Evaluation of the HIV lay counselling and testing profession in South Africa.
Evaluation of the HIV lay counselling and testing profession in South Africa.
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DOI：
10.1186/s12913-015-0940-y
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发表时间：
2015-07-22
影响因子：
2.8
通讯作者：
Van Rooyen H
中科院分区：
文献类型：
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作者：
Mwisongo A;Mehlomakhulu V;Mohlabane N;Peltzer K;Mthembu J;Van Rooyen H
随着南非开展全国艾滋病毒咨询和检测运动，接受过抽血培训的非专业艾滋病毒咨询师承担起了艾滋病毒检测的角色。本研究评估了南非艾滋病咨询师和测试人员的经验、培训、动机、支持、监督和工作量。目的是确定他们在与HCT服务相关的资源、培训、监督、动机和工作量方面的差距。此外，它还探讨了他们在任务转移背景下提供艾滋病毒检测的经验。这项研究是在南非九个省中的八个省进行的。从67个HCT站点招募了32名非专业咨询师，使用包括结构化和半结构化问题的两份问卷对他们进行了采访。一份问卷侧重于他们作为艾滋病毒咨询师的角色，另一份侧重于他们作为艾滋病毒检测者的角色。97%的咨询师报告说，他们接受过咨询和测试方面的培训。许多人认为他们的培训“绰绰有余”或“足够”，15.6%的人认为“不够”。答复者报告说，缺乏标准化的咨询和测试培训，并揭示了在为不和谐的夫妇、同性恋者、老年客户和儿童等特定群体提供咨询技能方面的差距。他们指出了卫生系统的障碍，包括指定的咨询空间不足，这损害了隐私和保密性。非专业咨询师承担着全国咨询和测试的重担，由于人员短缺，还承担其他任务，如行政和辅助职责。这项研究表明，南非的HCT咨询和检测服务主要由非专业咨询师和测试人员提供。他们面临的挑战是工作空间不足、特定群体的咨询技能有限、缺乏标准化的培训政策以及大量的行政和辅助职责。为了改善艾滋病毒传播服务，需要有标准化课程和进修课程的培训需求，以进行艾滋病毒咨询和检测，特别是针对特定的老年客户、不和谐的夫妇、同性恋者和儿童。卫生署应在任务转移政策下，将非专业咨询师正式纳入医疗体系，并适当分配任务。
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. 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. 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. 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.