Transformative Education
for Health Professionals

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Key Policy Issue #1: What to monitor, for what purpose, and how to do so?

Monitoring is not an end in itself; there is little value in producing information that will not influence decisions. Also, not all information has the same weight and potential influence on decision-making. Therefore, it is critical that policy-makers and implementers of change identify their information needs. There is no need to monitor everything and thereby accumulate data that will be unused. The issue here is to identify what data and information are critical for decision-making, whether to adjust an intervention to changing circumstances (formative evaluation) or whether to continue or stop its implementation (summative evaluation). Typically, information is needed on the inputs, processes and results of interventions, the latter always being the most difficult to measure as they take time to produce.

The WHO Handbook on Monitoring and Evaluation of Human Resources for Health proposes that monitoring of entry into the health labour market focus on seven dimensions, of which four concern education:

  1. the pool of eligible candidates for health education and training;
  2. recruitment and selection of students;
  3. accreditation of education and training institutions; and
  4. capacity and output of education and training institutions (Tulenko, Dussault and Mercer, 2012).

Do we need to include the subsequent employment of graduates? There is no point having educated health care graduates with no jobs. This framework can be a starting point for the definition of what it is worth monitoring. Indicators can be defined for each dimension to provide the information needed for the effective monitoring of the implementation process and the results.