Training for Health Professionals

摘要 正如美国卫生部长呼吁采取行动促进性健康和负责任的性行为所记录的那样， 行为，培训卫生提供者在性保健是至关重要的，以解决广泛的国家的 性健康和生殖健康问题。然而，严格的试验评估性健康课程的影响， 供应商的行为是罕见的。在撒哈拉以南非洲，艾滋病毒、性传播感染、 2010年，在非洲，少女怀孕、意外怀孕、不安全堕胎、女童童婚和男童性侵犯的问题 在这个世界上，切割女性生殖器、殴打妻子、婚内强奸、将同性恋定为犯罪， 对女同性恋、男同性恋、双性恋和变性者的污名化，关于手淫的神话导致 性功能障碍，男性和女性的性功能障碍率都很普遍，我们没有发现 对保健提供者进行正规的性保健培训。性健康教育，甚至是健康提供者的教育， 在非洲是一个敏感问题。因此，如果要使这类教育成为一种教育，就需要对其影响进行严格的研究。 广泛采用。最近，在达累斯萨拉姆的Muhimbili健康和相关科学大学， 我们改编了泛美卫生组织/世卫组织的性健康课程培训，供医疗保健提供者实施， 坦桑尼亚.参与者是87名护理，助产和专职健康科学的学生。前后评价 显示课程是高度可接受的，需要的，学生的愿望，在实施中是可行的， 有效地提高学生的知识，态度和技能，为病人提供性保健。的 在这一研究领域，合乎逻辑的下一步是进行第一次严格的全面性健康试验。 坦桑尼亚卫生专业人员的培训课程。有三个具体目标。目标1是进行 坦桑尼亚性保健服务提供的社会生态需求评估。以确定是否 助产，护理，医学和相关健康科学的学生将受益于一个课程或单独的 根据学科量身定制的课程，我们将进行焦点小组（每个学科3人）。我们还将进行 与关键线人进行个别访谈，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，确保它适合坦桑尼亚/撒哈拉以南地区的文化背景，并进行试点测试。 3是评估非洲为基础的，文化上适当的，性健康课程的有效性。我们将 根据候补名单对照评估对课程进行随机、对照、单盲试验 对性健康知识、态度和咨询技能的影响（每组n=206名学生;共412名）。 假设将测试课程是否有效，以及它是否对一个学科更有效， 另如果有效，MUHAS承诺为所有健康学生实施课程。给定 MUHAS在整个非洲的健康学生教育方面表现出色，本研究评估的课程 这是一个很有可能被广泛采用的新标准，为整个非洲的卫生专业人员提供培训。

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.