Couples’ voluntary HIV counseling and testing provider training evaluation, Zambia

• Type of Material: Article
• Authors: Kathleen Y Wu, Emory University; Marydale Oppert, Emory University; Kristin M Wall, Emory University; Mubiana Inambao, Emory University; Matildah K Simpungwe, Emory University; Nurilign Ahmed, Emory University; Joseph F Abdallah, Emory University; Amanda Tichacek, Emory University; Susan Allen, Emory University
• Language: English
• Date: 2017-01-23
• Publisher: Oxford University Press (OUP): Policy B - Oxford Open Option D
• Publication Version: Final Published Version
• Copyright Statement: © The Author 2017. Published by Oxford University Press.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/heapro/daw108
• Title of Journal or Parent Work: Health Promotion International
• ISSN: 0957-4824
• Volume: 33
• Issue: 4
• Start Page: daw108
• End Page: daw108
• Grant/Funding Information: The contents do not necessarily reflect the views of USAID or the United States Government.; This study was made possible by the generous support of the American people through the United States Agency for International Development (USAID).; This study was also supported by the AIDS International Training and Research Program Fogarty International Center (D43 TW001042); the Emory Center for AIDS Research (P30 AI050409); and the International AIDS Vaccine Initiative.; This work was supported by funding from the Canadian International Development Agency (PATH-CIDA CID.1450-08863-sub) and the US National Institutes of Health (NIH 5R01 MH095503).; The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
• Keywords: HIV/AIDS prevention; Zambia; task shifting; CVCT; training evalutaion
• Research Categories: Health Sciences, Public Health; Sociology, Public and Social Welfare

Abstract

With the expansion of couples’ voluntary HIV counseling and testing (CVCT) in urban Zambia, there is a growing need to evaluate CVCT provider trainings to ensure that couples are receiving quality counseling and care. We evaluated provider knowledge scores, pre- and post-training and predictors of pre- and post-training test scores. Providers operating in 67 government clinics in four Copperbelt Province cities were trained from 2008 to 2013 in three domains: counseling, rapid HIV laboratory testing and data management. Trainees received pre- and post-training tests on domain-specific topics. Pre- and post-training test scores were tabulated by provider demographics and training type, and paired t-tests evaluated differences in pre- and post-training test scores. Multivariable ANCOVA determined predictors of pre- and post-training test scores. We trained 1226 providers, and average test scores increased from 68.8% pre-training to 83.8% post-training (p < 0.001). Test scores increased significantly for every demographic group and training type (p < 0.001) with one exception—test scores did not significantly increase for those receiving counseling or data management training who had less than a high school education. In multivariable analysis, higher educational level and having a medical background were predictive of a higher pre-test score; higher pre-test scores and having a medical background were predictive of higher post-test scores. Pre- and post-test assessments are critical to ensure quality services, particularly as task-shifting from medical to lay staff becomes more common. Assessments showed that our CVCT trainings are successful at increasing knowledge, and that those with lower education may benefit from repeat trainings.