The training programme at Baylor – Uganda was developed in 2003. The aim of the programme is to strengthen and enhance continuing medical education and pre – service and in-service skills building for health professionals involved in the management of paediatric HIV/AIDS care and treatment.
To-date, over 2000 national and international health professionals have been trained. The training has been conducted in collaboration with the Department of Pediatrics and Child Health of Makerere University, Baylor International Pediatric AIDS Initiative (BIPAI), Ministry Of Health (MoH) and African Network for the Care of Children Affected by HIV/AIDS (ANECCA).
A total of ninety nine trainings were carried out in the period running from 1st July, 2008 – 30th June, 2009. Females still account for more than half the number of trainees.
The table below shows the number of health care providers trained by course.
Type of Training |
Number of trainings |
F |
M |
Total |
Community Home Based Care & Support |
9 |
165 |
194 |
359 |
Dry Blood Spot (DBS) |
52 |
352 |
287 |
622 |
Good Lab Practices |
1 |
19 |
20 |
39 |
Infant Feeding |
3 |
64 |
16 |
80 |
10-day Paediatric HIV/AIDS Counseling |
4 |
97 |
21 |
118 |
5-day Paediatric HIV/AIDS Management |
22 |
369 |
228 |
597 |
Positive Prevention |
2 |
49 |
8 |
57 |
Routine Counseling and Testing |
2 |
37 |
21 |
58 |
Training of Trainer (TOT) |
3 |
29 |
30 |
59 |
Total number trained |
|
1181 |
825 |
1989 |
Pre-Service training
Currently, Baylor-Uganda is training interns and post graduate students from Makerere University Medical School in paediatric HIV/AIDS management. The training is done to ensure that the students acquire necessary skills and competencies to establish and manage paediatric HIV/AIDS services. This programme will soon be extended to schools for clinical officers and nurses.
In 2008/2009, eighty three medical students (interns/postgraduates) from Makerere University benefited from a five -day paediatric HIV/AIDS management training. In addition, twelve undergraduate students from Kampala International, Makerere, Kyambogo and Mukono universities undertook internship in the counseling, home health, laboratory, social work and human resources departments at the Baylor-Uganda COE.
In-Service training
In March 2008, the five - day instructive training programme was revised to include clinical placement and on-site mentorship. This formed a more comprehensive three-pronged competency-focused and results based training approach that takes approximately three months to complete.
In the last twelve months, 1469 health professionals were trained. A total of 42 regional paediatric “experts “were oriented in mentorship skills so as to develop a local and sustainable clinical mentorship programme and enhance mentorship outcomes.
Distribution of trainees in Paediatric HIV/AIDs Management by Cadre
Cadre |
Number trained |
Percentage |
Doctors |
107 |
18% |
Clinical Officers |
132 |
22% |
Degree Nurses |
32 |
5% |
Registered Nurses |
56 |
9% |
Enrolled Nurses |
211 |
35% |
Nursing Assistants |
28 |
5% |
Others |
31 |
5% |
Total |
597 |
100% |
Continuous Professional Development
To continuously update health practitioners on issues and developments in paediatric HIV/AIDS care and treatment weekly continuous medical education (CMEs) and organisational learning sessions are conducted for staff and others from nearby health institutions.
Mentorship and support supervision
In order to consolidate the knowledge given and ensure that it is translated into practice, three on-site mentorship visits are carried out in the facilities where trainees are placed. Only those who are able to provide standard care, including enrolling of at least five children are graduated with a certificate of competence. To-date, 281 (47%) have been graduated.
Facilities with a high proportion of health care providers and those that attain strengthened systems are graduated to support supervision. To date twenty three out of the thirty three health facilities have achieved support supervision status.
Gains of the programme
Determining knowledge gain is key in determining the success of the training programme. In order to do this, pre and post tests are given to trainees before and after each didactic training. The graph below shows the knowledge gain among trainees by cadre.
Pre-test and Post test Performance of trainees by cadre
The overall average pre-test score among the trainees was 59% while the post test score was 72%. This shows that trainees gained knowledge on paediatric HIV/AIDS standard care practices though both differed among the different cadres as shown above
What we look forward to
- Strengthening pediatric HIV/AIDS in pre-service training
- Developing post training support program mechanisms and updates (journals, pamphlets, CD-ROMs and review meetings)
- Developing a monitoring and evaluation framework for clinical mentorship
- Training expert clients in basic pediatric HIV/AIDS management
- Supporting the Makerere University Department of Pediatrics and Child Health in the development of a national paediatric training curriculum aimed at consolidating and harmonising paediatric HIV/AIDS care and treatment training in the country.