title: Looking for sufficient change: Evaluation of counsellor training for STI syndromic management in India.
abstract: In India, public health care of Sexually Transmitted Infections is delivered through Designated STI/RTI Clinics (DSRCs) using syndromic management. This paper describes efforts, over three years, to improve in-service training for counsellors positioned at DSRCs-using a data approach. The programme managers realised, through rigorous monitoring of initial induction training reports that, while knowledge and attitudes of most trainees had improved as evident from t-tests, at least one-quarter scored worse on post-training assessments (n=859). Therefore, they undertook a survey using a competency approach to diagnose what critical competencies are influenced through training: counselling skills, risk reduction suggestions, labelling male and female anatomy, record-keeping and STI patient education (n=132). Survey results demonstrated that trainees failed to pass a two-thirds cutoff score in most competencies. These findings led the programme managers to modify training and implement tighter quality measures. In the second round of training - refresher training - outcomes on competency assessments before and after training showed more acceptable performance (n=833). The paper describes how programme managers, after an acceptance of such initial short-comings, developed customized assessments when literature provided limited guidance and how they worked to achieve change that was acceptable for programme needs.
authors.affiliation: National AIDS Control Organisation, Department of Health and Family Welfare, 36 Janpath, New Delhi 110 001, India. Electronic address: melitavaz@gmail.com.
authors.forename: Melita
authors.initials: M
authors.lastname: Vaz
authors.affiliation: National AIDS Control Organisation, Department of Health and Family Welfare, 36 Janpath, New Delhi 110 001, India.
authors.forename: Nisha
authors.initials: N
authors.lastname: Kadyan
authors.affiliation: National AIDS Control Organisation, Department of Health and Family Welfare, 36 Janpath, New Delhi 110 001, India; Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi 110 001, India.
authors.forename: Sumitha
authors.initials: S
authors.lastname: Chalil
authors.affiliation: National AIDS Control Organisation, Department of Health and Family Welfare, 36 Janpath, New Delhi 110 001, India.
authors.forename: Turlapati L N
authors.initials: TLN
authors.lastname: Prasad
authors.affiliation: National AIDS Control Organisation, Department of Health and Family Welfare, 36 Janpath, New Delhi 110 001, India.
authors.forename: Aman Kumar
authors.initials: AK
authors.lastname: Singh
mesh_terms: D002983:Clinical Competence; D003191:Comprehensive Health Care / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007194:India; D010353:Patient Education as Topic / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation / Q000379:methods*; D021841:Safe Sex; D012749:Sexually Transmitted Diseases / Q000188:drug therapy* / Q000517:prevention & control / Q000628:therapy
keywords: Competency assessment; Counsellor training; STI syndromic management; Training evaluation