Evaluation of Pre-Service Training in the African Region

Training needs assessments conducted in various countries of the WHO African Region during the last decade pointed out several challenges in pre- and in-service training of immunisation theory and practice by medical and nursing schools. Some of these challenges presented below required concerted action by the school and national immunisation services to deal with deficiencies in immunisation teaching:

  • Harmony between pre-service and in-service training was lacking;
  • EPI content was either not outlined in the curricula or it was incomplete or outdated;
  • Reference materials and demonstration equipment were lacking;
  • Time allocation to EPI theory was inadequate and the practical sessions were not adequately supervised;
  • Some lecturers and tutors lacked modern EPI training.

This situation prompted a systematic revision of EPI curriculum for both medical and nursing/midwifery schools. To facilitate this exercise, two EPI prototype curricula for medical and nursing/midwifery schools were developed in English and French. The curricula were distributed to all training schools and WHO Offices in the African Region. Many health professional schools have revised their curricula making efforts to incorporate EPI into their teaching agendas.

The rapid development of innovations and new technologies in immunisation programmes requires that, graduated students as tomorrows' staffs, are updated regularly if they have to cope with strategic changes and technical advancements.

To measure the level of introduction, WHO/AFRO and NESI planned to undertake an evaluation to assess the status of the introduction of immunisation curriculum in the training institutions of the African Region and its impact on the quality of training of medical and nursing school students.


To strengthen the teaching and learning of current immunisation practices within the existing curriculum for basic (pre-service) education programmes for doctors, nurses/midwives and other health professionals.

Specific Objectives

  • To determine the extent of revision of the immunisation course based on new developments in the programme;
  • To assess the technical knowledge and skills of teachers/tutors responsible for teaching EPI topics;
  • Ensuring whether:

- active methods and techniques are used for teaching/learning

- appropriate time is allocated to the course topics

- a sound balance exists between theoretical and practical sessions

- appropriate training materials in sufficient quantities are available in educational institutions

- appropriate supplies and demonstration equipment are available in educational institutions

- adequate learning and programme evaluation is conducted. 


  • Country visit by external evaluators for data collection and analysis;
  • Review of curricula of pre-service training institutions;
  • Interviews with:

-        EPI teaching coordinators/teachers

-        Field attachment and practical site tutors

-        Deans/principals of the training institutions

-        EPI managers

-        Partners supporting pre-service training in the country

  • Focus group discussions with teachers and students;
  • Review of training materials used for in-country MLM training courses.

Country visits were conducted in Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Madagascar, Niger, South Africa, Uganda and  Zimbabwe in 2011.

African Region
Sunday, 1 May, 2011 to Thursday, 15 December, 2011
Last updated : 2 August, 2017