Strategies for enhancing the competence of lay counsellors that provide voluntary HIV counselling and testing programme in the Mopani District, Limpopo Province, South Africa

Abstract

HIV counselling and testing has been recognised as an important component of HIV and Acquired Immune Deficiency Syndrome (AIDS) care and support, and is an essential part of HIV testing. In South Africa a commonly used model for counselling for HIV and AIDS in health facilities is performed by lay counsellors. In many countries Voluntary Counselling and Testing (VCT) has been found to be effective in reducing HIV infection, and helping partners to cope with illness. The use of lay counsellors is a way of scaling up VCT uptake services. Lay counsellors are trained and supervised by Non-Governmental Organizations working in partnership with the government Department of Health. The trained lay counsellors work alongside health professional in public health clinics and hospitals.

The purpose of the study was to develop strategies to enhance the competence of the lay counsellors implementing VCT in the health facilities of Mopani District, Limpopo Province. The findings of the study were used to develop strategies to enhance the competence of lay counsellors when implementing VCT programme.

Both qualitative and quantitative methods were used in this study. The qualitative study assisted the researcher to develop an understanding of the phenomenon as it exists in the real world. The research was conducted in the health facilities of the Mopani Districts, Greater Tzaneen, Greater Letaba and Baphalaborwa. The population consisted of lay counsellors implementing VCT in the health facilities. Data were collected using a semi-structured interview tool for Focus Group Discussions and individual interviews, and a structured checklist for observational sessions. Data collected from focus groups and from individual interviews were analysed qualitatively through the open coding method. Data from the structured observational checklist were analysed using the SPSS Version 15 to obtain frequency distributions and percentages.

Ethical clearance was submitted together with the research proposal to the Limpopo Department of Health and Social Development Research Ethics Committee. All lay counsellors signed informed consent form before they could participate in the study.

The researcher obtained permission to conduct the study from Mopani District Department of Health and Social Development and supervisors of the clinics. The research results revealed that lay counsellors were proficient in implementing the basic competencies of the VCT programme; however, they lacked some important counselling skills and knowledge of processes that should be implemented when counselling clients. The researcher recommends that regular in-service training, supervision, mentoring and monitoring should be implemented to increase the competence of lay counsellors. Based on the findings of this study, strategies were developed to improve the competence of lay counsellors.