In settings with a high HIV/TB burden and significant shortages of human resources for health (HRH), task shifting strategies have relied on lay workers to provide HIV testing and counselling (HTC) and adherence support for HIV and TB treatments. While in some countries these tasks were integrated into the work of existing community cadres such as community health workers, new basic cadres have been created and trained in other countries, supported mainly through international funds. Agreements made with donors have mostly been to provide temporary support until a long-term solution was found. Unfortunately, there are few examples where Ministries of Health have been able to absorb lay counsellors into their health system or otherwise sustain their work.
In this report (HIV/TB counselling: Who is doing the job?) we aim to document the role of lay counsellors in HTC and adherence support and assess bottlenecks related to operationalisation and sustained support in selected countries. We compare the experiences around lay counsellors providing HIV/TB care in a convenience sample of eight countries across sub-Saharan Africa: Guinea, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Zambia, and Zimbabwe. Sources of information include literature reviews; review of national policies; annual reviews of health sectors in different countries; donor proposals; and key informant interviews with government staff and partners around harmonisation of approaches (including job profiles, training, supervision and entry criteria), inclusion in national strategies, and financing of lay counsellors.
To access the report, please click here.
A High Level Regional Meeting on the role of lay counsellors in HIV testing and adherence support was organized in Johannesburg in April 2015. The meeting was attended by a group of 40 key senior participants from the Ministries of Health, Finance and Public Service as well as representatives of Civil Society Organizations, people living with HIV from Lesotho, Malawi, Mozambique, Swaziland, Republic of South Africa, Zambia and Zimbabwe, and donors. The meeting allowed for an exchange of experiences and approaches for improving integration, recognition and sustained financing for counsellors in enhancing quality HIV and TB treatment, care and support services. Recommendations put forward during this meeting can be found by clicking here (Johannesburg Declaration).
- Date September 3, 2015
- Tags HIV, Patient education and counseling