Couples’ voluntary HIV counseling and testing provider training evaluation, Zambia

Abstract

SummaryWith the expansion of couples’ voluntary HIV counseling and testing (CVCT) in urban Zambia, there is a growing need to evaluate CVCT provider trainings to ensure that couples are receiving quality counseling and care. We evaluated provider knowledge scores, pre- and post-training and predictors of pre- and post-training test scores. Providers operating in 67 government clinics in four Copperbelt Province cities were trained from 2008 to 2013 in three domains: counseling, rapid HIV laboratory testing and data management. Trainees received pre- and post-training tests on domain-specific topics. Pre- and post-training test scores were tabulated by provider demographics and training type, and paired t-tests evaluated differences in pre- and post-training test scores. Multivariable ANCOVA determined predictors of pre- and post-training test scores. We trained 1226 providers, and average test scores increased from 68.8% pre-training to 83.8% post-training (p < 0.001). Test scores increased significantly for every demographic group and training type (p < 0.001) with one exception—test scores did not significantly increase for those receiving counseling or data management training who had less than a high school education. In multivariable analysis, higher educational level and having a medical background were predictive of a higher pre-test score; higher pre-test scores and having a medical background were predictive of higher post-test scores. Pre- and post-test assessments are critical to ensure quality services, particularly as task-shifting from medical to lay staff becomes more common. Assessments showed that our CVCT trainings are successful at increasing knowledge, and that those with lower education may benefit from repeat trainings.

Enhancing HIV positivity yield in southern Mozambique: The effect of a Ministry of Health training module in targeted provider-initiated testing and counselling

“…This suggests that the training module in targeted PITC may successfully increase HIV positivity yield, as these differences were revealed when the study conditions—Hawthorne effect and extra HIV counsellors—were not present. Similar results were found in a study in Zambia, where providers trained in couples’ voluntary HTC increased their knowledge scores by 22% [ 24 ]. Furthermore, the fact that yield increased significantly among women, but not men, suggests that the training may be particularly effective in aiding diagnosis among a population with a low level of undiagnosed HIV.…”

Enhancing HIV testing yield in southern Mozambique: the effect of a Ministry of Health training module in targeted provider-initiated testing and counselling

“…This suggests that the training module in targeted PITC may successfully increase HIV testing yield, as these differences were revealed when the study conditions ─Hawthorne effect and extra HIV counsellors─ were not present. Similar results were found in a study in Zambia, where providers trained in couples’ voluntary HTC increased their knowledge scores by 22% [23]. Furthermore, the fact that yield increased significantly among women, but not men, suggests that the training may be particularly effective in aiding diagnosis among a population with a low level of undiagnosed HIV.…”

Increasing early infant male circumcision uptake in Zambia: Like father like son

“…Following completion of the S&S+LFLS training, study staff reviewed trainee’s performance for both interventions and recommended certification, or additional training on either or both interventions. As EIMC decision making has been linked to mother’s HIV status, the LFLS couples component included elements from the couples’ voluntary HIV testing and counseling (CVCT), which applies a solution-focused model to avoid blame and instead centers on present and future behavior based on the CVCT Curriculum [ 21 , 22 ]. The model has been endorsed by the GZMOH and integrated into ANC services’ standard of care.…”