Unit 6: Training and Supervision

#3-6-1

Warm Up Questions: Instructions

Take five minutes now to try the Unit 6 warm up questions in your manual.

Please do not compare answers with other participants.

Your answers will not be collected or graded.

We will review your answers at the end of the unit.

#3-6-2

What You Will Learn

By the end of this unit you should be able to:

describe requirements for staffing, training, and supervising of HIV sentinel surveillance programmes

identify potential sources of conflict when adding supervisory staff to existing programmes

#3-6-3

Sentinel Surveillance Staffing People needed to conduct a sero-survey

include: clinic staff laboratory technicians supervisory staff data managers or statisticians survey co-ordinators

Responsibilities for each surveillance staff member should be clearly defined in the sero-survey protocol.

#3-6-4

Table 6.1. Responsibilities of Sero-Survey Personnel at Local (clinic)

Level ensure that eligible women are included in the

sero-survey

draw blood specimens

split specimens for standard syphilis testing and for HIV testing

#3-6-5

Table 6.1. Responsibilities of Sero-Survey Personnel at Local (clinic)

Level, Cont. label and properly store specimens in

preparation for transport to the testing laboratory

fill in data collection forms

transmit data collection forms to regional level

train for other staff members’ duties in the case of absence

#3-6-6

Table 6.1. Responsibilities for Local Supervisory Staff

ensure efficient operation of sero-survey

supervise other surveillance staff

provide adequate oversight, ensure confidentiality

#3-6-7

Table 6.1. Responsibilities for a Local Courier (As Needed)

In some cases, someone from the Ministry of Health will be available to transport specimens to the testing laboratory.

If not, the clinic laboratory technician may be required to do so, especially if specimens will be tested in the same town or city.

#3-6-8

Table 6.2. Responsibilities for Regional Laboratory Technicians

order equipment, supplies, and test kits

conduct HIV testing

report results to data entry clerk

participate in quality control and quality assurance programmes

#3-6-9

Table 6.2. Responsibilities for Regional Data Entry Clerks

examine data for missing values and try to resolve these by communicating with clinic

combine data from data collection forms and laboratory results into single data set

#3-6-10

Table 6.2. Responsibilities for Regional Study Coordinator

ensure provision of equipment, supplies, and test kits

ensure adequate oversight and confidentiality at the regional level

provide training for local level and regional staff

disseminate survey findings

#3-6-11

Table 6.3. Responsibilities for National Level Lab Technician

ensure provision of equipment, supplies, and test kits to regional laboratories

conduct HIV tests as needed; for example, for difficult or borderline specimens

oversee quality assurance of testing procedures at regional and local levels

#3-6-12

Table 6.3. Responsibilities for National Level Data

Manager/Statistician enter data in the program’s computerised

database if this is not done at the regional level

examine data for missing values

manage data

analyse data

#3-6-13

Table 6.3. Responsibilities for National Level Surveillance

Coordinator develop sero-survey manual or protocol with

help from program staff ensure adequate funding provide adequate oversight and training at

the regional and national levels ensure confidentiality interpret findings in conjunction with regional-

level survey coordinators prepare survey reports and national reports

#3-6-14

Writing a Survey Protocol

The manual should describe all the steps and tasks involved in a sero-survey.

The manual should be detailed enough that it can be read and used at the local, regional and national levels

It can also serve as a guide to training needs, and be used for training survey personnel.

#3-6-15

Training According to the Survey Protocol

The survey manual should be explicit about training needs.

It should specify what types of personnel will need to be trained.

It should specify where training will occur.

It should specify who will be responsible for doing the training.

#3-6-16

Identifying Training Needs

Develop comprehensive job descriptions: skills required to perform each task risks associated with improper performance

of tasks

The survey coordinator should compare the job descriptions with the staff to identify the gaps in knowledge.

#3-6-17

Conducting Training

All personnel involved in a sero-survey must be trained, including supervisors, laboratory staff and clinic staff.

Training sessions may be conducted either at the clinic site, or in a central location at the regional or national level.

#3-6-18

Conducting Training, Cont.

The following should be included in all trainings:

review of the survey manual, operational procedures and field protocol

results from previous sero-surveys conducted at the site or in the region

an opportunity for participants to discuss concerns and ask for clarification of sero-survey operations

#3-6-19

Maintaining Motivation

Develop a sense of sero-survey ‘ownership.’

Define clear responsibilities and roles for staff at all levels.

Emphasise the importance of each person’s contribution to the sero-survey’s success.

Provide adequate staff training.

#3-6-20

Maintaining Motivation, Cont.

Ensure that the needed equipment and forms are available before the survey starts.

Assign data management and analysis responsibilities to regional coordinators.

#3-6-21

Supervisor Responsibilities

The supervisor should monitor all aspects of sentinel surveillance, including:

sampling

data and specimen collection and management

laboratory equipment

#3-6-22

Supervision

The levels of supervision should be kept to a minimum.

Make use of existing management structure at facility level. This will: minimise conflicts with the facility administrators offer more ownership in the process encourage effective management of the

surveillance activities

#3-6-23

Warm Up Review

Take a few minutes now to look back at your answers to the warm up questions at the beginning of the unit.

Make any changes you want to.

We will discuss the questions and answers in a few minutes.

#3-6-24

Answers to Warm Up Questions

1. Which staff members should be trained prior to conducting sero-surveys?

a. supervisors and managerial staff

b. laboratory staff

c. clinic staff

d. all of the above

#3-6-25

Answers to Warm Up Questions, Cont.

2. True or false? When planning for the supervision of testing facilities, the national surveillance organisers should hire an outside supervisor to staff each of the facilities where HIV testing occurs. False

#3-6-26

Answers to Warm Up Questions, Cont.

3. List three types of personnel necessary to conduct an HIV sero-survey. Clinic staff, laboratory technicians, supervisory staff, etc.

#3-6-27

Answers to Warm Up Questions, Cont.

4. The national surveillance supervisor should be responsible for supervision of:

a. specimen collection

b. data management

c. laboratory equipment

d. sampling

e. all of the above

#3-6-28

Small Group Discussion: Instructions

Get into small groups to discuss these questions.

Choose a speaker for your group who will report back to the class.

Take 15 minutes for this exercise.

#3-6-29

Small Group Reports

Select one member from your group to present your answers.

Discuss with the rest of the class.

#3-6-30

Case Study: Instructions

Try this case study individually

We’ll discuss the answers in class

#3-6-31

Case Study Review

Follow along as we go over the case study in class.

Discuss your answers with the rest of the class.

#3-6-32

Questions, Process Check

Do you have any questions on the information we just covered?

Are you happy with how we worked on Unit 6?

Do you want to try something different that will help the group?

#3-6-33