Agency-based empowerment training enhances sales capacity of female energy entrepreneurs in Kenya.

Globally, women's involvement in clean cooking value chains has been minimal. This is partly because of the multiple challenges faced by women that impede their capacity to effectively engage in the energy sector. To better discern gender-specific differences in involvement in the energy sector, the authors conducted a randomized trial in Kenya to compare sales performance of newly trained male and female improved cookstove entrepreneurs and to test the effects of an agency-based empowerment training on business activity. A total of 257 entrepreneurs completed either a 4-day entrepreneurial training (control) or a 4-day empowerment training (intervention) and were followed for nearly 8 months documenting business activity and sales. The empowerment training led to more than doubling of sales for both genders. In addition, participants in the intervention group were significantly more likely to demonstrate business commitment over time and nearly three times more likely to be higher sellers (relative risk = 2.7, 95% CI [1.4, 5.4]), controlling for gender and rural/urban locale. Women outsold men by a margin of nearly 3 to 1 and were more likely to continue to pursue leads despite limited sales. Nonactive participants (those selling 1 improved cookstove or less) were a larger percentage of the control group (72%) than the intervention group (50%), and more men were nonactive participants (65% of men) compared with women (56% of women).These data show that women can serve as active improved cookstove entrepreneurs in both urban and rural settings and that targeted agency-based empowerment training can significantly increase women's capacity to engage effectively within the improved cookstove value chain.

Effective in-service training design and delivery: evidence from an integrative literature review.

BACKGROUND: In-service training represents a significant financial investment for supporting continued competence of the health care workforce. An integrative review of the education and training literature was conducted to identify effective training approaches for health worker continuing professional education (CPE) and what evidence exists of outcomes derived from CPE. METHODS: A literature review was conducted from multiple databases including PubMed, the Cochrane Library and Cumulative Index to Nursing and Allied Health Literature (CINAHL) between May and June 2011. The initial review of titles and abstracts produced 244 results. Articles selected for analysis after two quality reviews consisted of systematic reviews, randomized controlled trials (RCTs) and programme evaluations published in peer-reviewed journals from 2000 to 2011 in the English language. The articles analysed included 37 systematic reviews and 32 RCTs. The research questions focused on the evidence supporting educational techniques, frequency, setting and media used to deliver instruction for continuing health professional education. RESULTS: The evidence suggests the use of multiple techniques that allow for interaction and enable learners to process and apply information. Case-based learning, clinical simulations, practice and feedback are identified as effective educational techniques. Didactic techniques that involve passive instruction, such as reading or lecture, have been found to have little or no impact on learning outcomes. Repetitive interventions, rather than single interventions, were shown to be superior for learning outcomes. Settings similar to the workplace improved skill acquisition and performance. Computer-based learning can be equally or more effective than live instruction and more cost efficient if effective techniques are used. Effective techniques can lead to improvements in knowledge and skill outcomes and clinical practice behaviours, but there is less evidence directly linking CPE to improved clinical outcomes. Very limited quality data are available from low- to middle-income countries. CONCLUSIONS: Educational techniques are critical to learning outcomes. Targeted, repetitive interventions can result in better learning outcomes. Setting should be selected to support relevant and realistic practice and increase efficiency. Media should be selected based on the potential to support effective educational techniques and efficiency of instruction. CPE can lead to improved learning outcomes if effective techniques are used. Limited data indicate that there may also be an effect on improving clinical practice behaviours. The research agenda calls for well-constructed evaluations of culturally appropriate combinations of technique, setting, frequency and media, developed for and tested among all levels of health workers in low- and middle-income countries.