South Africa
Spotlight: I-TECH Curricula Review for the Mpumalanga RTC
In order to educate health care workers (HCWs), the Mpumalanga Regional Training Centre (MRTC) conducts numerous, lengthy, trainings, often taking HCWs away from their jobs and reducing the care available to patients. To address this concern, MRTC requested consultant services from the CDC to review each training curriculum and provide recommendations for integration and revision of existing HIV, AIDS, STI, and TB (HAST) training programs. The goal was to streamline curricula to effectively train HCWs while reducing their time away from work. The CDC identified I-TECH as a collaborating partner to support the MRTC with this process as well as overall training development
In this context, I-TECH reviewed existing curricula and made recommendations. The team also evaluated stakeholder input, created a task team for training, piloted the curriculum, and developed a training-of-trainers program. The revised training model includes a comprehensive Basic HAST course, which was finalized and delivered to the MRTC in August 2009, and four specialized courses (TB/HIV, STIs, Counselling, and Maternal and Child Health).
Training Materials
- Basic HIV, AIDS, STI and TB Course for Health Care Workers
- Training of Trainers: Basic HIV, AIDS, STI and TB Course for Health Care Workers
Data on HIV and AIDS
South Africa’s AIDS epidemic is generalized to the entire population. Some current data are reflected below.
- The national HIV prevalence rate among adults (ages 15–49) is 18.1%.
- South Africa has the world’s highest number of people living with HIV.
- Half of all hospital admissions in South Africa are attributed to AIDS.
- As of September 2008, there were close to 1 million individuals receiving antiretroviral therapy (Reference: UNAIDS, Report on the Global AIDS Epidemic, 2008.).
Overview
Since 2003, I-TECH has been working in South Africa at the request of the National and Provincial Departments of Health (DOH) and the Centers for Disease Control and Prevention’s Global AIDS Program (CDC GAP) South Africa, to help implement the South African government’s operational plan for comprehensive HIV and AIDS care, management, and treatment.
I-TECH was initially invited to work in South Africa to develop and implement a national training center initiative, specifically at the Regional Training Centre (RTC) in the Eastern Cape Province. The nine South African provincial RTCs, also known as the Health Promotion and Quality Assurance (HPQA) centres, are responsible for training health care workers in the care and treatment of HIV and AIDS as well as sexually transmitted infections (STI), tuberculosis (TB), and other diseases associated with HIV.
I-TECH was legally registered in South Africa in May 2008, and currently employs 12 staff, with a central office in Pretoria and a smaller office in East London. It currently supports training, curricula development, systems strengthening, monitoring and evaluation, and organizational development of provincial RTC sites, including the Eastern Cape, Mpumalanga, Limpopo, and the Free State. It also supports clinical mentoring through a subcontract with the University of California, San Diego (UCSD).
In 2009, I-TECH SA, as a sub-partner with the National Alliance of State and Territorial AIDS Directors (NASTAD), received an award from the CDC to focus on improving and strengthening the linkage between provincial and district-level responses to HIV and AIDS care and prevention in Free State and Mpumalanga provinces.
Program Highlights
Clinical Mentoring. The clinical mentoring program for I-TECH South Africa was initiated in 2003 through a subcontract with UCSD, and is under the direction of Dr. Chris Mathews. Mentors are comprised of faculty and infectious disease fellows as part of the Owen Clinic, an HIV and AIDS specialty clinic. In addition to direct clinical mentoring, mentors provide ongoing clinical consultation on complicated cases via telephone, personal visits, and email. The program also includes a weekly clinical conference call initiated by UCSD that is open to all South African providers. The long-term strategy for the clinical mentoring program is to support the development of local, sustainable clinical mentoring programs at the HPQA centers, as appropriate and feasible.
Training Development and Activities. I-TECH's work in curriculum development, training, and distance learning has significantly scaled up, with substantial projects underway in Mpumalanga and Limpopo
provinces.
For the Future
I-TECH will continue to scale up in order to expand projects into other provinces and incorporate HIV prevention activities into existing work. I-TECH is working with MRTC to develop a broader training mission, link didactic training to mentoring, and use baseline assessments of key clinical indicators at health care facilities to monitor the outcomes of training interventions in the long term. The team also expects to take the final HAST and specialized course trainings (see "Spotlight") to the National Department of Health for potential use at the national level. Additional training development activities include prevention with positives materials and a comprehensive HIV care and treatment course to support I-TECH’s new work under the NASTAD grant.
