India
Spotlight: Training of Trainers at the Government Hospital of Thoracic Medicine
I-TECH has been actively working with staff at the Government Hospital of Thoracic Medicine (GHTM), which sees an estimated 30,000 HIV and AIDS patients a year. All nurses, as well as some ancillary staff have been trained on basics of HIV, symptom management, opportunistic infections, psychosocial issues, and palliative care.
To sustain continuing education at the hospital, a group of master trainers was established. These nurses, counselors, and nutritionists are helping to train physicians and other nurses about antiretroviral therapy (ART), as well as training ancillary hospital staff on infection control.
Ms. Devika, one of the GHTM master trainers, was asked at the last minute to conduct a training on nutrition for visiting Department of Public Health students. In a short span of time, she developed a presentation using the participatory methods she had learned during her I-TECH-led training of trainer (TOT) sessions. She conducted an energizer and then a brief presentation, which she continued even when there was no electricity by using other training methods, such as discussion of case studies. "I realized today how valuable the teaching techniques I had learned from I-TECH were, as I was able to practically put them to good use," she said.
The students gave her great feedback, expressing interest in working at GHTM in the future. When thanking the superintendent of the hospital for their visit, they especially requested that additional time be allowed for similar sessions the next time around.
Overview
I-TECH has been working in India since 2003 to equip health workers with enhanced knowledge and skills to care for people with HIV. I-TECH aims to enhance human capacity for HIV care and support in high-prevalence states in India through trainings and clinical mentoring visits at hospitals, antiretroviral treatment centers, non-governmental organizations, and other health centers. I-TECH runs an HIV fellowship program and a clinical consultation warm line for HIV clinicians, and is working on a national training website that will link the 11 National AIDS Control Organization (NACO)-sponsored regional training centers across India. I-TECH is also finalizing a comprehensive HIV and AIDS national curriculum for HIV specialists, medical officers, and nurses.
Program Highlights
Developing HIV Physician Leaders. The I-TECH HIV Fellowship Program at the Government Hospital of Thoracic Medicine (GHTM) in Chennai is an innovative year-long clinical training program supported by the Government of Tamil Nadu and the US Centers for Disease Control and Prevention (CDC) that prepares junior and mid-level physicians to be leaders in HIV-related care and support, education, and research in India. Fellows gain necessary skills to provide high quality HIV patient care through a variety of participatory training methods. For more information, refer to the HIV Fellowship Program brochure (PDF). I-TECH also supports GHTM with trainings for NACO-nominated HIV specialists and medical officers from all over India.
Expanding the Role of Nurses. I-TECH augments nurses' knowledge, skills, and practices by instilling confidence through training and capacity-building activities for its partners. Two of the latest curricula include a 13-module training for nurses on HIV and AIDS care, Empowering Nurses to Deliver HIV/AIDS Nursing Care and Education (ENHANCE), and a hands-on infection-control curriculum, Nurse Infection Control Education (NICE). In addition to enhancing knowledge and skills on HIV care and treatment among nurses, these trainings encourage task shifting from doctors to nurses, enabling them to reach more patients.
Ongoing activities include training of trainers, as well as trainings on HIV and AIDS, infection control, and home-based care. Continuing nursing education is also conducted through monthly Nurse Clinical Society Meetings at GHTM.
New Initiatives and Training Materials
Reaching Clinicians through a Clinical Consultation Line. The warmline, which provides access to HIV physicians for clinical guidance, support physicians in the application of clinical skills learned during NACO trainings for care of HIV-positive patients; the warm line will eventually be expanded to any clinician providing HIV and AIDS care in India.
Linking Up the Regional ART Training Centers. I-TECH is connecting 11 regional ART training centers through the development of an umbrella website. This website will act as a clearinghouse for HIV training resources with the goal of supporting these centers to provide high quality care and to train other physicians. This website will also have intranet and database capacity to provide training on management information systems (MIS) reports and to provide online continuing medical education courses in the future.
Development of a TOT Package for Follow-up Counseling Toolkit. I-TECH has developed a training package to assist CDC partners with the roll out of a comprehensive Follow-Up Counseling Toolkit for HIV counselors in India.
Development of Videos for Trainings. I-TECH is developing a number of videos for trainings, including:
- A set of ten short case videos on classic opportunistic infections found in HIV and AIDS patients and accompanying Facilitator Guide for training clinicians in both pre-service and in-service capacities.
- Jyothi's Hope: Living Positively, Part II: A short trigger video about Jyothi, who has AIDS, and her family. The video addresses stigma and treatment adherence issues and has messages on prevention with positives.
- Nursing video: This is a brief video focusing on how to develop and implement an individualized nursing care plan for people living with HIV and AIDS based on the collection of a comprehensive patient history.
