Prevention of mother to child transmission lay counsellors: Are they adequately trained?

Abstract

South Africa's high prevalence of human immunodeficiency virus (HIV) infected women requires a comprehensive health care approach to pregnancy because of the added risk of their HIV status. As a result of the shortage of health care workers in South Africa, lay counsellors play important roles in the prevention of mother to child transmission of HIV (PMTCT). There is no standardization of training of lay counsellors in South Africa, and training varies in length depending on the training organisation. The study aimed to investigate the training of lay counsellors by analysing their training curricula and interviewing lay counsellors about their perceptions of their training. A two phase research method was applied. Phase one documented an analysis of the training curricula. Phase two was semi-structured interviews with the participants. Purposive sampling was undertaken for this study. The total sample size was 13 people, with a final sample of 9 participants, determined at the point of data saturation. The research was qualitative, descriptive and contextual in design. The curricula analysed had different styles of delivery, and the approaches to learning and courses varied, resulting in inconsistent training outcomes. A need for supervision and mentorship in the working environment was also noted. The training of lay counsellors needs to be adapted to meet the extended roles that they are playing in PMTCT. The standardization of training programmes, and the incorporation of a system of mentorship in the work environment, would ensure that the lay counsellors are adequately prepared for their role in PMTCT.

Evaluation of the HIV lay counselling and testing profession in South Africa

“…Similar studies in this area indicated that many counsellors were found to be untrained [ 11 , 16 ]. Studies have indicated that training varies in length and content, depending on the training organisation [ 17 ], as was the case in this study, as they received training from different HCT organisations. Although not ascertained in this study, there could also be variation of training among lay counsellors in the same health facility.…”

The cost of caring: secondary traumatic stress and burnout among lay trauma counsellors in the Western Cape Province

“…Lay counselling represents one such service. Lay counsellors in South Africa are non-professional service providers and typically have no formal qualifications or professional certificates and are not affiliated with a professional regulatory body (Thurling & Harris, 2012). They provide social and emotional support and are most active in the provision of trauma counselling, education related to the prevention of gender-based violence, pre- and post-test HIV counselling, and counselling services related to promoting medication adherence for chronic medical health problems (Jansen van Rensburg, 2008; Peltzer, 2012).…”

The emotional wellbeing of lay HIV counselling and testing counsellors

“…Non-parametric tests were used to compare the scores Research on HCT mostly focuses on the implementation challenges (Friedman et al, 2007) and effectiveness of services (Myint & Mash, 2008; and the experiences of HCT counsellors (Mavhandu-Mudzusi et al, 2007;Richards and Marquez, 2005;Rohleder & Swartz, 2005). The governance, remuneration, lack of training and supervision and management of lay counsellors were identified as crucial challenges in implementation (Daniels et al, 2010;Friedman, 2005;Peltzer & Davids, 2011;Schneider et al, 2008;Thurling & Harris, 2012). A few studies evaluated the ability of lay counsellors to implement counselling.…”