Medical personnel trained in the care of HIV-related conditions
Knowledge about appropriate management of HIV and the infections associated with it is an important prerequisite for quality care at all levels of the health care system. Many national AIDS programmes are providing training to existing health service staff, upgrading their skills and knowledge in this area. However, the easiest and most sustainable way to ensure adequate knowledge in the long term is to integrate HIV-related information into the routine medical training for doctors, nurses and paramedics. This indicator measures the extent to which such information has been integrated into the regular training curricula of all medical personnel.
Number of medical graduates in the last 24 months (including nursing and paramedical staff where relevant) trained in all essential aspects of HIV knowledge and management
Total number of medical graduates in the last 24 months
There are two ways to measure this indicator. First, in a health facility survey health workers are asked about specific topics that were covered in their basic medical training and this provides the relevant information. Using the year of graduation will provide information about the time period (e.g., graduates in the two years preceding the survey). Alternatively, from the records of the health or education ministries, a list is constructed of all institutions providing professional training and issuing medical degrees, nursing or paramedical qualifications or conducting approved continuing medical education. A questionnaire is sent to each of these institutions, containing a checklist of items associated with training in knowledge of HIV and management of HIV infected patients. The checklist may be constructed according to national or international standards in the care and management of patients with HIV. It will typically include items on the epidemiology and natural history of HIV infection, on basic preventative counselling, on the diagnosis and management of common opportunistic infections, and of referral practices. Institutions are also asked for the number of students graduating at each level in the last 24 months. The indicator is the number of medical graduates in the last 24 months (including nursing and paramedical staff where relevant) trained in all essential aspects of HIV knowledge and management, divided by the total number of medical graduates in the last 24 months. Graduates of refresher or ongoing medical education courses are included in the indicator.
Geographic location: N/A
Pregnancy status: N/A
Time period: N/A
Type of orphan: N/A
Vulnerability status: N/A
This indicator is relatively easy to construct as long as institutions involved return the questionnaire. Its major limitation is that it does not attempt to measure the quality or the depth of the training given. The indicator measures the training of current graduates. Where HIV-related training is new to medical curricula and where retraining programmes are uncommon, it will not give a good picture of current levels of knowledge within the health system, since many existing staff will have been trained before the curriculum was introduced. However, it should provide a robust measure of trends in the minimum proportion of health service providers trained in HIV and associated care over time. The curricula should follow national guidelines for care of HIV-infected patients. The absence of such guidelines is in itself an indication that care and support services for HIV-infected people are likely to be inadequate. However, where they do not exist, international standards may be substituted as a measure of the curriculums adequacy.