1. Capacity summit Birchwood Hotel 19 th – 21 st Johannesburg Capacity building of health workers: Utilisation of a cost efficient facility based training approach (Capacity kazini Model) Digolo L¹, Kiragu M 1, M Obbayi 1, Otiso L¹ Capacity summit Birchwood Hotel 19 th – 21 st Johannesburg Building Partnerships, transforming lives 1 1

2. 2 LVCT – who are we? LVCT – an indigenous Kenyan NGO - country led, country managed, country priorities 1. Quality Assured HIV testing & counselling - Home based; Mobile; Workplace; Celebrity; >3million clients tested 2. Linking testing to palliative care/ART -12,000 HIV infected individuals, VCT+ model (families, 97% referral uptake) 3. Vulnerable & at risk populations -MSM/Prisons – 21,000 tested, 121 on Rx -Disability – 20,000 tested, Deaf VCT -Youth (one2one youth hotline,) -GBV/Post Rape Care – 9,000 survivors -Sex workers - 3 post test clubs, STI Rx.

3. Background A skilled, trained workforce can dramatically improve performance and add value to services. Despite implementing numerous trainings in the last few years, Kenya still has many health workers yet to receive basic HIV training Costly Off-the job trainings form the bulk of trainings Donor funds have been gradually reducing over the past few years Building Partnerships, Transforming lives 3

4. Objectives Building Partnerships, Transforming lives 4 To increase coverage of trained HCWs in necessary trainings To increase cost efficiency in trainings in a background of dwindling donor resources To train HCWs in an environment that enables practice of lessons learnt for acquisition of skills To train HCWs with minimal disruption of service delivery at facility level

5. Methods Cascade approach was utilised based on the National curriculums Active involvement of DMOHs and DASCOs, Med Superintendents. Trainings facility Led and management LVCT played supportive supervisory role 311 health providers trained between January 2010 and September 2012, 298 (96%) successfully completed the training. Certification done by NASCOP and DRH 5

6. Methods 6

7. Implementation models7 To be dictated by the various circumstances: 1.High volume facilities -that can have > 20 HCWS in training with no disruption of services, 3 hrs/ d when there is low client flow. 2.Low volume facilities-Participants will be conglomerated at a central facility in the district.The training will be 2-3 days in a week

8. Results Off the job trainingCapacity kazini model Facilitation352 530 Accommodation5700 0 Transport570 352 Lunch1600 230 Stationeries 300 Total85221412

9. Results

10. Advantages and disadvantages of FBT Advantages Low cost Task-based Minimal disruption of services Facility owned Disadvantages Lack of ideal training venues Longer duration before completion Attrition of participants Disruption of session with Health facility duties Building Partnerships, Transforming lives 10

11. Sustainability Collaborative approach: collaboration with key stakeholders at facility, regional and national level. Has been included in national curriculums Cheaper than conventional training Facility Led and managed Utilization of available resources: including venue and facilitators Building Partnerships, Transforming lives 11

12. Conclusion Facility based trainings are cheaper than off the job trainings/ hotel based trainings. This approach is replicable in most health facilities in Africa Building Partnerships, Transforming lives 12

13. ACKNOWLEDGEMENTS MOH Trocaire LVCT staff who were willing to try out new initiatives LVCT Management Building Partnerships, Transforming lives 13