Background: Blood was collected in district hospitals (DH), sent for HIV testing by ELISA at the National Antiretroviral Reference Laboratory (NARL) in Kigali and results retuned to clients. The National AIDS Control Program requested CARE Rwanda to assist in the decentralization of HIV/AIDS counseling services.
Objective: Increase accessibility to HIV/AIDS counseling services in district hospital in Rwanda.
Methods: Eighteen trainers from CARE and partners were recruited and trained for 6 weeks. They trained 4 nurses and social workers from each DH on HIV/AIDS counseling for 2 weeks (Module 1). A qualitative assessment using in-depth interviews and FGD with DH medical directors, counselors' colleagues and PLWHA was conducted.
Results: 156 counselors were trained. The mean age was 28 (± 5) years, 75% were women, 53% nurses, 34% social workers, and other 6%. Strong points: mean number of clients increased from 2 to 25 per day; confidentiality maintained; better collaboration among paramedical personnel; lectures on HIV/AIDS given. Weak points: counseling is not yet integrated and recognized as essential DH service; high risk of burn out; no outreach community service; DH still depend on NARL Kigali for ELISA blood screening while delays in results discourage potential clients.
Conclusion: Counseling should be recognized in DH. Counselors should be organized in support groups and more trained to meet demand. DH should screen blood samples with rapid tests.
Learning Objectives: Discuss the impact of decentralized health care services on HIV/AIDS testing in Rwanda. Identify effective program strategies to increase client numbers in HIV counseling and testing programs.
Keywords: HIV/AIDS, International Reproductive Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment