Page 117 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 6 of 7 Original Research

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can be efficacious and can facilitate the creation of more a year. Additional operational factors that may improve the
tolerant and respectful workplace norms. 25,26,29,30,31 Outcomes efficacy or effectiveness of sensitisation training should also be
from our study, as previously published data demonstrate, investigated, including types of content (e.g. clinical
suggest that healthcare workers at both sites held and competency models), delivery modalities (e.g. online vs. in-
expressed judgemental and moralising attitudes towards key person) and participant cadres (e.g. social workers and law
populations and also lacked the knowledge and awareness of enforcement). In addition, future training interventions and
specific key population health needs. These findings show evaluations should consider the inclusion of transgender
6
that healthcare workers who received the training people as a key population, given their vulnerability to HIV
intervention reported an increase in both their support of and infection. Lastly, future research should explore the impact of
acknowledgement of evidence-based interventions for key sensitisation training on key population service utilisation both
populations. as a stand-alone intervention and within the context of
integrated programming inclusive of community-driven
Limitations demand creation.

There were limitations to this study that should be considered. Conclusion
Firstly, participants in the qualitative component of the study
included a small purposively sampled group of healthcare This evaluation demonstrates that a relatively short
workers, which may have limited the range of data (one-day), low-cost training intervention can improve
collected. The recruitment and implementation of IDIs were healthcare workers’ levels of knowledge and awareness
constrained because of the operational logistics of clinics, about the specific HIV-related health needs and psychosocial
limited space and the availability of participants because of vulnerabilities of key populations, and reduce levels of
staff shortages and heavy workloads. In addition, the follow- prejudice and discrimination. 8
up IDIs had an even smaller sample size because of
respondents declining follow-up IDIs. The participants were Acknowledgements
not requested to include identifying information on their The authors would like to acknowledge the support from
training questionnaires in order to maximise confidentiality; the funders and implementing partners for this project, and
therefore, pre- and post-training analyses for individuals NACOSA (Global Fund), which funded the evaluation.
were not included in this study. Evaluations of future training Furthermore, they would like to acknowledge the
interventions should include linked pre- and post- co-investigators of the evaluation: Esda Van De Watt Broekman,
intervention assessments to determine individual changes Jacques Livingston, Machteld Busz, Hilde Roberts, Delene Van
more precisely (e.g. using a unique code) as well as an Dyk, Dawie Nel, Gordon Isaacs, Xander Flemming, Jacqueline
assessment of key populations service utilisation statistics Mbwana, Bram Langen, Benjamin Janse van Rense, Eva
pre- and post-intervention to identify changes in service Marumo, Felistus Momedi, Coceka Nogoduka, Jabulile Sibeko,
uptake. In addition, this study included a three-month period Steave Nemande, Manoj Kurian and Helen Savva. The
between baseline and follow-up data collection; however, a organisations involved in the training and evaluation include
different follow-up interval may have resulted in different ICAP South Africa, Mainline, OUT Wellbeing, Sex Workers
long-term changes in shifts in attitude. Future evaluations Education and Advocacy Taskforce (SWEAT), AMSHeR,
would benefit from a larger qualitative sample, and Bridging the Gaps, COC Netherlands, South African National
representation from all cadres of healthcare workers. Department of Health, Bonela, South African National AIDS

Recommendations Council, FHI360 and the US Centers for Disease Control and
Prevention.
Despite the stated limitations, this evaluation suggests that a
one-day integrated key population sensitisation training course Competing interests
can positively impact the perceptions, attitudes and knowledge The authors declare that they have no financial or personal
of healthcare workers about HIV-related issues affecting MSM, relationship(s) that may have inappropriately influenced
sex workers and PWUD. Such changes may contribute to the them in writing this article.
reduction in barriers to access health services and the promotion
of welcoming and enabling healthcare facilities. Evidence of
this nature is necessary to inform policy recommendations Disclaimer
regarding the need for sensitisation training programmes to be The views and opinions expressed in this article are those of
integrated into national pre- and in-service training for the authors and do not necessarily reflect the official policy or
healthcare workers, and contributes to existing data on position of any affiliated agency of the authors.
outcomes of sensitisation training of healthcare workers, 8.Building on this and other sensitisation training projects, I-TECH South Africa is
particularly in sub-Saharan Africa where access to sensitised developing, implementing and evaluating a comprehensive sensitisation and
healthcare services for key populations still remains a challenge. capacity development pilot intervention programme, with the objective of
sensitising clinical and non-clinical staff at the primary care and community levels
Future research is needed to determine how best to utilise on issues related to stigma and discrimination, as they relate to five key populations
(MSM, people in prisons and other closed settings, sex workers, PWUD and
transgender people).
refresher training and ongoing mentorship to maintain the https://www.go2itech.org/2017/06/key-populations-sensitization-training-for-
longevity of positive attitude changes for periods greater than health-care-workers-in-south-africa/.
http://www.sajhivmed.org.za 110 Open Access