title: Assessing the relevance, efficiency, and sustainability of HIV/AIDS in-service training in Nigeria.
abstract: More than three million people in Nigeria are living with HIV/AIDS. In order to reduce the HIV/AIDS burden in Nigeria, the US Government (USG) has dedicated significant resources to combating the epidemic through the President's Emergency Plan for AIDS Relief (PEPFAR). In-service training (IST) of health workers is one of the most commonly used strategies to improve the quality and coverage of HIV/AIDS services. At USAID/Nigeria's request, the USAID-funded CapacityPlus project conducted an assessment of PEPFAR-funded IST for all cadres of health workers in Nigeria. Using the IST Improvement Framework, developed by the USAID Applying Sciences to Strengthen and Improve Systems Project (ASSIST), as a guide, the authors developed a survey tool to assess the efficiency, effectiveness and sustainability of IST provided between January 2007 and July 2012 by PEPFAR-funded implementing partners in Nigeria. The instrument was adapted to the Nigerian context and refined through a stakeholder engagement process. It was then distributed via an online platform to more than 50 PEPFAR-funded implementing partners who provided IST in Nigeria. A total of 39 implementing partners completed the survey. Our survey found that PEPFAR implementing partners have been providing a wide range of IST to a diverse group of health workers in Nigeria since 2007. Most trainings are developed using national curricula, manuals and/or other standard operating procedures. Many of the partners are conducting Training Needs Assessments to inform the planning, design and development of their training programs. However, the assessment also pointed to a number of recommendations to increase the efficiency, effectiveness and sustainability of PEPFAR-funded IST. These actions are as follows: improve collaboration and coordination among implementing partners; apply a more diverse and cost-effective set of training modalities; allocate funding specifically for the evaluation of the effectiveness of training; improve links between IST and both continuing professional development and pre-service education; require implementing partners to create sustainability plans to transition training from PEPFAR funding to other funding sources; and develop a training information management system to track key aspects of IST, such as the number and types of providers, courses, and participants of PEPFAR-funded IST.
authors.affiliation: CapacityPlus, IntraHealth International Inc, 1776 I Street NW, Suite 650, Washington, DC 20006, USA. rburlew@capacityplus.org.
authors.forename: Randi
authors.initials: R
authors.lastname: Burlew
authors.forename: Amanda
authors.initials: A
authors.lastname: Puckett
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bailey
authors.forename: Margaret
authors.initials: M
authors.lastname: Caffrey
authors.forename: Stephanie
authors.initials: S
authors.lastname: Brantley
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D002648:Child; D003695:Delivery of Health Care; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006282:Health Personnel / Q000193:education*; D006296:Health Services; D006801:Humans; D007223:Infant; D007318:Inservice Training; D007391:International Cooperation; D008297:Male; D009549:Nigeria; D011247:Pregnancy
references.citation: BMC Public Health. 2012 Mar 12;12:184
references.pmid: 22410161