Recognising that doctors alone would not be able to meet this need, the Department of Health (DoH) authorised nurses to initiate treatment in 2010. This change in protocol offered an opportunity to dramatically improve the effectiveness of HIV programmes in primary health settings.
In partnership with the DoH, Anova, together with other partners, implemented Nurse Initiated Management of Antiretroviral Therapy (NIMART) training so nurses can help more patients access ARVs. Anova continues to train nurses in NIMART in Gauteng and Mopani – training thousands of nurses since 2010. After the training, Anova’s doctors continue to provide support and mentoring to the nurses at their place of work, to ensure that they can independently provide medical care and treatment to patients living with HIV.
Anova also trains health workers in TB management, elimination of mother-to-child transmission of HIV (EMTCT), training on monitoring and evaluation of HIV/TB programme performance and basic pharmacy principles.
Anova has developed competency training for clinical staff, and other materials catering to Key Populations, including men who have sex with men (MSM), transgender people, women who have sex with women, people who inject drugs, and sex workers. Anova has expanded this work outside of South Africa.
This key population training covers both sensitivity/diversity training and biomedical training. Training is followed by mentoring doctors and nurses to ensure that they have adequate skills to care for key populations. Nurse mentoring includes recapping the initial training and one-on-one sessions in which skills are demonstrated and cases discussed. Doctor mentoring takes place with groups and involves case discussions.
Comprehensive facilitator and participant manuals have been developed. Other training materials include pocket guides, posters on how to take a sexual history and clinic questionnaires.
This manual draws on the experience of the Anova Health Institute’s Health4Men project that provides sexual health services for men who have sex with men (MSM) in South Africa. The manual is a resource to assist healthcare workers to provide appropriate and accessible psychosocial and medical care for MSM.
In the light of an emphasis on extending access to competent sexual health services for two Key Population groupings, namely men who have sex with men (MSM) and sex workers (SW), the transgender population has generally been overlooked within the public health sector. This applies equally to sexual health-related research on Key Populations where transgender people have often been ignored; where they have been included, they have frequently been incorporated as being either MSM or SWs.
Importantly, transgender people experience their own set of unique barriers to accessing essential health services. These include transphobia and trans-prejudice, stigma and discrimination, and a pervasive lack of understanding and insight into their health needs among health professionals.
It is within this context that we welcome you to this training material.
This training content is intended to be preceded by another training course developed by the Anova Health Institute, Key Populations Diversity Training. Being exposed to this combined content has been designed, firstly, to facilitate the development of insight into various stereotypes and prejudices regarding members of Key Populations, including transgender people. Secondly, this current course will develop health workers’ knowledge regarding the rendering of competent health services specifically for transgender people.
We acknowledge the dedicated hard work of Dr Anastasia Tomson who developed this content on our behalf. It was a pleasure working with her throughout the process and we benefited greatly from her significant insights. We also acknowledge and thank Professor Roy Shires of the Endocrinology Department of the University of the Witwatersrand, and psychiatrist Dr Greg Jonnson for undertaking a review of elements of this training manual. We extend appreciation to Jill Schlachter who edited and structured this course content, and Anthony Dalton for the layout. The entire process was driven and coordinated by Glenn de Swardt.
Finally, we thank our donors for their support and confidence in us to undertake training of health workers on the provision of services to transgender people, and we express our sincere appreciation to the Department of Health for their generous partnership.
To download the Transgender Health Training manuals click on the links below: