Presentation 2 HIV AND AIDS INTEGRATION INTO NURSING AND MIDWIFERY CURRICULA AND CLINICAL PRACTICE IN BOTSWANA A podium presentation at the 3 rd Commonwealth Nurses and Midwives Conference, London, UK, March 12 th to 13 th 2016 By Mabel K.M. Magowe, Khumo Modisaeman, Glan Tebogo Tshenyego, Galeagelwe Baikepi, & Gaboelwe Rammekwa
OUTLINE Introduction and background Purpose Objectives Methods Results Discussion of the findings Conclusion
INTRODUCTION AND BACKGROUND HIV prevalence remains high in Botswana There is little evidence of decline. Prevention and care programs implemented by nurses and midwives Many training programs targeted to this cadre There is observable gap in the distribution of HIV and training NMCB developed a CPD framework Need to integrate HIV and AIDS into the national CPD framework
PURPOSE OF THE STUDY To examine the integration of HIV and AIDS content in in-service and pre-service curricula and clinical practice To guide this integration and to scale up HIV and AIDS service delivery.
SPECIFIC OBJECTIVES To analyze existing the nursing and midwifery curricula to determine coverage of HIV and AIDS care content To explore perceptions of nurses about the training they received and coverage of HIV and AIDS content in their training Identify gaps that exist in HIV/AIDS education and service for nurses and midwives in Botswana To utilize this information to refine the draft CPD program to address HIV/AIDS content and practice.
METHODS Descriptive cross sectional mixed method formative research Document review, In-depth qualitative interviews and quantitative survey methods Among nurses and midwives recruited in selected hospitals in Botswana Purposive sampling Ethical clearance, permissions from facilities, and informed consent Qualitative data were content analysed for themes Quantitative analysis in SPSS, presented in frequency distributions
RESULTS: PARTICIPANT CHARACTERISTICS Department where respondents works : Frequency Percentage Clinical services: Paediatrics, accident and emergency, maternity 31 34 Local clinic/health post 24 26.4 MOH Headquarters under policy relations and partnerships development, health sector 4 4.4 Institute of Health sciences(ihs)coordination 4 4.4 Nursing school 20 22.0 Clinical research 4 4.4 Attorney General s 1 1.1 University of Botswana 4 4.4 Total 92 100
SURVEY RESULTS 80 (87% had attended HIV and AIDS pre or either in-service courses: With the following content: Antiretroviral therapy (ART) management ART dispensing HIV & TV infections co-management HIV/AIDS counselling & testing, Paediatric HIV/AIDS Early infant HIV testing PMTCT
SURVEY RESULTS Duration of the training: 4.4% attended for less than one day, 46.6% attended for 3-5 days, 24% for 5 to 10 days 3.3% attended for more than 10 days, and the remaining were not sure Provider of the training: Ministry of Health, in Gaborone Adequacy of the training 90.1% said it was adequate Access: 75.6% said it was widely available to most colleagues
SURVEY RESULTS HIV/AIDS course attended N Yes N NO Fundamentals of HIV/AIDS 70 76.9 21 23.1 HIV/AIDS Counselling & testing 36 40.0 54 60.0 Paediatric HIV/AIDS 30 33.3 60 66.7 HIV & TV infections co-management 16 17.8 74 82.2 Early infant HIV testing 30 33.3 60 66.7 PMTCT 30 33.3 60 66.7 ART General training 62 68.9 28 31.1 ART dispensing 18 20.0 72 80.0
RESULTS: DOCUMENT (CURRICULA) REVIEW Health training institutions and University of Botswana (UB) UB utilizes the infusion approach and stand-alone courses HIV/AIDS Education, Prevention and Control core course Content infused into most nursing course units or topics There is an officer responsible curriculum integration None in the basic sciences except biological sciences
INSTITUTES OF HEALTH SCINCES (HIS) No responsible officer to ensure curriculum integration No stand alone courses Infusion into all programs within courses, units or topics Topics, Content not necessarily focused All students get to learn some HIV and AIDS content But may miss the core detailed introductory content
DISCUSSION The HIV and AIDS training is available In-service training is guided by work place of work and need But the basics should be offered to all The training is largely centralized and involving travel time Some nurses make individual effort to obtain training privately The UB curricula needs to strengthen the infusion in sciences IHS s need stand-alone courses and coordination
CONCLUSION stand-alone courses needed to provide detail Monitoring and evaluation needed to assess integration The integration of HIV and AIDS content into the CPD program not easy The point approach was utilized Hence any training in HIV and AIDS earns 5 CPD points