Publication: Evaluation of the HIV lay counselling and testing profession in South Africa
Issued Date
2015
Resource Type
Language
eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Health Services Research. Vol.15, (2015), 278
Suggested Citation
Mwisongo, Aziza, Mehlomakhulu, Vuyelwa, Mohlabane, Neo, Peltzer, Karl, Mthembu, Jacque, Rooyen, Heidi Van Evaluation of the HIV lay counselling and testing profession in South Africa. BMC Health Services Research. Vol.15, (2015), 278. doi:DOI 10.1186/s12913-015-0940-y Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/3222
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Thesis
Title
Evaluation of the HIV lay counselling and testing profession in South Africa
Other Contributor(s)
Abstract
Background: With the launch of the national HIV Counselling and Testing (HCT) campaign in South Africa (SA), lay
HIV counsellors, who had been trained in blood withdrawal, have taken up the role of HIV testing. This study evaluated
the experiences, training, motivation, support, supervision, and workload of HIV lay counsellors and testers in South
Africa. The aim was to identify gaps in their resources, training, supervision, motivation, and workload related to HCT
services. In addition it explored their experiences with providing HIV testing under the task shifting context.
Methods: The study was conducted in eight of South Africa’s nine provinces. 32 lay counsellors were recruited from 67
HCT sites, and were interviewed using two questionnaires that included structured and semi-structured questions. One
questionnaire focused on their role as HIV counsellors and the other on their role as HIV testers.
Results: Ninety-seven percent of counsellors reported that they have received training in counselling and testing.
Many rated their training as more than adequate or adequate, with 15.6 % rating it as not adequate. Respondents
reported a lack of standardised counselling and testing training, and revealed gaps in counselling skills for specific
groups such as discordant couples, homosexuals, older clients and children. They indicated health system barriers,
including inadequate designated space for counselling, which compromises privacy and confidentiality. Lay counsellors
carry the burden of counselling and testing nationally, and have other tasks such as administration and auxiliary duties
due to staff shortages.
Conclusions: This study demonstrates that HCT counselling and testing services in South Africa are mainly performed
by lay counsellors and testers. They are challenged by inadequate work space, limited counselling skills for specific
groups, a lack of standardised training policies and considerable administrative and auxiliary duties. To improve HCT
services, there needs to be training needs with a standardised curriculum and refresher courses, for HIV counselling
and testing, specifically for specific elderly clients, discordant couples, homosexuals and children. The Department of
Health should formally integrate lay counsellors into the health care system with proper allocation of tasks under the
task shifting policy.