A number of successes have been recorded in the region’s efforts to control the spread and mitigate the impact of HIV and AIDS, most notably, in the areas of -

  • strengthening the involvement of civil society;
  • prevention of mother-to-child transmission of HIV (PMTCT); and
  • the provision of antiretroviral (ARV) treatment,

but there is still a lot to be done. While these achievements are commendable, they have been accomplished in an environment where there exists a critically short supply of management systems and skills. This is due to a combination of factors such as small population sizes in various countries, the shortage of trained personnel and the inability to retain significant numbers of those trained. This high level of attrition in the region dictates that capacity-building must be an ongoing exercise so that the Caribbean can respond to the challenges posed by HIV and AIDS.

The Caribbean Regional Strategic Framework (CRSF) 2008 – 2012 has therefore identified the need to build capacity for HIV and AIDS services as one of its priority areas.

 

Human Resource Development

Training of health care workers.

The lead agency in the region with responsibility for human resource development is the Caribbean HIV/AIDS Regional Training (CHART) Network. The CHART Network was established in 2003 for the purpose of contributing to systematic capacity development among institutional-  and community-based health care workers involved in the prevention of HIV/AIDS,  in the care, treatment and support of persons living with HIV and AIDS, and for all Caribbean people.

To date, the Network consists of six national training centres and a Regional Coordinating Unit (RCU), the latter being situated at the University of the West Indies (UWI), Mona Campus, Jamaica and functioning as part of the UWI HIV/AIDS Response Programme (UWIHARP). The National Training Centres (NTCs) are located as follows: three centres are situated in Ministries of Healthin The Bahamas, Barbados and Jamaica, respectively; and two centres are placed within non-governmental organisations in Haiti  - GHESKIO (Le Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes) and Partners in Health/Zanmi Lasante.  A National Training Centre, situated at the UWI St. Augustine Campus,  was launched in Trinidad and Tobago in June 2007.  Tthis centre operates in collaboration with the Ministry of Health Central Office and the South-West Regional Health Authority of Trinidad and Tobago. In addition to the sites with active training centres, the Network includes the Organisaiton of Eastern Caribbean States (OECS) HIV/AIDS Project Unit.

This Network of training centres has trained and mentored approximately 16,500 healthcare workers from the public and private sectors in 29 countries and rerritories across the region. Over the next two years, the CHART Network, with support from the PANCAP Round 9 Global Fund Grant, will seek to train 2,400 additional health care providers.

Another key agency supporting the training of health care workers in all fields is the Pan American Health Organisation HIV Caribbean Office(PHCO). 

 

Training of Caribbean Health Leaders

The UWI/HARP has established a new regional initiative for training Caribbean health leaders. This initiative, the Caribbean Health Leadership Initiative (CHLI) was established in 2007 and seeks to train persons who are in leadership positions across the health spectrum. The programme aims to create a cadre of effective, committed leaders who will create positive change in HIV and AIDS and other health programmes and in the health systems of Caribbean countries. The approach taken by CHLI is based on the rationale that skills gained through systematic training in leadership and management will redound to the benefit of entire health systems.

The programme focuses initially on personal and professional development, building healthy teamwork and teaching systems. Scholars are encouraged to strengthen their reflective skills. Groups of five or six scholars work together in action-learning projects with each group guided by a mentor. The ultimate goal is that CHLI graduates will influence change in their respective countries and will form an enduring leadership-learning network across the Caribbean. The principal aim is not academic qualification, but personal learning and the acquisition of wisdom that can be applied to workplace settings. The programme is expected to interface with post-graduate academic leadership programmes at the University of the West Indies.

One of the key target groups is national AIDS Programme Managers. Three cohorts of health leaders have so far been trained. The CHLI will seek to train 40 additional leaders over the next two years  under the Global Fund Round Nine Grant.

The UWI recently commenced a programme for a Doctorate in Public Health which is expected to contribute a score of graduates to the region’s health programmes. The PANCAP Global Fund Round 9 Grant is expected to provide support to this programme in the coming years.

 

Strengthening Laboratory Support

Due to the small size of the geograpy, economy and pouplations of many countries in the region, many do not have the laboratory capacity to provide the laboratory services required for the diagnosis and monitoring of persons living with HIV and AIDS.

Through the PANCAP Round 3 Global Fund Grant, support was provided for the establishment of a regional laboratory network. This network will be further strengthened with support from the  United States President's Emergency Plan for AIDS Relief (PEPFAR) and the PANCAP Round 9 Global Fund Grant.

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