Task-shifting HIV counselling and testing services in Zambia: the role of lay counsellor
Date
2009
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Human Resources for Health
Abstract
Background: The human resource shortage in Zambia is placing a heavy burden on the few health
care workers available at health facilities. The Zambia Prevention, Care and Treatment Partnership
began training and placing community volunteers as lay counsellors in order to complement the
efforts of the health care workers in providing HIV counselling and testing services. These
volunteers are trained using the standard national counselling and testing curriculum. This study
was conducted to review the effectiveness of lay counsellors in addressing staff shortages and the
provision of HIV counselling and testing services.
Methods: Quantitative and qualitative data were collected by means of semistructured interviews
from all active lay counsellors in each of the facilities and a facility manager or counselling supervisor
overseeing counseling and testing services and clients. At each of the 10 selected facilities, all
counselling and testing record books for the month of May 2007 were examined and any
recordkeeping errors were tallied by cadre. Qualitative data were collected through focus group
discussions with health care workers at each facility.
Results: Lay counsellors provide counselling and testing services of quality and relieve the
workload of overstretched health care workers. Facility managers recognize and appreciate the
services provided by lay counsellors. Lay counsellors provide up to 70% of counselling and testing
services at health facilities. The data review revealed lower error rates for lay counsellors,
compared to health care workers, in completing the counselling and testing registers.
Conclusion: Community volunteers, with approved training and ongoing supervision, can play a
major role at health facilities to provide counselling and testing services of quality, and relieve the
burden on already overstretched health care workers.
Description
Research Article
Keywords
human resource, Zambia, Care and Treatment, HIV counselling