Namibia: Counselors from the community help meet the needs of the community (February 2006)

Namibia is one of few countries in Africa utilizing community or lay counselors for counseling and performance of rapid testing in public health facilities. The Ministry of Health and Social Services, in collaboration with the Emergency Plan, introduced the community counselors program in May 2005 to increase capacity to provide counseling and testing services and enhance the effectiveness of prevention of mother-to-child transmission (PMTCT) and antiretroviral treatment (ART) services.

Quality counseling and testing is a cornerstone for the success of PMTCT, ART and other services. Yet due to a lack of human resources capacity, quality services had been limited in Namibian public health facilities, with healthcare workers unable to cope with the high demand. Community counselors, selected from the community by health workers, fill this crucial gap in human resources by assisting overburdened health workers with counseling and testing and a wide range of other activities.

The program grew from 24 counselors in May to 112 counselors, providing services in 45 public health facilities, in September 2005. The counselors are recruited and trained rigorously for twelve weeks before deployment to public health care facilities, and they work under close supervision from health care providers in charge of clinics. In just these initial few months, the initial counselors provided pre-test counseling to 11,474 clients and post-test counseling to 9,540, reflecting the important gap in the clinical setting that these counselors are filling.

In July 2005, the Ministry officially launched rapid HIV testing in public health facilities. Community counselors have been trained in rapid diagnostic test techniques by laboratory scientists at the Namibia Institute of Pathology (NIP). More than 95 % of deployed counselors have passed the rapid HIV testing examination and have been certified to perform the tests. This is a major accomplishment, considering that rapid testing is typically conducted by NIP laboratory scientists and the average community counselor has only a junior or senior secondary level of schooling. Community counselors provide an affordable ($200 per month) and effective resource appropriate to the needs of Namibian communities.

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