title: Task-shifting HIV counselling and testing services in Zambia: the role of lay counsellors.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Family Health International/Zambia Prevention Care and Treatment Partnership, Lusaka, Zambia. parsa.sanjana@gmail.com
authors.forename: Parsa
authors.initials: P
authors.lastname: Sanjana
authors.forename: Kwasi
authors.initials: K
authors.lastname: Torpey
authors.forename: Alison
authors.initials: A
authors.lastname: Schwarzwalder
authors.forename: Caroline
authors.initials: C
authors.lastname: Simumba
authors.forename: Prisca
authors.initials: P
authors.lastname: Kasonde
authors.forename: Lameck
authors.initials: L
authors.lastname: Nyirenda
authors.forename: Paul
authors.initials: P
authors.lastname: Kapanda
authors.forename: Matilda
authors.initials: M
authors.lastname: Kakungu-Simpungwe
authors.forename: Mushota
authors.initials: M
authors.lastname: Kabaso
authors.forename: Catherine
authors.initials: C
authors.lastname: Thompson