International AIDS Conference location:Toronto, Canada date:2006
Issues: Lack of skilled human resources is one factor limiting scale-up of antiretroviral treatment programs in resource-poor settings. We describe how an NGO program contributes to scaling-up capacity in Cambodia, where the health system remains handicapped by political unrest from previous decades. A training program was established through a proposal funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM).
Description: In 2001, Sihanouk Hospital Center of HOPE established a training program for physicians. The objective is to train clinicians to provide comprehensive HIV care, including antiretrovirals. This six month program stresses both clinical skills and applied theory. A committee with members from government, NGOs and international medical schools advises the training program concerning content, selection and evaluation the trainees. In 2004 and 2005, 24 candidates successfully completed the program and are now working in HIV care; 18 of these 24 treat more than 10 patients each with antiretrovirals.
Lessons learned: A functional clinical site is a critical asset for effective training. In countries lacking experienced clinicians, an NGO program can contribute to building capacity in HIV care and assist the government in establishing high quality training of health care workers. Careful screening of candidates is needed to ensure program graduates will subsequently work in direct-care settings.
Recommendations: NGO programs should consider adding a formal training component to their functioning HIV care programs in settings where there is a lack of qualified human resources. Candidates should be properly selected and training programs should be organised in discussion with governmental and non-governmental partners.