Table 1

Content and tutors’ evaluation of level 2 course

ContentTutors’ comments
Day 1: Fundamentals of contraception
  • Unmet need, consent and confidentiality

  • Overview of methods and their efficacy

  • Physiology and natural methods

  • Anatomy and sterilisation

This led to discussion about recent deaths from septic abortion and missed opportunities to discuss contraception.
Lively flipchart session to draw out prior knowledge and discuss the advantages, disadvantages and efficacy of methods.
Participants struggled to remember physiology and explain rhythm method. Moon beads were a useful visual aid.
Group work drawing anatomy did build on prior knowledge. Hospital surgeon's talk on sterilisation was well received
Day 2: Methods
  • Injections

  • Implants

  • Intrauterine devices (IUDs)

  • Oral contraceptives

Intensive day with PowerPoint presentations about each method. Interspersing this with small group sessions using flipcharts, case discussion, MEC wheels, videos and practice with models helped maintain interest
Day 3: Contraceptive counselling
  • Condoms, male and female

  • Principles of counselling

  • Counselling scenarios

An HIV ‘expert patient’ demonstrated the promotion and use of male condoms. Few had seen female condoms before.
Session based on WHO counselling tools.
Substantial time was given to role play, allowing participants to consolidate their knowledge of methods and side effects
Day 4: Sexual health/practical skills
  • STI diagnosis and management

  • Demonstrations of cervical cytology, implant insertion and removal, IUDs

Session based on Uganda guidelines for vaginal discharge, pelvic pain, genital ulcers and urethral discharge in men. Participants recreated algorithms using pre-prepared post-it notes. Quiz and case discussion on teenage STIs.
Parallel groups had case discussions, videos and observation of procedures with clinic patients who had consented to this. (This worked well, but no IUDs were fitted that day)
Day 5: Reaching target groups
  • Emergency contraception

  • Adolescent-friendly services

  • Preparing presentations for antenatal mothers, parents on paediatric ward, teenagers

  • Final assessment (MCQ exam and course evaluation)

Slide presentation and brainstorming on ways to make SRH services more accessible to teenagers.
After an introduction by a health promotion worker, groups of three to four trainees spent 30 min preparing health promotion talks for the rest of the group who role played the target audiences
  • MCQ, multiple choice question; MEC, medical eligibility criteria; SRH, sexual and reproductive health.