Use of facility-based assessment in the evaluation of a comprehensive leprosy training program in Nepal

A facility-based assessment (FBA) was done to evaluate a comprehensive leprosy training program in Nepal. The training course was developed to prepare the Basic Health Services staff for integrated leprosy work. FBA is a coordinated set of data collection activities designed to determine the extent to which patients are properly diagnosed, treated, and cared for in the treatment facility. During the present evaluation, the data collection activities included: observation of health worker performance, exit interviews with leprosy patients, interviews with health workers, inventory of essential equipment and supplies, and collection of routine statistical data. The objectives of the training course were used as guidelines for the evaluation. Surveys and observation visits were done repeatedly and compared with a (untrained) control group. Different actors involved in leprosy care were used as informants, and different data collection methods were used which enabled cross-checking of the information. Part of the data collection activities was already routinely carried out. FBA proved to be a very useful and effective tool for the evaluation of a leprosy training program. Those parts of the training which need extra attention during the course itself as well as during refresher training and supervision visits became obvious.