The Training Unit
Protecting Families Against HIV/AIDS (PREFA) worked with 40 districts to determine training needs of health workers for comprehensive PMTCT service provision. The target was to train 330 health workers in IMAI/IMPAC, 150 health workers in infant and young child feeding, 330 health workers in rapid HIV testing, 90 health workers in TOT in PMTCT counseling in infant and young child feeding (IYCF), EID and RH/FP(using IMAI/IMPAC approach). 600 health workers were to be trained in data management, 20 PREFA staff to be trained as per need, 210 family support group members trained as peer mentors. 930 VHTs trained in community PMTCT service delivery.
However following changes in PMTCT/Paedriatric ART/Infant feeding guidelines at the end of 2010 and in the light of available resources PREFA shifted it focus to train health workers on 2010 WHO PMTCT guidelines so as to equip them with knowledge and skills on the new changes in PMTCT ARVs prophylaxis guidelines that the government had adopted for the HIV Infected regnating women and their infants to ensure that all the HIV exposes infants are initiated to NVP at birth and to be maintained on NVP for as long as they are still breast feeding and followed up, tested and enrolled into care in order to give them the chance to be screened and managed early.
PREFA worked closely with MOH in scaling up training of health care workers on the new developments in PMTCT/EID so as to strengthen PMTCT/ EID service delivery. The districts were involved in the selection of health workers from all PMTCT service sites to be trained on new policy guidelines in order to hasten the roll out process of the new policy in their health facilities and districts. As one of the training strategies, mentorship and coaching was an integral part of the continuing professional development process that took place at the facilities where health care workers manage pregnant women. Mentorship and coaching was aimed at providing individualized hands on support to trained health workers as well as achieving the outcomes that include; improved quality of HIV care and treatment services to pregnant women through joint observation, discussion, direct problem solving, mentoring each other on the topics observed through onsite visits and quarterly support supervision, health care workers motivation improved because of the effective technical support provided, and use of district trainers to provide technical support to health workers at facility level and peer mentors providing technical support to fellow health workers at facility level on day-today basis.
This was conducted by district mentors with support of MOH national mentors and PREFA technical staff to support application of classroom learning to clinical care environment. It was aimed at enabling the health workers obtain updates for quality service delivery. The district trainers provided education foundation for continuing education that followed and worked closely with technical mentors to coordinate all activities in regard to integrated PMTCT capacity building
Participants were selected in consultation with the district health officers and ensured that the relevant staffs were trained. The cadre of staff included Midwives, Clinical Officers, Enrolled Midwives, Laboratory personnel, and nursing assistants all of which are relevant to the PMTCT-EID program. These were chosen from the maternity, Outpatient, MCH, Paediatric section, ART clinic, Laboratory and administration departments with at least a staff coming from the DHO’s office in the different districts for continuity and follow up of issues agreed upon during the trainings. Action work plans were made by all the health units under the guidance of the facilitators, to ensure that even those facilities that had not started the program do so. Notably, training was very timely and appropriate as most health workers were practicing PMTCT/EID but had no clear understanding of the system in addition to the updates.