Evaluation of the HIV lay counselling and testing profession in South Africa

Details

• Alternative Title:
  BMC Health Serv Res
• Personal Author:
  Mwisongo, Aziza ; Mehlomakhulu, Vuyelwa ; Mohlabane, Neo ; Peltzer, Karl ; Mthembu, Jacque ; Van Rooyen, Heidi
• Description:
  Background
  
  With the launch of the national HIV Counselling and Testing (HCT) campaign in South Africa (SA), lay HIV counsellors, who had been trained in blood withdrawal, have taken up the role of HIV testing. This study evaluated the experiences, training, motivation, support, supervision, and workload of HIV lay counsellors and testers in South Africa. The aim was to identify gaps in their resources, training, supervision, motivation, and workload related to HCT services. In addition it explored their experiences with providing HIV testing under the task shifting context.
  
  Methods
  
  The study was conducted in eight of South Africa’s nine provinces. 32 lay counsellors were recruited from 67 HCT sites, and were interviewed using two questionnaires that included structured and semi-structured questions. One questionnaire focused on their role as HIV counsellors and the other on their role as HIV testers.
  
  Results
  
  Ninety-seven percent of counsellors reported that they have received training in counselling and testing. Many rated their training as more than adequate or adequate, with 15.6 % rating it as not adequate. Respondents reported a lack of standardised counselling and testing training, and revealed gaps in counselling skills for specific groups such as discordant couples, homosexuals, older clients and children. They indicated health system barriers, including inadequate designated space for counselling, which compromises privacy and confidentiality. Lay counsellors carry the burden of counselling and testing nationally, and have other tasks such as administration and auxiliary duties due to staff shortages.
  
  Conclusions
  
  This study demonstrates that HCT counselling and testing services in South Africa are mainly performed by lay counsellors and testers. They are challenged by inadequate work space, limited counselling skills for specific groups, a lack of standardised training policies and considerable administrative and auxiliary duties. To improve HCT services, there needs to be training needs with a standardised curriculum and refresher courses, for HIV counselling and testing, specifically for specific elderly clients, discordant couples, homosexuals and children. The Department of Health should formally integrate lay counsellors into the health care system with proper allocation of tasks under the task shifting policy.
  
  
• Subjects:
  Adult Counseling Delivery Of Health Care Family Characteristics Female Health Services Needs And Demand HIV Infections HIV Seropositivity Humans Interviews As Topic Male Mass Screening Motivation Patient Acceptance Of Health Care Qualitative Research Surveys And Questionnaires Young Adult

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• Source:
  BMC Health Serv Res. 15.
• Pubmed ID:
  26197722
• Pubmed Central ID:
  PMC4509846
• Document Type:
  Journal Article
• Funding:
  U2G PS000570/PS/NCHHSTP CDC HHS/United States ; U2G/PS000570/PS/NCHHSTP CDC HHS/United States ; PEPFAR/United States
• Name as Subject:
  United States. President's Emergency Plan For AIDS Relief (PEPFAR)
• Place as Subject:
  South Africa
• Volume:
  15
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:d629e1de13ff44c7c492211063ed89b83d895deb728f3be28b4be6bc470e541bf8375525ad1a9c41c4a4e5ff985173675e0d028126a40b1fd1f93cbba40217fa
• Download URL:
  https://stacks.cdc.gov/view/cdc/33954/cdc_33954_DS1.pdf
• File Type:
  [PDF - 424.43 KB ]