Zambia: Distance-learning course for antiretroviral therapy providers
February 2008
As in other countries in the region, scale-up of HIV/AIDS care and treatment in Zambia has been rapid. The country has
expanded from three antiretroviral therapy (ART) sites in early 2005 to more than 150 facilities today. As a result, many more Zambians are able to access ART and other HIV care services throughout the country.
HIV care and treatment is a dynamic field, with frequent changes in technical information. Providers need opportunities to update their knowledge and skills, and assistance in identifying gaps and developing solutions for their own programs. Guidelines and training materials need to be updated regularly, and creative approaches should be taken to encourage continued education and performance improvement.
Through the Centers for Disease Control and Prevention (CDC) University Technical Assistance Projects award, Jhpiego and CDC are developing a training course on ART and opportunistic infections management for HIV/AIDS service providers in Zambia. The overall goal is to improve quality of care at the ART clinics in Zambia by offering providers an opportunity to improve their knowledge and skills related to HIV/AIDS care and treatment. Up to 200 providers from approximately 100 service facilities are targeted for enrollment in the course in the first year, with plans for nationwide scale-up in the next year.
The project will start in early 2008 with a meeting of participating partners and stakeholders. The meeting will be followed by an orientation for provincial clinical care specialists, who will enroll ART teams in the course, administer knowledge assessments, and provide support and supervision to the providers as part of their routine visits to ART sites.
The course focuses on key HIV/AIDS care and treatment concepts
and clinical protocols, and employs a performance and quality improvement approach to help providers transfer their initial training more effectively to the workplace. Course exercises are designed for use by teams rather than individual providers to reinforce the importance of working together as a team, which is critical to continuity of care for people living with AIDS.
The course will be delivered using “distance-learning approaches” (i.e., through various electronic multimedia) to HIV/AIDS service delivery sites throughout the country. It is composed of 12 technical modules on topics such as:
- ART provision
- HIV care for women and children
- Opportunistic infection management
- Pain management
Each module contains a lecture recorded by a local clinical expert, a visual presentation and printed materials including assignments and tests. This format reinforces key points, updates clinicians’ past training and will allow for quick and inexpensive future updates as guidelines and information change. Also included in the presentations are recorded interviews with people living with HIV/AIDS, which help providers better understand the psychosocial aspects of providing HIV/AIDS services.
A new module will be sent out each month for a year, starting in
spring 2008. Providers will review the video lectures, discuss questions with
their team and—through a focused assessment at their facility—identify gaps in
quality of care and feasible ways to address them. The team will record their plans in an ART team action plan that, along with the knowledge test, will provide a foundation for provider certification at the end of the course.
To monitor the progress of the training, quarterly knowledge tests will be administered by the provincial clinical care specialists at the time of the routine visits. At the end of the training year, the providers will take a final exam and their action plans will be evaluated by
the provincial clinical care specialists. If the participants pass, they will receive a certificate of completion from the Zambia Ministry of Health and move on to implement their action plans.
A more in-depth program evaluation is planned to measure the impact of the training on provider knowledge, attitudes and clinical practices, as well as the usefulness of
the course content and the appropriateness of the course format.
About Jhpiego
For nearly 40 years, Jhpiego, (pronounced "ja-pie-go"), has empowered front-line health
workers by designing and implementing simple, low-cost, hands-on solutions that
strengthen the delivery of health care services, following the
household-to-hospital continuum of care. We partner with community- to
national-level organizations to build sustainable, local capacity through
advocacy, policy and guidelines development, and quality and performance
improvement approaches.
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