory training techniques WORKSHOP “OST in Developing Countries: A Primer”
Participatory training techniques
WORKSHOP
“OST in Developing Countries:
A Primer”
Atul Ambekar, Alok Agrawal (India)
Training for OST staff
• A multi-disciplinary team of staff is involved in
service delivery
–
–
–
–
–
–
Doctor
Counsellor
Nurse
Programme Managers
Outreach workers and peer educators
Programme monitors / evaluators
• Relative advantages and disadvantages of training
them together or training them separately?
Induction Training on OST
0 A five day training programme
0 Conducted soon after recruitment of staff
0 Conducted for a mixed group of staff (nodal officers,
doctors, nurses, counselors, data managers,
programme managers and outreach workers)
0 Class-room type training
0 Highly interactive and participatory
0 Exposure visit – an essential component
0 BASED UPON A MANUAL
0 Outcome:
0 Trained staff who begin service delivery after receiving a
certificate
Organization of the manual
Rajat Ray, Anju
Dhawan, Atul
Ambekar (2011),
Implementing OST :
A Training manual
for service
providers, NACO,
Government of
India, New Delhi
Highlights of the manual
0 Developed as a ‘guide’ for facilitators
0 Not a substitute for practice guidelines or operating
procedures
0 Flexibility for facilitators for local adaptation
0 Applicable to a variety of OST settings
0 Entire training programme has been designed to be
participatory in nature
0 Strives to address all three components – knowledge,
attitudes and skills
0 Manual encourages training programmes for mixed group
of participants
Organization of the manual
0 Organization of the manual
0 Content 
0 Format
Content of the manual
0 Initial pages:
0 Acknowledgements
0 Message from DG, NACO
0 Foreword (from NACO)
0 Table of contents
0 Background
0 “About the manual”
0 TOR for facilitators
0 Preparations for the training programme
0 Draft agenda
0 Sessions (arranged chronologically)
0 Annexure
0 Record formats
0 Evaluation and feedback sheets
Areas covered in the training
0 Drugs, Drug Dependence, Harm Reduction, Principles
of drug treatment, OST: Basic knowledge (and attitude)
0 Assessment and Diagnosis: Clinical skills
0 OST (induction, maintenance, dispensing): Clinical
skills
0 Psycho-social interventions: Clinical skills
0 Exposure to a functioning OST centre
0 Programme management: Dispensing, record
maintenance, stock keeping, reporting, referral and
linkage: knowledge , attitude and skills
Content of the manual
0 Initial pages:
0 Acknowledgements
0 Message from DG, NACO
0 Foreword (from NACO)
0 Table of contents
0 Background
0 “About the manual”
0 TOR for facilitators
0 Preparations for the training programme
0 Draft agenda
0 Sessions (arranged chronologically)
0 Annexure
0 Record formats
0 Evaluation and feedback sheets
Training sessions
Day
Day 1
Sessions
Introduction exercise: meeting strangers and
building a rapport
Basics of Drugs: Overview of drugs and drug use
disorders
Drug-related problems and harms
Local drug abuse scenario
General principles of drug treatment and harm
reduction
Training sessions
Day
Sessions
Opioid substitution therapy – overview
Assessment and diagnosis
Day 2 Assessment and diagnosis: role-play and case
demonstration / presentation
Buprenorphine- pharmacology
Training sessions
Day
Sessions
Implementing OST with buprenorphine:
induction, stabilisation, discontinuation
Special clinical situations – adolescents; women;
HIV; other medical conditions, dual diagnosis
Day 3
Psychosocial interventions
Role-play / demonstration of psychosocial
interventions
Scheme for implementing OST in Government
centres: an overview
Training sessions
Day
Sessions
Exposure to the OST clinic, including
demonstration
Debriefing and experience sharing
Day 4 Programme management–I
Procurement and supplies
Programme management–II
Record maintenance and reporting
Training sessions
Day
Day5
Sessions
Programme management-III
Referral and networking, engaging civil society
Programme management-IV
Minimum standards of care, reporting
Open session
Working together: meeting between
stakeholders
Content of each session
0 Objectives
0 Materials and method
0 Steps
0 Highlights (as box items)
0 Contents of the presentation
Organization of the manual
0 Organization of the manual
0 Content
0 Format 
Format
0 The manual has been designed to be available
in two versions:
1. Hard copy:
0 Description of all the sessions
0 Handouts of slides along with ‘notes’ for the
facilitator
Format
0 The manual has been designed to be available
in two versions:
1. Hard copy:
0 Description of all the sessions
0 Handouts of slides along with ‘notes’ for the
facilitator
2. Digital version: (available as a CD or online)
0 The manual proper as a pdf file
0 Power point presentations as hyper links
Training techniques used in
the manual
0 Participatory presentation and
discussion
0 Group Work
0 Observations and de-briefing
0 Role Plays
Group work
0 Ideal size: 4 – 10 people
0 Shared characteristic: Same place of work /
same profession
0 Fosters team building and bonding
0 Provides opportunity for those to be heard
who may be silent in front of larger audience
0 Encourages learning from the peers \
0 Helps assessment of pre-existing knowledge
and understanding by the facilitator
Role play
0 Best suited for skill-based sessions
0 Ideally at least the first such role play should
be almost scripted
0 Based on a pre-decided case vignette
0 Played by two facilitators (one playing client and
another playing the staff)
0 Should be followed by feedback and
discussion
Observation and De-briefing
0 Gives a more ‘real’ and ‘hands-on’ experience
0 Requires logistic arrangements and
preparations
0 Should be coupled with de-briefing
0 The facilitator should be well conversant with
the
0 Setting observed
0 Setting in which participants are likely to work
Refresher Training
0 Ideal time: About 6 months after the initiation
into programme and then annually
0 May be smaller in duration than the Induction
training
0 Requires more skilled and experienced
facilitators
0 The agenda needs to be tailored and customized
as per the perceived needs of the participants
0 May have to be coupled with a stock taking
exercise or a programme review
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