The bottlenecks and best buys concept

For virtually all health professional schools, there is a set of nine areas in which bottlenecks may be encountered when considering scaling up production (see box below). Findings about constraints in these core areas can guide a school in prioritizing its “best buys” in scaling up its education and training programs. Best buys are interventions that are likely to have the largest impact on scaling up the production of quality graduates with relatively small additional investment.

The Bottlenecks and Best Buys approach enables a school to look at the nine capacity areas in whole or part. The process involves conducting interviews with key informants, conducting surveys of educators and students, and observing school facilities. CapacityPlus has developed tools—such as checklists and data collection/analysis tools—to facilitate this process. This evaluation process can determine if there are multiple gaps or just a few critical areas needing priority attention and which of those can be addressed most cost-effectively. Schools will typically either require concentrated attention in limited areas or have across-the-board needs in most of the nine areas.

Nine Areas of Health Professional School Capacity

For virtually all health professional schools, there is a set of nine core elements that need to be considered and addressed. These are:  

  1. Educators (full/part-time, classroom/clinical recruitment, selection, retention, development)
  2. Students (graduate/postgraduate recruitment, selection, retention)
  3. Management (financial management, oversight/governance, including government relations with a school)
  4. Infrastructure (classrooms, demonstration rooms, laboratories, libraries, computer labs, dormitories, cafeterias, electricity, water, Internet)
  5. Materials and equipment (textbooks, teaching/learning materials, computers, anatomical models, simulators, diagnostic equipment, clinical supplies)
  6. Curriculum (theoretical and practical, responsive to needs, regularly updated)
  7. Clinical practice (variety and appropriateness of sites, mentoring and supervision, infrastructure and equipment)
  8. Quality assurance (accreditation of institutions, certification/licensing of graduates)
  9. Partnerships and exchange (exchange of faculty/students, partnerships between other schools and with service delivery facilities both public and private).

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