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Investing in the Future: Impacting Real Lives

Effectiveness of three models of providing post training support for capacity building in Pediatric HIV management. Presented by Dr Umaru Ssekabira- Training department of the Infectious Diseases Institute(IDI) College of Health Sciences M akerere University-Kampala Uganda.

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Investing in the Future: Impacting Real Lives

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  1. Effectiveness of three models of providing post training support for capacity building in Pediatric HIV management. Presented by Dr Umaru Ssekabira- Training department of the Infectious Diseases Institute(IDI) College of Health Sciences Makerere University-Kampala Uganda. Presented at “The second HIV capacity Building Partner’s Summit-Birchwood Hotel and conference Centre Johannesburg, South Africa March 19-21, 2013” Investing in the Future: Impacting Real Lives

  2. Background information • Building and maintaining Health care workers (HCW) capacity for HIV patient mgmt.- is critical given the rapidly changing guidelines. • In service & pre-service training equips, refreshes HCW knowledge and skills. • Post training support- vital for continuing professional development and knowledge & skills retention. • Most commonly utilized approaches are costly; • onsite follow up, • mentoring and coaching. • Widespread use of mobile phones for short messages (SMS) and phone call reminders. • IDI implemented and evaluated three models of providing post training support for pediatric HIV care in Uganda. Investing in the Future: Impacting Real Lives

  3. Objectives General Objective: • To compare the effectiveness of three models of providing post training support for capacity building in Pediatric HIV management. Specific objectives • To compare the effectiveness of the three models of post-training support . • To determine whether there was a difference in knowledge retention amongst the three models. • To identify the most cost effective model of providing post-training support • To identify the effectiveness of computer based, phone calls and SMS messages in evaluating training. Investing in the Future: Impacting Real Lives

  4. Description of context • Study was conducted in 18 HF in 6 rural districts of south western Uganda. • The six districts are part of a group of nine districts with accelerated HIV program implementation courtesy of an IDI-CDC funded project. • Healthcare workers ( clinical officers, nurses & midwives) involved in Management of Pediatric HIV patients were recruited. • Good coverage with Mobile phone network • Widespread use of mobile phones for SMS and phone calls, internet. • Facilitation for field visits and presence of staff Investing in the Future: Impacting Real Lives

  5. Methodology • Baseline assessment in all health facilities including Technology literacy and resources assessment. • 5 day classroom based Pediatric ART Management course for 72 HCW • Introduction to mobile phone based learning included • Random allocation of facilities to three models; • blended- onsite and distance follow up support. 25 HCW • distance follow up- received weekly SMS quiz questions, reminder texts of key messages from training and voice calls. 23 HCW • Onsite (control)- CMEs, case scenarios-24 HCW • Post training support for three months • Access to assistance via the IDI toll-free line for patient management problems. Investing in the Future: Impacting Real Lives

  6. 5 Key interventions-Study profile Investing in the Future: Impacting Real Lives

  7. Assessment of OutcomesKnowledge retention evaluated at 4 times using MCQ test Comparison of scores at T2 and T4 using T test and Annova Investing in the Future: Impacting Real Lives

  8. Assessment Knowledge retention assessed by • Assessment of scores of in the post test for all groups • For blended and distance post-training evaluation includes: • Evaluation of SMS quiz responses • Evaluation of computer based assessment responses Investing in the Future: Impacting Real Lives

  9. Challenges and counter-strategies employed • Staff Absenteeism/ trainee drop out. • Heavy clinic days • Participants reluctant to answer phone calls • Funding for onsite support Investing in the Future: Impacting Real Lives

  10. Distribution of participants by gender Investing in the Future: Impacting Real Lives

  11. Evidence of success and achievementsMean percentage scores with all included Investing in the Future: Impacting Real Lives

  12. Mean percentage scores with absentees excluded Investing in the Future: Impacting Real Lives

  13. Comparison of mean scores across interventions

  14. Lessons learnt There is need to create a special relationship with trainees in the distance mode to increase their receptiveness to the intervention. Investing in the Future: Impacting Real Lives

  15. Conclusions • Results show no difference in knowledge retention amongst the three arms • Post training support using distance learning methods could be as effective as onsite • Need for a randomized controlled trial with a bigger sample size to confirm findings Investing in the Future: Impacting Real Lives

  16. ACKNOWLEGEMENTS • Outreach services department • Extended Kibale Kiboga Project • Centers for Diseases Control-Uganda • The 6 District Health Teams • The 18 health facilities • Training department staff • Participants

  17. Thank You Investing in the Future: Impacting Real Lives

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