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Methods: Evaluation methods included: a desk review of the MLM course reports, WHO/AFRO MLM modules and reference documents; interviews with MLM course participants, facilitators, supervisors, Ministry of Health officials and country-based partners; focus group discussions; and questionnaires.
Results: During 2000-2004, eleven MLM courses were held and 642 participants were trained. Of the 151 course participants interviewed, 85% rated the course as very useful and 15% as useful. Modules on new vaccines, immunisation safety, cold chain and vaccine management, communication and problem solving were most appreciated. According to supervisors, the MLM training has contributed to significant improvements in the performance of the staff after attending the MLM course. Using DTP3 as an indicator, immunisation coverage in the African Region increased from 49% in 1991 to 53% in 2001 and 69% in 2004.
Conclusions: The MLM training has increased the performance of the trained staff and therefore contributed to the improvement of EPI coverage in the African Region. However, MLM training remains a predominantly vertical event and should be harmonised with other health training programmes for various levels of the health system.