Researchers conducted this study to develop and test a distance-learning program to improve the quality and efficiency of family planning services in Guatemala.

The setting was rural family planning services in Guatemala. The study design was quasi-experimental with one intervention and one control group and with pre-and post-intervention measures. Two staff members from each of 20 randomly selected health districts were trained as the training program leaders. In turn, the 40 trainers trained 240 service providers under the supervision of four health area facilitators. The results were compared with 20 randomly selected control health districts. The intervention was a distance-learning program including 40 in-class hours followed by 120 in-service practice hours spread over four months. Distinctively, the program used a cascade approach to training, intensive supervision, and close monitoring and evaluation. Consultation observations were used to assess the quality and completeness of reproductive health information and services received by clients.

The intervention showed a positive impact on reducing the number of contacts before the consultation and client waiting times. 

The study concluded that distance-learning programs are a practical methodology for training health professionals in rural areas.