An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa

HIV counseling and testing (HCT) has been prioritized as one of the prevention strategies for HIV/AIDS, and promoted as an essential tool in scaling up and improving access to treatment, care and support especially in community settings. Home-based HCT (HBHCT) is a model that has consistently been f...

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Main Authors: Vuyolwethu Magasana, Wanga Zembe, Hanani Tabana, Reshma Naik, Debra Jackson, Sonja Swanevelder, Tanya Doherty
Format: Article
Language:English
Published: Taylor & Francis Group 2016-01-01
Series:SAHARA-J
Subjects:
Online Access:http://dx.doi.org/10.1080/17290376.2016.1248477
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spelling doaj-57d3dcd52fb24bd19c98be89347a0a652020-11-25T00:14:28ZengTaylor & Francis GroupSAHARA-J1729-03761813-44242016-01-0113118819610.1080/17290376.2016.12484771248477An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South AfricaVuyolwethu Magasana0Wanga Zembe1Hanani Tabana2Reshma Naik3Debra Jackson4Sonja Swanevelder5Tanya Doherty6Health Systems Research Unit, South African Medical Research CouncilHealth Systems Research Unit, South African Medical Research CouncilHealth Systems Research Unit, South African Medical Research CouncilHealth Systems Research Unit, South African Medical Research CouncilSchool of Public Health, University of the Western CapeBiostatistics Unit, South African Medical Research CouncilHealth Systems Research Unit, South African Medical Research CouncilHIV counseling and testing (HCT) has been prioritized as one of the prevention strategies for HIV/AIDS, and promoted as an essential tool in scaling up and improving access to treatment, care and support especially in community settings. Home-based HCT (HBHCT) is a model that has consistently been found to be highly acceptable and has improved HCT coverage and uptake in low- and middle-income countries since 2002. It involves trained lay counselors going door-to-door offering pre-test counseling and providing HCT services to consenting eligible household members. Currently, there are few studies reporting on the quality of HBHCT services offered by lay counselors especially in Sub-Saharan Africa, including South Africa. This is a quantitative descriptive sub-study of a community randomized trial (Good Start HBHCT trial) which describes the quality of HBHCT provided by lay counselors. Quality of HBHCT was measured as scores comparing observed practice to prescribed protocols using direct observation. Data were collected through periodic observations of HCT sessions and exit interviews with clients. Counselor quality scores for pre-test counseling and post-test counseling sessions were created to determine the level of quality. For the client exit interviews a continuous score was created to assess how satisfied the clients were with the counseling session. A total of 196 (3%) observational assessments and 406 (6%) client exit interviews were completed. Overall, median scores for quality of counseling and testing were high for both HIV-negative and HIV-positive clients. For exit interviews all 406 (100%) clients had overall satisfaction with the counseling and testing services they received, however 11% were concerned about the counselor keeping their discussion confidential. Of all 406 clients, 393 (96.8%) intended to recommend the service to other people. In ensuring good quality HCT services, ongoing quality assessments are important to monitor quality of HCT after training.http://dx.doi.org/10.1080/17290376.2016.1248477home-based HIV counseling and testingcounseling qualitySouth Africalay counselorssupervision
collection DOAJ
language English
format Article
sources DOAJ
author Vuyolwethu Magasana
Wanga Zembe
Hanani Tabana
Reshma Naik
Debra Jackson
Sonja Swanevelder
Tanya Doherty
spellingShingle Vuyolwethu Magasana
Wanga Zembe
Hanani Tabana
Reshma Naik
Debra Jackson
Sonja Swanevelder
Tanya Doherty
An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa
SAHARA-J
home-based HIV counseling and testing
counseling quality
South Africa
lay counselors
supervision
author_facet Vuyolwethu Magasana
Wanga Zembe
Hanani Tabana
Reshma Naik
Debra Jackson
Sonja Swanevelder
Tanya Doherty
author_sort Vuyolwethu Magasana
title An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa
title_short An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa
title_full An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa
title_fullStr An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa
title_full_unstemmed An assessment of quality of home-based HIV counseling and testing performed by lay counselors in a rural sub-district of KwaZulu-Natal, South Africa
title_sort assessment of quality of home-based hiv counseling and testing performed by lay counselors in a rural sub-district of kwazulu-natal, south africa
publisher Taylor & Francis Group
series SAHARA-J
issn 1729-0376
1813-4424
publishDate 2016-01-01
description HIV counseling and testing (HCT) has been prioritized as one of the prevention strategies for HIV/AIDS, and promoted as an essential tool in scaling up and improving access to treatment, care and support especially in community settings. Home-based HCT (HBHCT) is a model that has consistently been found to be highly acceptable and has improved HCT coverage and uptake in low- and middle-income countries since 2002. It involves trained lay counselors going door-to-door offering pre-test counseling and providing HCT services to consenting eligible household members. Currently, there are few studies reporting on the quality of HBHCT services offered by lay counselors especially in Sub-Saharan Africa, including South Africa. This is a quantitative descriptive sub-study of a community randomized trial (Good Start HBHCT trial) which describes the quality of HBHCT provided by lay counselors. Quality of HBHCT was measured as scores comparing observed practice to prescribed protocols using direct observation. Data were collected through periodic observations of HCT sessions and exit interviews with clients. Counselor quality scores for pre-test counseling and post-test counseling sessions were created to determine the level of quality. For the client exit interviews a continuous score was created to assess how satisfied the clients were with the counseling session. A total of 196 (3%) observational assessments and 406 (6%) client exit interviews were completed. Overall, median scores for quality of counseling and testing were high for both HIV-negative and HIV-positive clients. For exit interviews all 406 (100%) clients had overall satisfaction with the counseling and testing services they received, however 11% were concerned about the counselor keeping their discussion confidential. Of all 406 clients, 393 (96.8%) intended to recommend the service to other people. In ensuring good quality HCT services, ongoing quality assessments are important to monitor quality of HCT after training.
topic home-based HIV counseling and testing
counseling quality
South Africa
lay counselors
supervision
url http://dx.doi.org/10.1080/17290376.2016.1248477
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