Title: The Role of CHART and the Importance of Continuing Education for PMTCT
1The Role of CHART and the Importance of
Continuing Education for PMTCT
Wendy Sealy Training Coordinator CHART Barbados,
HIV/AIDS Programme Management Unit, Ministry of
Health, Barbados. Symposium on Management of
Mother-to-Child Transmission of HIV/AIDS Feb. 5
6, 2009
2Objectives
- Outline the role of the CHART Network in the
training and education of healthcare workers in
the Caribbean region. - Identify the role of continuing education in
healthcare - Describe the importance of continuing education
in PMTCT
3Why CHART?
Caribbean HIV/AIDS Regional Training
4HIV Infection Rates in Adults by Region of the
World in 2004
Source UNAIDS
5The Pan-Caribbean Partnership against HIV/AIDS
- Established February 2001
- PANCAPs five-year strategic agenda seeks to
- decrease the no. of new HIV infections
- provide care and support for those affected by
HIV/AIDS - reduce stigma and discrimination, and
- mobilize the response to the epidemic
6- CHART began as an idea at more than one
location - An idea shared with neighbours
- In early 2001, CARICOM CAREC requested needs
assessment related to HIV/AIDS care support
training in the Caribbean region - Key stakeholders in the region shared their
experience and thoughts with the assessment team
from CDC/GAP, Univ. of Washington and US
Southeast AIDS Education Training Center (AETC)
7- Gestational period 14 years
8- The Vision Statement
- The Caribbean HIV/AIDS Regional Training
(CHART) Network leads the way in training
excellence with the aim of reducing the burden
and impact of HIV, AIDS and related conditions in
every Caribbean country and territory.
9Mission Statement
- The mission of the CHART Network is to strengthen
the capacity of national healthcare personnel and
systems to provide access to quality HIV and AIDS
prevention, care, treatment and support services
for all Caribbean people through the development
of a robust and sustainable training network.
10Location of Training Centres
- Jamaica
- Bahamas
- Haiti-GHESKIO/ PIH Zami Lazante
- Barbados
- OECS HAPU
- Trinidad and Tobago
- Regional Coordinating Unit, UWI, Mona, Jamaica
11The shape of
PANCAP
FUNDING
TECHNICAL SUPPORT
12A Caribbean Map
CHART Coordinating Center
CAYMAN IS.
ST. KITTS
BELIZE
NEVIS
PANCAP
13Governance Structure
- CHART Network Governance Structure consists of
-
- Advisory Board which meets once a year
- 2. Executive Council at least twice a year
- NB. The organization is governed by a
constitution and Bye-Laws
14 Regional Partners
- PANCAP
- CARICOM
- Caribbean Association of Pharmacists
- Caribbean Dental Group
- CAREC/PAHO
- Caribbean Nurses Organization
- CRN
- CCNAPC
- CFNI/PAHO
- CHRC
- OECS Regional Coordinating Mechanism
- Others
15 International Partners
- I-TECH
- ANAC
- BroadReach
- CDC-GAP
- FXB
- HRSA
- HIV/AIDS Alliance
- IAS-USA
- Lutheran Medical Center
- MEASURE/MACRO
- Merck
- Universities
- Cornell
- Harvard
- UAB
- Vanderbilt
- UNAIDS
- USAID
- Others
16Categories of personnel being trained across the
CHART Network
- Physicians
- Nurse practitioners
- Clinical nurses
- Public Health nurses
- Pharmacists
- Dentists
- Laboratory workers
- Social workers
- Counsellors
- Community health aides
- Accompagnateurs
- Contact investigators
- Health administrators
- PLWHAs
17 Priority Themes (1)
- Comprehensive Treatment, Care and Support
- Team approaches to care, support and treatment
- The approach to the patient and the family
- PMTCT
- VCT
- Use of ARVs
- Prophylaxis and Rx of Opportunistic Infections in
the Caribbean - Dx and Rx of TB
- Rx of STIs
- Appropriate use of the laboratory techniques
18 Priority Themes (2)
- Nutrition for non-nutritionists
- Record keeping informatics
- Notification
- Confidentiality
- Prevention in the context of care
- Stigma and discrimination
- Psychosocial care
- The health care worker as an advocate
- Basic counselling skills for the health care
worker
19 a flexible model
- By prior arrangement, teams of trainers
- will work either at CHART Centres or other
training sites - Learning activities
- will occur at points of delivery of care as
much as possible
- Trainers
- Caribbean nationals and experienced persons from
outside of the Caribbean - Learners
- may sometimes go abroad
20The Model levels of training
- Taken from the US AIDS Education and Training
Centers (AETC) Model
21Level 1 mainly didactic
- Large groups
- Typically
- Lectures
- Journal club
- Grand rounds
- Special topic seminars
Learners largely in passive mode some
interaction.
22Level 2 Skills-building workshops
- Smaller groups, interactive, e.g.
- Case discussion
- Simulated patients
- Role play
23Level 3 Working with real patients and situations
- Clinical observation of patient care
- Interaction with patients during care
- Mini-residencies
- Preceptorships
- Telemedicine
24Level 4 Clinical consultation mentorship style
- Interaction between the mentee and the mentor
via - Telephone or fax
- Internet
- On-site consultation
- Other
25Focus present and future
- Scaling up Number and Quality of Training Efforts
- National Training Centers as Centers of
Excellence - linked to Health Facilities for Study Tours and
Preceptorships - Database of trainers
- Regular Clinical Consultation
- Study Tours
- Training Certification
- Strengthening In-service and Pre-Service
Training
26Importance of Continuing Education
- DEFINITIONS
- Continuing Education
- Specialist courses to update professionals
regular courses or training designed to bring
professionals up to date with the latest
developments in their particular field. Encarta
Dictionary - Educational classes or experiences for licensed
professionals that extend, update, or renew their
knowledge of practices in their field.
Answers.com - For the profession of pharmacy is the structured
educational activity designed or intended to
support the continuing development of pharmacists
and /or pharmacy technicians to maintain and
enhance their competence (promote problem-solving
and critical thinking). Accreditation Council for
Pharmacy Education
27The context of Continuing Education
- Continuing education vs traditional education
- The latter offers formal schooling which offers
basic skills to start persons off in the world of
work - The former however offers additional knowledge
and skills to enhance the work of the participant
and to apply lessons to their work experience -
28Benefits of Continuing Education
- A more skilled workforce which is more productive
- Employers more likely to hire or retain persons
who have continuing education on their resume
(organization likely to remain competitive) - Use of a variety of teaching/learning
methodologies and interactive media to allow for
continuing education through distance learning
29Applicability of continuing education to pharmacy
practice
- The development and maintenance of
proficiency in five core areas - Delivering patient-centered care
- Working as part of a multidisciplinary team
- Practicing evidence-based medicine
- Focusing on quality improvement
- Using information technology
- (Adapted from Institutes of Medicines Health
Professions Education A bridge to Quality, 2003)
30The Importance of Continuing Education in PMTCT
31Barbados National PMTCT Curriculum Goals
- To equip healthcare workers (HCW) with sufficient
knowledge and basic skills to care for pregnant
women with HIV and their infants. - To demonstrate the benefit of antiretroviral
therapy (ART) in reducing the risk of
mother-to-child transmission of HIV (MTCT) and
caring for mothers and families
32Curriculum Development process
- Design- Conceptualization stage attention given
to varied components including the philosophical
underpinnings, goals, objectives, content,
learning experiences and and evaluation. - Develop- planning, construction and logical step
by step procedures used to produce written
documents.E.g. vision statements, goals,
standards, performance benchmarks. - Implement-Stakeholder contribution to
operationalize the curriculum through meetings. - Monitor-Follow through to ensure that practice
is in keeping with goals and objectives of
national curriculum. - Evaluate-Data collection process on the field to
determine the effectiveness of the curriculum
design. - Review-Information gained from data analysis is
used to guide appropriate adjustments.
33Barbados National PMTCT Curriculum Process
- Participation of a group of health care
providers from the LRU, QEH and Polyclinics
participated in I-TECH/CHART training activity in
Bahamas for the Scaling up of PMTCT activities
in the Caribbean region in 2005 - The participation of CHART Coordinator and Health
Education Officer of the MOH to the Technical
Working Group meeting of the Bahamas National
PMTCT Curriculum process in 2006 - Establishment of a PMTCT Curriculum Committee in
2007 - PMTCT Stakeholder Meeting, May, 2007
- Draft curriculum compiled by a curriculum
specialist from I-TECH - PMTCT Technical Working Group meeting, September,
2007 - Piloting of the Barbados PMTCT National
Curriculum, November 2007
34Barbados National PMTCT Curriculum
- Course Structure
- Format
- 5 full days
- 10 Modules
- Interactive, adult learning
- Didactic (lectures)
- Two main documents
- Facilitator manual
- Participant manual
35Barbados PMTCT Curriculum Course content
- Course Introduction
- Module 1 Introduction to HIV/AIDS
- Module 2 Introduction to PMTCT
- Module 3 PMTCT Interventions/ARV Prophylaxis
- Module 4 Adherence in HIV Care
- Module 5 HIV Testing
-
- Module 6 Infant Feeding
- Module 7 Continuum of Care for Women, Children,
Families - Module 8 Stigma and Discrimination
- Module 9 Healthcare Worker Safety
36Key Points
- CHART promotes multidisciplinary team education
and training programmes for health care workers
including pharmacists in the Caribbean region. - PMTCT is concerned with care and services for
pregnant women and their families. - Continuing education is lifelong learning geared
at enhancing and strengthening the knowledge and
skills of healthcare workers in their area of
specialization. - The importance of PMTCT in continuing education
in PMTCT assures that healthcare workers are able
to access current information to enable them in
providing quality care to clients.
37Thank youAcknowledgements Dr. Anton Best,
SMOH (CD), Ministry of Health, BarbadosProf.
Brendan Bain, Director, CHART RCUwww.chartcaribb
ean.org