Scaling up HIV/AIDS trainings for nurses and auxiliary nurse midwives

Background

Nurses and Auxiliary nurse midwives (ANMs) have a central role in providing care and support to people living with HIV (PLHIV) and can address stigma/discrimination. Global Fund supported the Indian Nursing Council (INC) and the National AIDS Control Organisation (NACO),India to implement a project  by Futures Group and partners (2008-2013) to train and empower staff nurses and ANM in providing better care and treatment to HIV patients through 55 Nursing training institutions across  640 districts in India.

Method

95000 nurses were trained by 848 master trainers (nurses themselves), through a six-day curriculum on HIV care and management;  a large focus on addressing stigma/discrimination and counselling. A similar three-day training package was developed for 8000 ANMs at the primary health care facilities. The ANM training package was developed in 11 Indian languages. Project impact assessment compared results of 2010 and 2013.  Trainers provided ongoing periodic supportive supervision.

Results

Satisfaction levels of nurses’ services accessed by PLHIV improved from 58% in 2010 to 70% in 2013. Counselling on treatment adherence and referrals improved. Almost 100% of PLHIV reported returning to the same ART center for continuation of treatment. Global Fund extended the project for two more years to include nurse from peripheral health facilities and private hospitals. Tuberculosis management was  addedto the training curriculum.

Conclusions

Nurses as master trainers are effective in training nurses. Addition of continuous supportive supervision to classroom training can improve quality of training resulting in improved nursing care for PLHIV and marked reduction in stigma and discriminatory practices in health facilities.