Human resource capacity remains the single largest obstacle to establishing a sustainable and quality HIV/AIDS program in Guyana. Appropriate and coordinated training was considered essential to reduce the shortage of skilled workers in the health sector, and in this context, in 2005, I-TECH established a collaborative program with the Guyanese Ministry of Health and the U.S. Centers for Disease Control and Prevention Global AIDS Program (CDC-GAP) to support training. The goal identified was to coordinate and ensure high quality training in HIV/AIDS care and treatment according to national policy and international standards. To this end, four objectives were elaborated, and their associated activities have been funded by PEPFAR over the past five years.

In support of its first objective, I-TECH has collaborated closely with the Ministry of Health as well as other donor agencies and implementing partners, to co-ordinate, record and promote HIV/AIDS trainings using both TrainSMART, an electronic monitoring database, and a national HIV and AIDS Care and Treatment Training Calendar. An additional objective of the program has been the facilitation of monitoring and evaluation activities, where these relate to HIV/AIDS care and treatment trainings

Thirdly, the program has also worked with public and private sector partners to develop national, standardized, in-service curricula on HIV Basics for nurses, pharmacists and Medex. Likewise, in keeping with PEPFAR's focus on pre-service training of the health workforce, since FY2008, I-TECH has been assisting with the integration of HIV/AIDS care and treatment content into pre-service curricula for nurses, pharmacists, physicians, laboratory technologists and Medex. The final and fourth objective of the I-TECH program has been the support of the national HIV and AIDS website. This has successfully promoted an understanding and awareness of the Government's National HIV and AIDS Strategic Plan, and also encouraged information-sharing and increased access to HIV and AIDS information, resources, and tools for health professionals, members of the media, and the general public.

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

1. Pre-service training been clearly elaborated as a priority since FY09. Appropriate HIV content will be integrated into the pre-service Community Health Worker training course in the Ministry of Health.

2. The database currently tracking HIV-related training will be transitioned into the Ministry of Health to monitor human resource training across all areas of health.

3. Training of Trainers will be expanded to increase the skilled human resource base for training adult health learners in the pre-service and in-service setting. Two additional master trainers will also be certified.

4. Mentoring of Medex in the interior and rural areas will continue to refine their clinical skills in providing supportive care to PLHIV and other residents with targeted communicable and infectious diseases such as tuberculosis and malaria.

Activity Narrative: Human resource capacity remains the single largest obstacle to establishing a stable and quality HIV/AIDS program in Guyana. Appropriate and coordinated training is essential to reduce the shortage of skilled workers in the health sector. To improve upon the quality of pre-service training of health care providers, I-TECH will continue to support the MOH to integrate HIV/AIDS into pre-service training programs. I-TECH has already initiated the process of integrating the approved HIV/AIDS content into the pre-service Medex training program within the Health Sciences Education Unit (HSEU) and the HIV/STI core course for medical, pharmacy, medical technology and nursing students within the Faculty of Health Sciences at the University of Guyana. This process will be continued with the integration of appropriate HIV/AIDS related content into the Community Health Worker (CHW) pre-service curriculum within the Health Sciences Education Unit (HSEU) of the Ministry of Health. In addition, the support provided to the University of Guyana for preservice training of medical, pharmacy, medical technology and nursing students within the area of HIV and AIDS will be boosted by an improved quality education through the provision of needed teaching resources, learning aids and the enhancement of study and laboratory facilities for skills upgrading.

Since 2008, I-TECH began a process of training trainers to expand the skilled human resource base for effective training of health care workers. This was continued in FY2009 with the development of a training program for tutors of the nursing schools, the Medex and the CHW programs in the MOH. I-TECH will continue to build the community of trainers skilled in the application of teaching methodologies that support adult learning techniques in the pre- and in-service environments by providing six training-of-trainers courses. These courses will utilize the HIV Basics for Nurses, Pharmacists and Medex curricula previously developed through the Guyana National Training Coordination Centre as well as the Stigma and Discrimination and PMTCT curricula developed within the Caribbean. I-TECH will also continue to build skills in curriculum development by training two (2) more master trainers who are health-professionals. One master trainer (a Medex) attached to the Ministry of Health was already trained in 2009.

Likewise in 2008, I-TECH introduced TrainSMART, a web-based database that tracks the numbers of HIV-related training events, trainers and trainees in Guyana. It includes data from I-TECH, PEPFAR training partners and the Government of Guyana. Local training partners have been trained to use this database for various purposes including reporting, assessing coverage gaps and/or duplication of training provided to the health workforce, as well as in support of rational planning for training interventions. I-TECH will now work closely with the Human Resources Department of the Ministry of Health to transition TrainSMART into the MOH as a national human resource monitoring and reporting tool.

In 2009, I-TECH began a program of mentoring Medex in the interior of Guyana for the supportive care of PLHIV in association with the local office of the Francois Xavier Bagnoud Center of the University of Medicine and Dentistry of New Jersey. I-TECH will continue to support the mentoring of Medex in the rural and hinterland areas in all areas of care and treatment of communicable infectious diseases such as tuberculosis and malaria as well as in the supportive care of PLHIV in the absence of a physician.

Finally, I-TECH will continue to support the national HIV/AIDS website. The site, which has been operational since fall 2005, serves as a primary communication tool and a resource for health professionals, donors, implementing partners and the general public. Funding supports the Webmaster who provides continual improvement to and maintenance of the site. I-TECH through the Guyana National HIV Training and Coordination Committee (GYNTCC) will also maintain a national training calendar so events are timely, not redundant and do not overlap.

Funding is from HHS/HRSA and in-country oversight resides with the CDC Office which provides technical and administrative support.

Deliverables/Additional Targets: HIV/AIDS content integrated into core pre-service curriculum for CHW at HSEU. Training of Trainers Curricula based on HIV Basics for Nurses/Pharmacists/Medex Curricula Training of Trainers for new and current tutors and other health care professionals Training Database transitioned to the MOH for tracking human resources within the public sector HIV/AIDS website Training calendar updated on a quarterly basis