Sarah A Gutin1,2, K Rivet Amico1, Elsa Hunguana3, António Orlando Munguambe3, Carol Dawson Rose2. 1. 1 Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA. 2. 2 Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA. 3. 3 I-TECH Mozambique, Maputo, Mozambique.
Abstract
BACKGROUND: Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. METHODS: We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. RESULTS: With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. CONCLUSION: Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.
BACKGROUND: Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. METHODS: We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. RESULTS: With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. CONCLUSION: Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.
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