(WP)STI/ICP/OCD/042-E Report series number: 99/GE/36(FIJ) English only
REPORT WORKSHOP ON STI AND REPRODUCTIVE HEALTH COUNSELING FOR PACIFIC ISLAND COUNTRIES
Convened by: WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC Suva, Fiji 6-15 October 1999
Not for sale Printed and distributed by: World Health Organization Regional Office for the Western Pacific Manila, Philippines October 1999 "
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NOTE
The views expressed in this report are those of the participants in the Workshop on STI and Reproductive Health Counseling for Pacific Island Countries and do not necessarily reflect the policies of the Organization.
This report has been prepared by the World Health Organization Regional Office for the Western Pacific for governments of Member States in the Region and for those who participated in the Workshop on STI and Reproductive Health Counseling for Pacific Island Countries, which was held in Suva, Fiji from 6 to 15 October 1999.
CONTENTS
I. SUMMARY ................................................................................................................. 1 2. INTRODUCTION 1.1 1.2 1.3 1.4 ......... '" ......................................................................... 2
Objectives ........................................................................................ 2 Participants, observers and resource persons ............................................... 2 Organization of the workshop ............................................. '" ................. 2 Opening ceremony ........................... '" ............................................... 2
2. PROCEEDINGS ....................................................................................... '" 3 2.1 Summary of the first day ....................................................................... 3 2.2 Summary of the second day ..... , .............................................................. 3 2.3 Summary of the third day ..................................................................... .4 2.4 Summary of the fourth day ................................................................. '" 5 2.5 Summary of the fifth day ...................................................................... 5 2.6 Summary of the sixth day - counselling on STI case results .............................. 6 2.7 Summary of the seventh day .................................................................. 6 2.8 Summary of the eighth day .................................................................... 6 2.9 Evaluation ....................................................................................... 7 2.10 Closing ceremony .............................................................................. 7
4. CONCLUSIONS .......................................................................................................... 7 ANNEXES: ANNEX 1 - LIST OF PARTICIPANTS, CONSULTANT, TEMPORARY ADVISERS, OBSERVERS AND SECRETARIAT ............................. II ANNEX 2 - AGENDA .............................................................................. 17
Keywords Sexually transmitted diseases / Counseling / Sexuality / Pacific Islands / Fiji
SUMMARY
In order to improve sexually transmitted infection (STI) services, the WHO Regional Office hosted an eight-day workshop with representatives from nine Pacific island countries and areas of the Region from the 6th to the 15 th October 1999. During this workshop, the participants: 1. reviewed and assessed STI counseling components of STI service delivery in Pacific island countries; identified key issues in STI and reproduce health counselling theory and practice in the Pacific;
2.
3. discussed value clarification and sexuality with regard to STI counseling issues, especially regarding young people; 4. observed STI counseling activities; and 5. developed action plans for improving STI counseling activities. This was the first regional workshop on STI counseling in the Western Pacific Region. It was an initial step towards expanding and improving the understanding and skills of health workers in counseling STI patients. In evaluating the workshop, the participants said that the: • • • workshop had focused on their needs; objectives of the workshop had been achieved; and the experience had been worthwhile. Additionally, the participants concluded that they had: 1) acquired skills in problem solving and situational analysis; 2) developed an awareness of the importance of personal values management and confidentiality in enhancing client relationships; 3) gained an understanding of the aims ofSTI counseling and; 4) developed an appreciation of the importance of integrating STI counseling into both reproductive health and primary health care services.
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I.
INTRODUCTION
1.1
Objectives The objectives of the workshop were to: a) review and assess the counseling components of STI service delivery in Pacific island countries; b) identify key issues in STI and reproductive health counseling theory and practice in the Pacific; c) discuss value clarification and sexuality with regard to STI counseling issues, with a focus on young people and STI issues; d) observe STI counseling activities; and e) develop action plans for improving STI counseling activities.
1.2
Participants, observers and resource persons
Eighteen participants representing nine Member States and three observers representing non-governmental organizations attended the training course. Two temporary advisers also attended the workshop. The secretariat from the WHO Western Pacific Regional Office provided technical and operational support for the workshop. The list of workshop participants, observers and the secretariat is attached as Annex I. 1.3 Organization of the workshop
The workshop was held in Suva, Fij i, from 6 to 15 October 1999. A range of methods were used during the workshop, including: presentations, small group discussions, case studies, plenary sessions and observation of clinical services. The workshop timetable is attached as Annex 2. There was no single chairperson for the workshop. Different participants took responsibility to act as chairpersons. Dr Ninkama Moiya of Papua New Guinea was elected rapporteur of the workshop. 1.4 Opening ceremony
The workshop was opened by the Honourable Luke Rokovada, Permanent Secretary of Health, Fiji. In his speech, the Hon. Rokovada highlighted the magnitude of the STI problem in the member countries and the need to adopt a strategy that takes into account the social, cultural and economic factors that have contributed to the increase in STI. The WHO Representative for the South Pacific, Dr Shichuo Li, replied on behalf of the Regional Director. Dr Li noted that STI services often focus on medical treatment. Generally, little time is spent on educating and counseling patients to prevent further infections. Dr Li urged
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the participants to overcome the sensitivities and cultural issues that confront health workers in discussing sexual issues and he emphasized this specifically with reference to working with young people. 2. PROCEEDINGS
2.1
Summary of the first day The day's proceedings focused on the STI situation in the Pacific.
The overall situation of STI in Pacific island countries and areas was reviewed. There have been few STI prevalence studies in Pacific island countries. However, the significant numbers of clinical cases demonstrate that there is a high rate of STI infections among the sexually active population. This is especially true of young people. Participants discussed STI reporting procedures within countries and highlighted the need for improved data collection. Participants noted a number of problems in the reporting of STI data, including: • • • • • poor reporting by private doctors of STI cases; self-treatment by patients of STI; limited STI screening (e.g., of pregnant women); limited laboratory testing capacity for STI; excessive time taken for processing of some STI tests (e.g., confirmatory HIV screening results); and a lack of personnel trained in STI data management and analysis.
•
The participants from each country gave a brief presentation on the STI situation in their country. Overall, an increase in the number of STI cases was noted. Common factors in this increase in STI cases were noted to include: changes in sexual behaviour; low condom use; and poor education and counseling of patients, which often results in subsequent infections. Discussions were also held about the benefits of a public health approach versus a medical/clinical approach to STI programmes. 2.2 Summary of the second day
The day's proceedings focused on core STI counseling attitudes and skills, including: the aims of STI counseling; communication skills; showing empathy; and encouraging treatment adherence. The workshop participants and resource persons identified the key aims of STI counseling as: • assisting clients to understand STI transmission and prevention, including the identification of personal strategies to prevent subsequent infections;
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•
giving clients the opportunity to discuss how to tell their sexual partners about their infection, and the need for them to go for treatment; and improving STI treatment efficacy through addressing treatment adherence problems.
•
The workshop sessions on communication skills focused on strategies that enable clients and health workers to discuss sensitive issues, including sexual behaviour. A major issue in STI counseling is the possibility of the health worker's own values negatively affecting the clientcounsellor relationship. This is especially common when clients engage in sexual behaviour disapproved of by health workers. Health workers need to be aware of this situation, and to ensure that they are non-judgemental in a counseling situation. The workshop participants identified and discussed various culturally-appropriate strategies for this situation. 2.3 Summary ofthe third day The day's proceedings focused on counseling skills for STI prevention. In discussions with clients, health workers often focus on information-giving. For example, health workers might give information about STI transmission and prevention to STI clients. Health workers often seem to believe that information-giving will promote behaviour change and thereby prevent future STI. However, the workshop discussions emphasized that information-giving is only the first step in promoting behaviour change by clients. Information-giving alone is not usually enough to prevent further STI infections. STI prevention counseling and education by health workers should include: • discussion with clients of the barriers they perceive in negotiating with partners for safer sex; problems clients may experience in utilizing and enjoying safer sex practices; issues around condom use, including the use of appropriate lubricants, strategies that clients could use if they experience condom breakage. e.g. avoiding douching, the use of emergency contraception, etc.; approaches to build clients' problem-solving skills; and efforts to build self-esteem and decision-making by clients.
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• •
In plenary discussions, the workshop participants discussed their experience with these issues in their own cultures and health services. They also discussed appropriate strategies for coping with these issues in their own settings. The STI counseling and service delivery needs of vulnerable groups such as sex workers and men who have sex with men were discussed. Participants recognized that existing health services often do not meeting the specific STI service needs of these groups. Special efforts need to be made to reach these groups. Outreach services, peer education, and NGO activities are all important strategies in STI service delivery for these groups.
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2.4
Summary of the fourth day
The day's proceedings focused on STI clinical counseling activities. The participants discussed the importance of the initial clinical discussion between STI clients and health workers. This initial discussion is crucial for a positive outcome for the client, including promoting appropriate behaviour change. Health worker time with individual clients is usually very limited. It is important that health workers make the best use of this time in asking clients about their sexual risk behaviour and to support clients in identifYing strategies to prevent future infections. Participants were trained to conduct a risk assessment and provide clients with information on STI prevention simultaneously. Health workers should begin clinical sessions by explaining to clients why sensitive questions about sexual behaviour need to be asked. Participants were trained in strategies for integrating i.) assessment of clients:· safe sex knowledge, risk assessment and problem solving strategies, with ii.) STI information giving, attitude and skill development. The participants discussed the specific issues that men may have in accessing health services. Special strategies, such as peer education, may be needed to reach men with reproductive health education, and to promote appropriate health care-seeking behaviour. 2.5 Summary of the fifth day The day's proceedings focused on youth and reproductive health counselling; In small group activities and plenary discussions, participants reviewed the special reproductive health needs of young people. Young people need to be encouraged to access STI, family planning, and other reproductive health services. It is important that any barriers which discourage young people from accessing services are removed. Common barriers include judgemental attitudes by health workers and inappropriate clinic hours (e.g.,. during school hours). Community-based programmes and peer education are important strategies for reaching young people with appropriate reproductive health education. Participants noted several key issues they experienced when trying to integrate STI counseling into reproductive health counseling. For health workers, these issues include: • • • • a lack of privacy and confidentiality in many clinic settings; a lack of training in STI management and counseling for health care WQrkers; the burden of multiple roles for health care workers; and a lack of experience in providing services for clients with special needs, e.g. men who have sex with men, sex workers, and young people. Participants identified some strategies they could use to address these issues, including: • • the development of monthly work plans to address time constraints; identifYing staff with the skills and interest to undertake STI counseling;
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• • 2.6
making flexible appointment arrangements; and prioritising client appointments. Summary of the sixth day - counseling on STI case results The day's proceedings focused on counseling clients on their STI case results.
Role-play and small group activities were used to focus on strategies for counseling clients on their STI case results, including giving either positive or negative results. Participants agreed that counseling sessions provide a key opportunity for education on safer sex, and to explore problems with safer sex practices. The need to communicate STI results (either positive and negative) in person, and confidentially, were emphasized. A key task for health workers is to assist clients to find ways to discuss with sexual partners positive STI case results and the need for treatment. Follow up counseling for infected clients should address ongoing emotional, physical, welfare and spiritual needs. Health workers should explore with clients the behavioural constraints of treatment adherence and the practice of safer sex. 2.7 Summary of the seventh day The day's proceedings focused on site visits to clinics undertaking STI counseling. Participants visited STI and other reproductive health services provided by the government and non-government organizations. Participants summarized the key features observed during these visits. They also discussed ways they could incorporate elements of these programmes in services in their own countries. The value of multi-sectoral support for clients, and the benefits of government and NGO partnerships were noted. The need for user-friendly counseling environments, including private counseling rooms, was discussed. the value of peer counselors for young people was emphasized. Also, it was realized that integrating STI services into other health services reduces stigma for those attending such services, especially in small communities. Participants also observed church-based HIV and AIDS education efforts. Participants discussed the important role of the church in their communities, especially in reducing discrimination against, and providing support for, people living with HIV and AIDS. It was agreed that partnerships between health services and religious bodies were especially important in Pacific communities. 2.8 Summary of the eighth day The day's proceedings focused on developing STI counseling action plans. In developing their action plans, participants identified: • • potential partnerships with community stakeholders; the resources needed to implement counseling programmes;
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• •
responsibilities in the health system for planning, training and monitoring STI counseling activities; and barriers to strengthening STI counseling services, and strategies to overcome these barriers.
A common issue in country action plans was the need to establish effective partner relationships between government and nongovernmental organizations, to respond to increasing STI cases and to expand STI counseling. The lack of training for health workers in STI counseling was noted as a key issue. The need for in-service training, and integrating STI counseling into the training curriculum for health workers was also noted. Following the workshop, many participants plan to meet with policy and health planners to advocate for the integration of STI counseling into primary health care settings. 2.9 Evaluation Workshop participants completed course evaluation forms on a daily basis. Their conclusions were that they had: • • acquired skills in problem solving and situational analysis; developed an awareness of the importance of personal values management and confidentiality in enhancing client relationships; gained an understanding of the aims of STI counseling and; and had developed an appreciation of the importance of integrating STI counseling into reproductive health and primary health care services. Closing ceremony
• •
2.10
The WHO Representative in the South Pacific, Dr Shichuo Li, presented the closing speech on behalf of the Regional Director of the WHO Regional Office of the Western Pacific. Dr Li congratulated the participants on their enthusiastic and active participation in the workshop. He noted the positive feedback ofthe participants in particular higlilighting the skills acquired by participants in prevention counseling and the development of personal and country action plans.
3.
CONCLUSIONS
1. In most Pacific Island countries, there is a lack of adequate data on STI prevalence and trends. There is a need to improve health information networks, specific STI datal information collection and to undertake special studies, e.g. STI prevalence studies.
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2. There is a need to strengthen local capacity for undertaking research on regular STI data collection, special studies and related services. It is essential that agencies and individuals from outside of the region undertaking research studies in the Pacific: a) engage in active partnership with Pacific island countries and communities; and b) disseminate their findings to these countries and communities. Such studies should include efforts to strengthen local research capacities. 3. People providing STI counseling need adequate training, follow-up and support for the referral of complex cases. They include government health workers, NGOs, and others such as traditional healers. 4. Further efforts are needed to: a) promote STI services at the primary health care level; b) revise the role of specialist STI services to focus OIl referral care, technical support and supervision of STI services at primary level; and c) to improve prevention efforts in STI clinics, including STI education and counseling, and condom promotion. 5. In a number of Pacific Island countries, pregnant women may be tested for HIV, especially in capital cities. Some of these countries have the opportunity to use ARV to prevent mother to child transmission ofHIV. There is a need to review this situation and to develop appropriate guidelines and protocols. In most countries, HIV testing strategies involve sending samples abroad for confirmatory tests, with long delays before people know their HIV status. These delays cause distress among patients and delays the provision of counseling and other support. These testing strategies should be reviewed, to enable confirmatory tests to be done in-country (e.g., with a second type of ELIZA test) whenever possible.
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7. There is a need to improve the communication and counseling skills of health workers through the revision of curricula, teaching methods and in-service training programmes. 8. The attitudes of health workers towards people with STI, including PL WHA (People Living with HIV and AIDS), are very important in assisting patients to develop positive attitudes towards their situation, and in contributing to family and community acceptance of PL WHA. There is a need for health workers to have training to: a) promote a good understanding of STI (including HIV) and acceptance ofPLWHA, and b) provide a user-friendly health service. 9. Anyone providing STI counseling must be aware of the influence of their own attitudes and values on their interactions with clients who may have differing values. This is especially important when working with marginalized groups such as sex workers and MSM. Training programmes for STI counselors need to address this issue. There is also a need for STI counselors to support outreach and peer education activities, especially for these marginalized groups. 10. STI counseling needs to focus on the education and empowerment of clients, to enable them to more effectively practice safer sex. Condom promotion remains a key part of safer sex, and STI counselors need to promote correct and consistent condom use whenever appropriate. II. Training of people doing STI counseling needs to include prevention counseling and assessment of STI risk. Such training should be part of health worker curricula and should
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be included in in-service and refresher training courses. Opportunities shouli:lbe developed to enable health workers to share their experience and skills in prevention and risk assessment counseling with each other.
12. STI counseling efforts with men need to recognize the local cultural definitions of masculinity, and accepted behavioural norms. These definitions and norms may constrain both men and women in practising safer sex. However, it is also importantcto recognize that these norms are changing, and that health workers need to approach men as individuals. 13. As most STI patients are under age thirty, it is essential that STI services are-accessible, available, appropriate and affordable for young people. STI services, including STI counseling, need to be "user friendly" to young people, which includes welcoming attitudes by health workers, and guarantees of confidentiality for all patients. STI counseling services need to spend extra time with vulnerable youth, including younger adolescents (those age 15 and younger), young women, homeless youth, and out-of-school youth. 14. Since the 1994 International Conference on Population and Development, many countries have recognized the need to integrate STI services into wider reproductive health services. Further efforts, including training of all health workers, need to be made to ensure such integration is achieved. 15. People providing STI counseling must be trained to give positive STI results to patients in an appropriate manner. They also need to be provided with referral and otherresources for patients experiencing serious mental health problems. 16. Partner notification (or contract tracing) is an important part of STI services, and should be promoted by people providing STI counseling. STr services need to develop appropriate partner notification systems. 17. There is a need for a multi-sectoral approach to STI issues, including STkounseling, which involves government, NGOs, religious, and other organizations. The approaches used by these different organizations can be especially effective in advocacy, using different approaches to reach different groups; and mobilizing communities and resources.
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WORLD HEALTH ORGANIZATION
ORGANIZATION MONDIALE DE LA SANTE
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL WORKSHOP ON STI COUNSELING FOR PACIFIC ISLAND COUNTRIES 6-15 October 1999 Suva, Fiji
WPRlOCD/STI( 4 )/99/1B/2 30 September 1999 ENGLISH ONLY
INFORMATION BULLETIN 2 LIST OF PARTICIPANTS, CONSULTANT TEMPORARY ADVISERS, OBSERVERS AND SECRETARIAT
1.
PARTICIPANTS
COOK ISLANDS
Ms. Tae Nootutai Health Inspecto Ministry of Health POBox 109, Avarua Rarotonga Cook Islands TEL. NO. (682)29664/29110 FAX NO. (682) 23109129110 EMAIL: aremaki@oyster.net.ck
FIJI
Dr Sophaganine Ty Medical Officer-in-Charge STI Clinic Ministry of Health 92 Amy Street Suva Fiji TEL. NO.: (679)311 312 FAX NO.(679) 306163
Dr Lusi Tuilada Medical Officer-in-Charge Dreketi Health Centre P.O. Box 70 Dreketi Post Office Vanualevu Fiji TEL. NO. (679) 813 010 Ext. 44 FAX NO. (679) 814 080
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Annex 1
REPUBLIC OF KIRlBA TI
Ms Keene Rotitaake District Principal Nursing Officer DPNO's Office PO Box 268 T.G.H. Nawerewere Tarawa Republic of Kiribati TEL. NO.(686) 28317/28100 FAX NO. (686) 28152
Ms Veronica Tekire District Principal Nursing Officer DPNO's Office POBox 268 T.G.H. Nawerewere Tarawa Republic of Kiribati TEL. NO. (686)21900/28100 FAX NO. (686)28152
Mr Benete Tokanang District Principal Nursing Officer DPNO's Office POBox 268 T.G.H. Nawerewere Tarawa Republic of Kiribati TEL. NO. (686)28\06 FAX NO. (686)28152
PAPUA NEW GUINEA
Dr Ninkama Moiya Senior Medical Adviser National AIDS Council Secretariat Office P.O. Box 1345 Boroko, N.C.D. Papua New Guinea TEL. NO. (675) 301 3978 FAX NO.(675) 323 1629
Ms Priscilla Agelavu Medical Social Worker Social Work Department Port Moresby General Hospital Free Mail Bag Boroko, N.C.D. Papua New Guinea TEL. NO. (675) 324-8289/279/381 FAX NO. (675) 325-0342
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Annex 1 SAMOA Dr Nuualofa Tuuau Potoi Director Preventive Health Services Private Mail Bag Apia Samoa TEL. NO. (685) 21 212 Ext. 376 FAX NO. (685) 21106 EMAIL: NuualofaTuuauPotoi@health.samoa.net.ws
Mr. Alapati Anoia Senior Nurse STDIAIDS Clinic Department of Health Apia Samoa TEL. NO. (685) 40012 FAX NO. (685) 26553
SOLOMON ISLANDS
Mrs Sarah Ben Principal Nursing Officer Reproductive Health Division Ministry of Health & Medical Services P.O. Box 349 Honiara Solomon Islands TEL. NO. (677) 20295 FAX NO. (677) 20085
Mr Amos Lapo STI National Coordinator Disease Prevention and Control Unit Ministry of Health & Medical Services P.O. Box 349 Honiara Solomon Islands TEL. NO. (677) 21043 FAX NO. (677) 20085
TONGA
Mrs 'Ofa Sanft Tukia Senior Health Officer Ministry of Health P.O. Box 59 Nuku'alofa Tonga TEL. NO.(676) 23200 FAX NO.(676) 24291
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Annex 1
Mrs Ngaluafe 'Akau'ola Public Health Midwife Ministry of Health P.O. Box 59 Nuku'alofa Tonga TEL. NO.(676) 23 200 FAX NO.(676) 24 291
TUVALU
Dr Vilikesa Rabukawaqa Health Assistance Manager Health Adviser - Tuvalu Ministry of Health, Women & Community Affairs Funafuti Tuvalu TEL. NO. (688) FAX NO. (688) 20832/20405
VANUATU
Mr. Henry Wetul Registered Nurse P.O. Box 009 Port Vila Vanuatu TEL. NO. (678)22-512 FAX NO. (678) 26-204
Ms. Leitangi J. Philip Senior Midwife POBox 009 Port Vila Vanuatu TEL. NO. (678) 22-512 FAX NO. (678) 26-204
2.
CONSULTANT
Ms Kathleen Casey Clinical Psychologist/Senior Educator Albion Street Centre Division of Medicine, Prince of Wales Hospital NSW Health, 150-154 Albion Street Surry Hills NSW 2010 Australia TEL NO. (612) 93321090 FAX NO. (6\ 2) 9332 4219 EMAIL: caseyk@sesahs.nsw.gov.au
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Annex 1 3. TEMPORARY ADVISERS
Ms Luse Fatupaito Lecturer Behavioural Science School of Public Health & Primary Care Fiji School of Medicine Private Mail Bag Suva Fiji TEL. NO. (679) 311 700 FAX NO. (679) 303469 EMAIL: luse.J@fsm.ac.fj
Mr Temo Sasau Youth Coordinator Fiji Red Cross Society P.O. Box 569 Suva Fiji TEL. NO. (679)314 133 FAX NO. (679) 303818
4.
REPRESENTA TIVES/OBSERVERS
FIJI SCHOOL OF MEDICINE
Dr Ayoade Olatunbosun-Alakija Trainer/Coordinator Fiji School of Medicine, Private Mail Bag, Suva Fiji TEL. NO.(679) 31 1-700 FAX NO.(679) 308-122 EMAIL ADDRESS:ayoade@fsm.ac.fj Internet: http://www.fsm.ac.fj
FIJI SCHOOL OF NURSING
Ms. Tokasa Vodivodi Fiji School of Nursing, Tamavua Suva Fiji TEL. NO. (679) 321-499 FAX NO. (679) 321-013
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Annex 1 SAFETY NET CARE FlJlI REPRODUCTIVE AND FAMILY HEALTH ASSOCIA nON OF FIJI (RFHAF) Ms. Vulase Waqanivalu Vodo Safety Net Care ASSOCIATION FijilRFHAF Box 2495 Government Buildings Suva Fiji TEL. NO. (679) 306-175 FAX NO. (679)306-178
5.
SECRETARIAT
Mrs K. Fritsch Nurse Educator Office of the WHO Representative in the South Pacific P.O. Box 113 Suva Fiji TEL. NO. (679) 304-600 FAX NO. (679) 300-462 EMAIL: fritschk@who.org.fj
Mrs Nancy Fee Intercountry Programme Adviser WHO Regional Office for the Western Pacific United Nations Avenue Manila TEL. NO. 63 25288001 FAX NO. 63 2 5211036 EMAIL: feen@who.org.ph
Dr Maria Elena F. BOlTomeo Medical Officer (STI/HlV/AIDS) Office of the WHO Representative in the South Pacific P.O. Box 113 Suva Fiji TEL. NO. (679) 304-600 FAX NO. (679) 300 462 EMAIL ADDRESS:borromeom@who.org.fj
Ms. Reiko Muto Associate Professional Officer Office of the WHO Representative in the South Pacific P.O. Box 113 Suva Fiji TEL. NO. (679) 304-600 FAX NO. (679) 300-462 EMAIL: mutor@who.org.fj
WORKSHOP ON STI/HIV AND REPRODUCTIVE HEALTH COUNSELLING FOR PACIFIC ISLAND COUNTRIES PROGRAMME o·
TIME Session 1 8:00 a.m. 8:30a.m.
DAY 1 Wed 6 October Theme: STI in Pacific Countries Registration Opening Ceremony Workshop Objectives Introductions Group Photograph
TIME
08:30 08:45
DAY 2 Thur 7 October Theme: Core STI Counselling Skills Recap
TIME
08:30 08:45
Sensitive Issues Exercise Risk Game
DAY 3 Frid 8 October Theme: Prevention Counselling Recap Counselling Process -Concept of counselling -Rapport/Environment -Problem Solving Model
TIME
08:30 08:45
DAY 4 Mon 11 October Theme: Clinical Activities Recap Risk Assessment Case Activity Feedback
TIME
DAY 5 Tues 12 October
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08:30 08:45
Theme: Special Issues: Youth and Reproductive Health Recap Counselling and Educating Young People -Value Statements -Mini-lecture and Case Study -Summary
10:00
10:45
Session
Session
10:15 BREAK Session
10:45
10:30
Session
Session
2 10:30 a.m. 11 :15 Group Expectations Ground Rules Fear in the Box Activity STI's in the Pacific
2 11:00 Attitudes and Values: -Values Clarification -Countertransference -Managing Your Discomfort
2 10:30 Problem-Solving Practice
2 11:00 Integrated Pre-Screening Counselling
2 10:45
Counselling and Educating Young People -continued Reproductive Health
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-..I
11:30
11:30 12:30
12:30
12:30
12:30 LUNCH BREAK Attitudes and Prevention Counselling -Information -Attitudes -Negotiation -Problem Solving 03:00
12:30
Session 3 1:30 p.m.
Session 3 STI's in Pacific Island Countries 01:30 Cultural and Service Issues -Country Presentations Summary and Comments
Communication Skills
Session 3 01:30
Session 3 01:30
Role Plays
Session 3 01:30
STI's in the Context of Reproductive Health -Discussion -Casework 03:00
03:00
03:00
03:00 BREAK Working with Special Groups: Sex Workers and MSM 03:15 Debrief: Key Issues and Strategies 04:15 Working with Men 03:15
Session 4 3:1505:00
Session 4 Public Health Approach to STI's 03:15
Aims of STI/HIV Counselling
Session 4 03:15
Result Provision Partner Notification ~ ~
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TIME Session 1 8:30am. 08:45 09:15 10:15 Session
WORKSHOP ON STIfHIV AND REPRODUCTIVE HEALTH COUNSELING FOR PACIFIC ISLAND COUNTRIES PROGRAMME DAY 8 DAY 6 TIME DAY 7 TIME Frid 15 October Wed 13 October Thurs 14 October Theme: Case Follow-Up Theme: STIIHIV Theme: Clinical Visits Activities 'Recap Interactive Exercise Positive Resuh Provision -Clinical Visits10:45 BREAK . Session .Session 10:30 08:30 08:45 !'!ecap 3riefing for Clinical VISits 'J8:3O Counselling Action Plans Making STI Counselling and Services a Reality
i tv
2 10:30 a.m. Role Plays: Giving Bad News Gase WorK - debrief 1(ey Issues and Strategies
2 11:00
2 11:30 -Clinical VisitsAction Planning
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CD
11:30 12:30 Session 3 1:30 p.m.
12:30 LUNCH BREAK 'Session Casewor1< debriefing -Key Issues and Strategies
12:15 .Session
3 01:30
3 12:45
.'resentation of Country Action Plans
-Clinical Visits02:30 Follow-up Counselling ,ssues and Referral 03:30 Session 4 03:30 05:00 -
03:00 BREAK 0315 Problem Solving for Treatment Adherence 06:30 --
De-briefing
'~3:()()
.Evaluation
(;Iosing Wor1<shop Dinner
,
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