Evaluation of a training program to increase the capacity of health care providers to provide antiretroviral therapy to pediatric patients in sub -Saharan Africa

Harrison N Kamiru, The University of Texas School of Public Health


More than 810,000 people from sub-Saharan Africa had accessed antiretroviral therapy by the end of 2005. This represented a marked scale up in provision of antiretroviral therapy (ART) in sub-Saharan Africa but there are still many challenges in delivering ART especially to children. Baylor International Pediatric AIDS Initiative (BIPAI) offered the Swaziland government this service for the pediatric population. The purpose of this study was to evaluate the effectiveness of BIPAI's health care provider training program for the provision of ART to pediatric population. The specific aims were: (1) to present a comprehensive description of barriers to effective delivery of ART to children in Swaziland; (2) to propose a health care provider training program based on a theoretical planning model; (3) to compare the Baylor training program with the proposed health care provider training program; (4) to assess coverage and delivery of the training program, and (5) to assess the impact of training on physicians' and nurses' knowledge of HIV/AIDS and HIV-related pediatric practices, attitudes towards people with AIDS, and self-efficacy to provide ART. Qualitative data were collected through semi-structured in-depth interviews with both BIPAI trainers and doctors and nurses from Swaziland. Quantitative data were collected from pre-test and post-test survey from the BIPAI training program in Swaziland. A systematic literature review was conducted on the subject of factors affecting health care providers in delivering ART. Transcribed interviews were coded for themes using a deductive approach. Quantitative data analysis involved descriptive statistics, univariate and bivariate analysis, and factor analysis using Stata-8.2, and SPSS-14. The training program significantly increased health care providers' knowledge about HIV/AIDS, ART, and pediatric care, self-efficacy to provide various aspects of care to pediatric patients and positive health care providers' attitudes towards people living with AIDS. There is a general lack of factual information about ART in Swaziland. Health care providers have fears about treating pediatric HIV patients because they do not feel adequately prepared to manage them. These barriers are affecting provision of ART and need to be taken into account when designing new and improved care, treatment, and training programs.

Subject Area

Public health

Recommended Citation

Kamiru, Harrison N, "Evaluation of a training program to increase the capacity of health care providers to provide antiretroviral therapy to pediatric patients in sub -Saharan Africa" (2006). Texas Medical Center Dissertations (via ProQuest). AAI3258577.