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Pre-service Education

Background: A Global Shortage

Moz Pre-Service

The global shortage of qualified health care workers in resource-limited settings is a significant barrier to achieving strong health systems and positive health outcomes. As leaders seek ways to address this shortfall, they have given local pre-service educational institutions an increasingly urgent mandate to graduate greater numbers of well-prepared health care workers, including clinicians, nurses, laboratory specialists, and others. Pre-service institutions therefore face the challenge of expanding the number of graduates without sacrificing the quality of education students receive. Any sustainable response to the shortage of health care workers must, therefore, include strategies to support pre-service educational institutions in this effort. 

I-TECH Five-Step Framework for Building the capacity of Pre-Service Educational Institutions

Strengthening pre-service institutions is a complex, multi-year endeavor. Successful initiatives rely on effective partnership, collaboration, and coordination, as well as high quality technical expertise and interventions. They require the involvement and consensus of multiple stakeholders, including ministries of health and education, educational institutions, professional associations, regulatory bodies, donors, partner organizations, local organizations, and communities. I-TECH uses a systematic approach to develop and implement a comprehensive capacity building strategy tailored to the specific needs of each partner institution.

I-TECH’s approach to pre-service strengthening is based on years of experience in educational reform in countries around the globe, as well as lessons learned from key stakeholders and implementing organizations. It follows a comprehensive framework adapted from I-TECH's Partnership Model, which articulates an intentional progression toward local ownership and control, and emphasizes building local capacity to pursue new priorities identified by stakeholders.

The framework consists of five phases:

Pre-Service Flow

  1. Coordination and Planning
    In the first phase, I-TECH assists key stakeholders to clearly define challenges to pre-service education, articulate and inventory interventions currently in place, and identify gaps and areas of need.
  2. Comprehensive Needs Assessment
    In Phase 2, I-TECH and stakeholders conduct a comprehensive needs assessment of the pre-service educational training institution(s) or relevant stakeholders identified in Phase 1.
  3. Implementation of Technical Assistance Plan
    Findings from the comprehensive needs assessment inform the development of a detailed technical assistance plan to sustainably strengthen the institution.
  4. Monitoring and Evaluation of Program Interventions
    Monitoring and evaluation activities, including continuous quality improvement, are incorporated throughout I-TECH’s institutional capacity building activities.
  5. Transition and Integration
    Capacity-building interventions are designed with the long-term aim of transitioning and integrating new capacities into existing institutions and systems within mutually determined and realistic timeframes. This means ensuring that pre-service capacity built through I-TECH programs can be sustained by the educational institution in the long term.

For more information on I-TECH’s pre-service activities, please contact Stacey Lissit, Senior Training Advisor, at or +1-206-221-7332


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