Training for Health Professionals

摘要 正如美国卫生局局长促进性健康和负责任的性行为的行动呼吁中所记录的那样 在行为方面，对卫生服务提供者进行性健康保健方面的培训对于解决国家广泛的 性健康和生殖健康问题。然而，评估性健康课程对 提供商的行为很少见。在撒哈拉以南非洲，艾滋病毒、性传播感染、 青少年怀孕、意外怀孕、不安全堕胎、女孩童婚和对男孩的性侵犯 世界上，切割女性生殖器、殴打妻子、婚内强奸、将同性恋定为刑事犯罪、 对女同性恋者、男同性恋者、双性恋者和变性人(LGBT)的污名化，关于手淫导致的神话 性功能障碍在男性和女性中都很常见，我们发现没有 对保健提供者进行正规的性保健培训。性健康教育，即使是对健康提供者， 在非洲是一个敏感的问题。因此，如果要进行这种教育，就需要对其影响进行严格的研究。 被广泛采用。最近，在达累斯萨拉姆的穆亨比利健康与联合科学大学(MUHAS)， 我们调整了泛美卫生组织/世卫组织为医疗保健提供者提供的性健康课程培训，以便在#年实施 坦桑尼亚。参与者是87名护理、助产和相关健康科学专业的学生。岗位评价前 表明课程是学生高度接受、需要和期望的，在实施中可行，以及 有效地提高学生向病人提供性健康护理的知识、态度和技能。这个 顺理成章地，这一研究的下一步是进行全面的性健康的第一次严格试验 坦桑尼亚卫生专业人员培训课程。有三个具体目标。目标1是进行一次 坦桑尼亚性健康服务的社会生态需求评估。以确定是否 助产学、护理学、医学和相关健康科学专业的学生将从一个课程或单独的课程中受益 根据学科定制课程，我们将组织焦点小组(每个学科3人)。我们还将进行 与主要信息提供人进行个别访谈，以解决结构和文化问题。在目标2中，我们将进一步 调整我们的课程，确保它在文化上适合坦桑尼亚/撒哈拉以南地区的背景，并进行试点测试。目标 3是评估以非洲为基础、适合文化的性健康课程的有效性。我们会 对课程进行随机、对照、单盲试验，对照等待名单对照评估 对性健康知识、态度和咨询技能的影响(每臂206名学生，共412人)。 假设将测试课程是否有效，以及它是否对一门学科比 又一个。如果有效，MUHAS已承诺为其所有健康学生实施该课程。vt.给出 MUHAS在整个非洲的健康学生教育中是卓越的，这项研究评估的课程有 很有可能被广泛采纳为非洲各地卫生专业人员培训的新标准。

ABSTRACT As documented in the US Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior, training of health providers in sexual health care is critical to addressing a broad array of the nation's sexual and reproductive health concerns. Yet rigorous trials evaluating the effects of sexual health curricula on provider behavior are rare. In sub-Saharan Africa, an environment which has the highest rates of HIV, STI, teen pregnancy, unwanted pregnancy, unsafe abortion, child marriage of girls and sexual assault of boys in the world, and where female genital cutting, wife-beating, marital rape, criminalization of homosexuality, stigmatization of Lesbian, Gay, Bisexual and Transgender (LGBT) persons, myths about masturbation leading to dysfunction, and rates of sexual dysfunction in both men and women are common, we could find no formalized training of health providers in sexual health care. Sexual health education, even of health providers, is a sensitive issue in Africa. Consequently, a rigorous study of its effects is needed, if such education is to be widely adopted. Recently, at Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, we adapted a PAHO/WHO sexual health curriculum training for healthcare providers for implementation in Tanzania. Participants were 87 nursing, midwifery, and allied health science students. Pre-post evaluations show the curriculum to be highly acceptable, needed, and desired by students, feasible in implementation, and effective in improving student knowledge, attitudes, and skills in providing sexual health care to patients. The logical next step in this line of research is to conduct the first rigorous trial of a comprehensive sexual health training curriculum for health professionals in Tanzania. There are three specific aims. Aim 1 is to conduct a social ecological needs assessment of sexual health care delivery in Tanzania. To determine whether midwifery, nursing, medical, and allied health science students would benefit from one curriculum or separate curricula tailored by discipline, we will conduct focus groups (3 from each discipline). We will also conduct individual interviews with key informants to address structural and cultural issues. In Aim 2, we will further adapt our curriculum, ensure it is culturally tailored to the Tanzanian/sub-Saharan context, and pilot test it. Aim 3 is to evaluate the effectiveness of an African-based, culturally-appropriate, sexual health curriculum. We will conduct a randomized, controlled, single blinded trial of the curriculum against a waitlist control assessing effects on sexual health knowledge, attitudes, and counseling skills (n=206 students per arm; 412 in total). Hypotheses will test if the curriculum is effective, and whether it is more effective for one discipline than another. If effective, MUHAS has committed to implement the curriculum for all their health students. Given MUHAS is preeminent in health student education across Africa, the curriculum assessed in this study has high potential to be widely adopted as a new standard of training for health professionals across Africa.