In areas with a shortage of physicians, nurses have enabled the expansion of access to HIV care and treatment. Despite practicing within an expanded scope, few data are available on nurses’ capabilities and practice in the context of the services they provide.
To better understand the scope of task shifting in HIV care, ICAP conducted a survey that included 180 nurses at four health facilities in Eastern Province, Kenya. ICAP has been supporting the provision of HIV care, treatment and PMTCT services in these facilities since 2008 through funding from the U.S President’s Emergency Plan for AIDS Relief (PEPFAR).
The assessment evaluated nurses’ training, current practice and competency across 286 essential nursing tasks for HIV care and treatment, grouped into 12 key task areas identified by the World Health Organization’s (WHO) task-shifting guidelines. Significant gaps in training and competency were identified in HIV testing and counseling, ART and early and long-term follow-up on ART.
At a meeting that took place on November 27 in Nairobi, ICAP shared the findings from the survey with Kenya’s Ministry of Health. At the meeting, Cabinet Secretary for Health Mr. James Wainaina Macharia pledged the government’s continued support of ICAP’s efforts to train the country’s nurses in comprehensive HIV care and treatment.
Based on the survey findings, ICAP has partnered with the Ministry of Health to develop a training curriculum for nurses already in practice that provides competency-based education in HIV care and treatment. Special emphasis will be placed on tasks identified as having high or moderate gaps in training or competency. The curriculum will be utilized by the Ministry of Health and in ICAP’s pre-service and in-service training provided through its HRSA-funded Global Nursing Capacity Building Program (GNCBP).
The nursing assessment provided new knowledge and concrete evidence on what nurses are doing in HIV care and treatment and where there are gaps in training and competency. “This information will ensure that a planned adaptation of an in-service training curriculum for nurses is relevant and responds to the needs of Kenyan nurses,” said Dr. Mark Hawken, ICAP country director in Kenya.