Unit 1: Introduction to Accompagnateur Training

Background

The aim of this unit is to provide a framework for the course so that participants know what to expect. This unit should also set the tone for the course, establishing ground rules and creating a collaborative and respectful learning environment. This unit is designed to help participants begin to develop the kind of positive, trusting relationships with fellow participants that will sustain them in their future roles as accompagnateurs. It should also be stressed that they are starting the course with a wealth of knowledge, and that their ideas, suggestions, and experiences should be valued and drawn upon throughout the training.

Objectives

By the end of the unit, participants will be able to:

1. Recognize the facilitator(s) and fellow participants.
2. Describe the rationale and key topics to be covered throughout the course.
3. Use the Accompagnateur’s Handbook, recognizing icons, graphics, and objectives.
4. Describe the ground rules they jointly established to create a respectful and trusting environment.
5. Describe the importance of confidentiality, both about patient information and about information shared during the training.

Time Required

2 hours, 45 minutes

Unit Overview

Key Points

• Participants have much to share with their peers, so encourage everyone to contribute frequently to the discussions and exercises.
• Try to learn everyone’s name and encourage participants to do the same.
• Encourage the participants to ask questions at any time throughout the course.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (3.7 MB) | Kinyarwanda (3.59 MB) | Kreyol  (3.85 MB) | Sesotho (4.94 MB)| Chichewa (2.98 MB)
  
• Participants' Handbook (pdf) - English (4 MB) | Kinyarwanda (3.41 MB) | Kreyol (3.59 MB) | Sesotho (5.93 MB) | Chichewa (2.41 MB)
  
• Visual Aid (Powerpoint/pdf) - English [Flipcharts (2.3 MB) / Slides (2.7 MB)] | Kinyarwanda (1.54 MB) | Kreyol (7.47 MB) | Sesotho (1.73 MB)| Chichewa (3.26 MB)
  
• Visual Aid Notes (pdf) - Kinyarwanda (1.54 KB) | Kreyol (2.8 MB) | Sesotho (970.52 KB)
  

Unit 2: Introduction to Partners In Health

Background

The aim of this unit is to introduce participants to the mission and vision of Partners In Health (PIH), including the concepts of health as a human right, building community partnerships, solidarity with the poor, and social justice. PIH is committed to improving the health and well-being of people living in poor communities. PIH believes that health care is a fundamental right, not a privilege. Accompagnateurs play a key role in ensuring that PIH fulfills its mission and vision. Accompagnateurs provide companionship and support to patients, distribute medicine, provide community education, and are a critical link between the clinic and the community. Accompagnateurs are the cornerstone of PIH's work and success and are essential in helping to improve the health of a community. This unit should create a sense of excitement and purpose within participants - they are joining a network of almost 5,000 employees in nine different countries speaking eight different languages, all united with the same goal of providing high-quality, comprehensive health care to those most in need.

Objectives

By the end of the unit, participants will be able to:

1. Explain the mission and vision of Partners In Health (PIH) (providing access to primary health care and education, addressing socioeconomic needs, building community partnerships through solidarity, and working in collaboration with national governments).
2. Discuss the concepts of solidarity and liberation in health.
3. Explain the concept of a human right and its relevance to Partners In Health (PIH).
4. Describe the importance of accompagnateurs to the Partners In Health (PIH) model and in the community.
5. Explain how accompagnateurs are chosen.
6. Describe important qualities of the patient-accompagnateur relationship.

Time Required

2 hours, 15 minutes

Unit Overview

Key Points

• The mission and vision of PIH includes providing access to primary health care and education, addressing socioeconomic needs, building community partnerships through solidarity, and working in collaboration with national governments.
• PIH believes that access to health care, education, food, water, shelter and respect are fundamental human rights.
• Accompagnateurs are the cornerstone of PIH’s work and success and are essential in helping to improve the health of a community.
• A successful accompagnateur is one who can walk with the suffering — a person who is empathetic, responsible, trustworthy, non-judgmental, and respectful.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) English (1.8 MB) | Kinyarwanda (1.59 MB) | Kreyol (2.18 MB) | Sesotho (1.58 MB)| Chichewa (1.26 MB) 
• Participants' Handbook (pdf) English (2.6 MB) | Kinyarwanda (1.87 MB) | Kreyol (10.83 MB) | Sesotho (11.23 MB)| Chichewa (1.36 MB)
  
• Visual Aid (Powerpoint/pdf) - English [Flipcharts (2.8 MB) / Slides (11.4 MB)] | Kinyarwanda (3.81 MB) | Kreyol (50.27 MB) | Sesotho (7.97 MB) | Chichewa (14.7 MB) 
• Visual Aid Notes (pdf) - Kinyarwanda (3.81 MB) | Kreyol  (21.58 MB) | Sesotho (1.14 MB)
  

Unit 3: What is HIV/AIDS?

Background

HIV/AIDS progresses in stages, and asymptomatic HIV can last for many years. However, antiretroviral (ARV) medicine must be taken to control the disease, regardless of the severity of symptoms. In addition, people living with HIV/AIDS may get opportunistic infections: infections that arise because HIV has weakened their immune systems. Accompagnateurs must recognize the stages of HIV/AIDS and the symptoms of various opportunistic infections. This unit starts their clinical training with basic information about HIV and AIDS.

Objectives

By the end of the unit, participants will be able to:

1. Describe the concept of germ theory.
2. Explain what the acronyms HIV and AIDS mean, what the diseases are and how they differ.
3. Define the four different stages of HIV and AIDS.
4. Recognize the major symptoms associated with HIV and AIDS.
5. Explain that there are multiple opportunistic infections associated with AIDS.

Time Required

1 hour, 40 minutes

Unit Overview

Key Points

• HIV is a virus that multiplies in the body and destroys the immune system.
• When HIV multiplies in the body and destroys the immune system, people can get sick and die; this sickness is called AIDS.
• HIV has four stages: primary HIV infection, quiet HIV infection, active HIV infection, and AIDS.
• HIV often looks like a lot of other diseases.
• If someone has any AIDS-like symptoms, he or she should go to the clinic and get tested.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (4.2 MB) | Kinyarwanda (5.91 MB) | Kreyol (6.28 MB) | Sesotho (6.34 MB) | Chichewa (5.89 MB) 
• Participants' Handbook (pdf) - English (10.7 MB) | Kinyarwanda (6.4 MB) | Kreyol (11.26 MB) | Sesotho (7 MB) | Chichewa (8.04 MB) 
• Visual Aid (Powerpoint/pdf) - English [Flipcharts (3.1 MB) / Slides (2.4 MB)] | Kinyarwanda (6.34 MB) | Kreyol (8.47 MB) | Sesotho (6.53 MB)| Chichewa (7.26 MB)
  
• Visual Aid Notes (pdf) - Kinyarwanda (3.2 MB) | Kreyol (4.11 MB) | Sesotho (3.27 MB) 

Unit 4: HIV/AIDS: Prevention and Transmission

Background

The job of an accompagnateur encompasses much more than merely observing patients
taking their medicine. Accompagnateurs observe their patients for side effects and other
needs and share information about HIV/AIDS with members of their community. The
more accompagnateurs know about HIV/AIDS and its manifestations, the better they
will be at their jobs. This unit helps accompagnateurs support patients, refer them to the
clinic when necessary, and recommend testing for those who are experiencing HIV and
AIDS-like symptoms.

Objectives

By the end of the unit, participants will be able to:

1. List at least three ways in which HIV is and is not transmitted.
2. Describe who can get HIV.
3. Explain what an HIV test is, and why it is important to be tested.
4. Discuss how to avoid getting infected with HIV.
5. Demonstrate how to use male and female condoms.
6. Share information with community members about HIV/AIDS.
7. Discuss their role in clinic referral for AIDS-like symptoms.

Time Required

3 hours, 10 minutes

Unit Overview

Key Points

• Anyone can get HIV.
• People taking AIDS medicines can live long lives.
• HIV travels in blood, semen, vaginal secretions, and breast milk.
• The best ways to avoid HIV and AIDS are to use condoms and to avoid contact with other people’s blood.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (6.4 MB) | Kinyarwanda (7.34 MB) | Kreyol (8.57 MB) | Sesotho (8.25 MB) | Chichewa (7.31 MB)
  
• Participants' Handbook (pdf) - English (3.3 MB) | Kinyarwanda (2.33 MB) | Kreyol (2.63 MB) | Sesotho (2.74 MB) | Chichewa (2.19 MB)
  
• Visual Aid (Powerpoint/pdf) - English [Flipcharts (2.3 MB) / Slides (2.6 MB)] | Kinyarwanda (3.21 MB) | Kreyol (3.78 MB) | Sesotho (2.94 MB) | Chichewa (3.05 MB)
  
• Visual Aid Notes (pdf) - Kinyarwanda (1.55 MB) | Kreyol (1.64 MB) | Sesotho (1.58 MB)

Unit 5: Treatment of HIV/AIDS

Background

Antiretroviral medicines (ARVs) need to be taken at specific times of the day, under specific conditions (for example, with food, without food, etc.). They also need to be taken throughout a patient’s lifetime. The more that accompagnateurs understand about HIV/AIDS treatment, the easier it is for them to encourage their patients to continue their treatment and to avoid behaviors that will endanger their health. This unit introduces ARVs and issues of adherence. This topic is continued in Unit 6, which addresses the side effects of these medicines.

Objectives

By the end of the unit, participants will be able to:

1. Explain that antiretrovirals (ARVs) work to stop HIV from multiplying in the body.
2. Explain when ARVs should be taken, how often, for how long, and the correct dosage.
3. Recognize the names of ARVs and the basic symbols used in treatment cards.
4. Explain that ARVs should be stored in dry, dark, cool areas out of the reach of children.
5. Recognize signs that patients are consistently taking ARVs and using good health practices, as well as signs that they are not.
6. Demonstrate how to use treatment cards.
7. Define the term “adherence” and describe problems of adherence.

Time Required

2 hours

Unit Overview

Key Points

• ARVs work to stop HIV from multiplying in the body.
• HIV treatment is life-long.
• People living with HIV/AIDS must take ARVs at specific times of the day and under specific conditions.
• It is difficult to take ARVs every day forever, but if people living with HIV/AIDS stop taking them, the infection will develop resistance to the medicine.
• Taking alcohol or drugs makes it harder for ARVs to work.
• Good nutrition helps patients stay healthy.

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) English (2.6 MB) | Kinyarwanda (1.98 MB) | Kreyol (2.41 MB) | Sesotho (2.51 MB) | Chichewa (1.69 MB) 
• Participants' Handbook (pdf) - English (3 MB) | Kinyarwanda (2.18 MB) | Kreyol (2.68 MB) | Sesotho (2.71 MB)| Chichewa (2.02 MB)
  
• Visual Aids (Powerpoint/pdf) - English [Flipcharts (2.4 MB) / Slides (5.4 MB)] | Kinyarwanda (2.15 MB) | Kreyol (2.4 MB) | Sesotho (2.31 MB)| Chichewa (3.02 MB)
  
• Visual Aid Notes (pdf) - Kinyarwanda (1.41 MB) | Kreyol (2.06 MB) | Sesotho (1.41 MB)

Unit 6: Side Effects of Antiretroviral Medicine

Background

Many of the side effects of antiretroviral medicines (ARVs) are dangerous. They can threaten the health of patients and challenge patients’ commitment to continuing treatment. The accompagnateur is the only trained person who sees the patient every day, and is therefore the most likely to notice side effects quickly and make sure the patient gets appropriate medical care. This unit provides accompagnateurs with the knowledge and skills they need to monitor patients for side effects, to advise them to seek treatment, and to counsel patients on the importance of adherence.

Objectives

By the end of the unit, participants will be able to:

1. Define the term “side effect.”
2. List five major side effects of ARVs.
3. Pose questions to assess whether a patient has side effects.
4. Recognize three signs for immediate referral to the clinic.
5. Recognize three signs for referral to the clinic within a week.

Time Required

1 hour, 50 minutes

Unit Overview

Key Points

• A bad reaction to a medicine is called a side effect.
• Antiretrovirals can cause many side effects.
• Accompagnateurs must ask patients how they are feeling every day.
• Patients with urgent side effects, including allergic reactions, should visit the clinic immediately.
• Patients with common non-urgent side effects should visit the clinic within a week of experiencing the side effect.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (8.1 MB) | Kinyarwanda (9.33 MB) | Kreyol (10.64 MB) | Sesotho (10.7 MB) | Chichewa (9.31 MB)
  
• Participants' Hand book (pdf) - English (8.1 MB) | Kinyarwanda (3.5 MB) | Kreyol (3.7 MB) | Sesotho (3.76 MB)| Chichewa (3.49 MB)
  
• Visual Aid (Powerpoint/pdf) - English [Flipcharts (1.5 MB)/ Slides (1.9 MB)] | Kinyarwanda (4.04 MB) | Kreyol (4.4 MB) | Sesotho (4.11 MB) | Chichewa (4.07 MB)
  
• Visual Aid Notes (pdf) - Kinyarwanda (2.85 MB) | Kreyol (2.86 MB) | Sesotho (7.76 MB) 

Unit 7: Women and HIV/AIDS

Background

Women are more vulnerable to HIV/AIDS than men are for many reasons. To be effective, accompagnateurs need to understand the strain this vulnerability puts on their female patients and all the women in their community. They also need to know how to educate women to avoid infection and how to support women who are infected in their daily lives, in healthy pregnancies, and beyond. This unit deepens the accompagnateurs’ understanding of issues related to HIV/AIDS and women, and it provides them with an opportunity to practice how they will work with women in their communities.

Objectives

By the end of the unit, participants will be able to:

1. Describe the impact of HIV/AIDS on women.
2. Describe five ways that women are more vulnerable than men to HIV/AIDS.
3. Describe how women with HIV can transmit HIV to their infants and how they can prevent transmission.
4. Explain how accompagnateurs should follow up with mothers after delivery.
5. Demonstrate how to prepare infant formula.

Time Required

2 hours, 45 minutes

Unit Overview

Key Points

• Women are more vulnerable to HIV/AIDS than men because of biological, social, and cultural factors.
• Cultural practices, economic dependency, abandonment by their spouses, lack of rights regarding land ownership and inheritance, and lack of education are all factors that affect women living with HIV.
• All pregnant women should be tested for HIV.
• Antiretrovirals (ARVs) can protect a baby from getting HIV from its mother.
• Infant formula can protect a baby from getting HIV from its mother.
• HIV-positive pregnant women should see their doctor frequently.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (3.3 MB) | Kinyarwanda (7.12 MB) | Kreyol (8.2 MB) | Sesotho (8.96 MB) | Chichewa (7.84 MB) 
• Participants' Handbook (pdf) - English (12.8 MB) | Kinyarwanda (12.8 MB) | Kreyol (5.41 MB) | Sesotho (5.64 MB) | Chichewa (5.38 MB)
  
• Visual Aid (Powerpoint/pdf) - English [Flipchart (4.5 MB) / Slides (9.8 MB)] | Kinyarwanda (6.79 MB) | Kreyol (7.21 MB) | Sesotho (7.49 MB) | Chichewa (7.33 MB) 
• Visual Aid Notes (pdf) - Kinyarwanda (4.42 MB) | Kreyol (4.84 MB) | Sesotho (4.91 MB)

Unit 8: Sexually Transmitted Infections

Background

HIV is a sexually transmitted infection (STI) that is more easily transmitted to a new person if that person already has a different STI. The major difference between HIV and other STIs is that most other STIs can be cured, but HIV cannot be cured, only controlled. Accompagnateurs need to know about the range of STIs, not just HIV. Their unique role within the community also makes them well suited to educating others about STIs and how to avoid them, and urging those who display symptoms of STIs to seek treatment. This unit is designed to equip them for that aspect of their role.

Objectives

By the end of the unit, participants will be able to:

1. Explain what a sexually transmitted infection (STI) is.
2. Explain how STIs are transmitted.
3. Compare and contrast HIV and other STIs.
4. Recognize the symptoms of STIs.
5. List ways to protect against STIs.
6. Explain the importance of having partners tested when a patient is diagnosed with an STI.
7. Share information about STI prevention and treatment with community members.

Time Required

1 hour, 40 minutes

Unit Overview

Key Points

• HIV is more easily transmitted to people who have STIs than to people who do not.
• People can get an STI when they have sex with someone who has an STI.
• If a person is diagnosed with an STI, his or her partner should get tested immediately.
  
• HIV is an STI.
  
• People often do not know they have an STI because they have no symptoms.
  
• After abstinence, the best protection against STIs is a condom.
  
• Accompagnateurs should teach their community members about STIs.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (7.1 MB) | Kinyarwanda (4.85 MB) | Kreyol (5.53 MB) | Sesotho (5.68 MB)| Chichewa (4.91 MB)
• Participants' Handbook (pdf) - English (9.7 MB) | Kinyarwanda (2.08 MB) | Kreyol (2.26MB) | Sesotho (2.26 MB) | Chichewa (2.11 MB) 
• Visual AId (Powerpoint/pdf) - English [Flipchart (0.9 MB) / Slides (0.8 MB)] | Kinyarwanda (2.02 MB) | Kreyol (2.03 MB) | Sesotho (2.06 MB)| Chichewa (2.01 MB)
  
• Visual Aid Notes (pdf) - Kinyarwanda (1.59 MB) | Kreyol (1.56 MB) | Sesotho (1.6 MB)
  

Unit 9: Stigma and Discrimination

Background

Stigma and discrimination occur when people think about and act negatively toward a certain group of people. Stigma and discrimination toward people living with HIV/AIDS are barriers to HIV prevention, treatment, and for many reasons. They deter people from getting tested, telling their partners they are HIV-positive, going to the clinic for treatment, and getting necessary care and support. Stigma and discrimination can lead to isolation, violence, abandonment, and the breakdown of social networks in the community. This unit aims to help accompagnateurs understand and recognize stigma and discrimination, recognize their own attitudes toward people living with HIV/AIDS, and decrease stigma and discrimination in their communities.

Objectives

By the end of the unit, participants will be able to:

• Empathize with people living with HIV/AIDS who are stigmatized and discriminated against.
• Define and recognize stigma and discrimination.
• Identify the causes of stigma and discrimination.
• Describe the consequences of stigma and discrimination.
• Recognize their own attitudes about people living with HIV/AIDS and how these attitudes affect their work.
• List strategies accompagnateurs can use to decrease stigma and discrimination related to HIV/AIDS in their community.

Time Required

3 hours, 35 minutes

Unit Overview

Key Points

• Stigma is a negative attitude or belief you have about another person because you think he or she is different in some way (what you think).
• Discrimination is an unfair way of treating someone or acting toward someone because you think he or she is different in some way (what you do).
• Often people do not talk about, learn about, prevent or treat HIV because of stigma and discrimination.
  
• Accompagnateurs can decrease stigma and discrimination by educating people, setting an example, and offering people support, care, and treatment for HIV.
  
• Accompagnateurs need to be aware of their own feelings and attitudes toward people living with HIV/AIDS.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (2.8 MB) | Kinyarwanda (2.81 MB) | Kreyol ( 3.51 MB) | Sesotho (3.56 MB) | Chichewa (2.74 MB)
• Participants' Handbook (pdf) - English (3.1 MB) | Kinyarwanda (2.3 MB) | Kreyol (2.63 MB) | Sesotho (2.67 MB) | Chichewa (2.39 MB)
  
• Visual Aid (Powerpoint/pdf) - English [Flipchart (1.8 MB) / Slides (0.6 MB)] | Kinyarwanda (1.75 MB) | Kreyol (1.77 MB) | Sesotho (1.78 MB)| Chichewa (1.74 MB)
  
• Visual Aid Notes (pdf) - Kinyarwanda (1.22 MB) | Kreyol (1.24 MB) | Sesotho (1.25 MB)
  

Unit 10: Psychosocial Support and Effective Communication

Background

HIV/AIDS has profound effects upon individuals, families, households, and communities. It is a medical condition that also has social, psychological, and economic implications. Through the efforts of individuals, family members, and community members, people living with HIV/AIDS can receive the support they need to cope with the disease. This unit will help accompagnateurs understand the psychological and social issues associated with HIV/AIDS and provide them with the communication skills necessary to support people living with HIV/AIDS.

Objectives

By the end of the unit, participants will be able to:

• Explain how HIV/AIDS affects individuals, families, households, and communities.
• Identify ways in which the community can support people living with HIV/AIDS.
• Describe the psychological and emotional issues faced by people living with HIV/AIDS.
• Recognize signs of depression in order to refer a patient to a social worker or doctor.
• Identify sources of support (besides accompagnateurs) that can help people living with HIV/AIDS cope with psychological and social issues.
• Describe the role of accompagnateurs in providing psychological and social support to people living with HIV/AIDS.
• Identify and demonstrate effective communication and helping skills.

Time Required

4 hours

Unit Overview

Key points

• HIV/AIDS affects individuals, families, households, and communities and requires the efforts of all to deal with the HIV/AIDS crisis.
• HIV/AIDS is a medical condition that also has social, psychological, and economic implications.
• Psychological and emotional issues associated with HIV/AIDS include fear,loss, grief, guilt, denial, anger, anxiety, low self-esteem, depression, and suicidal thoughts.
• Accompagnateurs can provide psychological and social support for people living with HIV/AIDS by encouraging patients to meet with other people living with HIV/AIDS, to meet with spiritual or religious leaders, or to seek guidance from social workers or doctors.
  
• Accompagnateurs can provide support to people living with HIV/AIDS by practicing effective communication skills such as being empathetic, actively listening, respecting the patient, asking open-ended questions, and maintaining confidentiality.
  
• Accompagnateurs can help community members better understand HIV/AIDS, the psychological and social issues associated with the disease, and the ways in which they can support people living with HIV/AIDS.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (3.6 MB) | Kinyarwanda (4.42 MB) | Kreyol (3.8 MB) | Sesotho (5.7 MB) | Chichewa (4.47 MB) 
• Participants' Handbook (pdf) - English (10.7 MB) | Kinyarwanda (4.01 MB) | Kreyol (4.49 MB) | Sesotho (4.56 MB) | Chichewa (4.15 MB) 
• Visual Aid (Powerpoint/pdf) - English [Flipchart (8.7 MB) / Slides (4.2 MB)] | Kinyarwanda (5.02 MB) | Kreyol (3.8 MB) | Sesotho (5.12 MB) | Chichewa (5.02 MB) 
• Visual Aid Notes (pdf) - Kinyarwanda (3.78 MB) | Kreyol (3.8 MB) | Sesotho (3.88 MB)
  

Unit 11: Tuberculosis

Background

Tuberculosis (TB) is a deadly infection, especially for people living with HIV/AIDS. People living with HIV/AIDS are more susceptible to getting TB than those without HIV. TB also makes HIV worse. The aim of this unit is to give participants general information on TB: common symptoms, risk factors, diagnostic tests, and various modes of prevention. Accompagnateurs, who see people living with HIV/AIDS every day, may be the first to notice when someone has TB symptoms, or the first to notice when a TB patient is not taking his or her medicine. Thus, they should act as community leaders and advisors in recognizing TB symptoms and discussing prevention and diagnostic techniques with others.

Objectives

By the end of the unit, participants will be able to:

1. Describe how tuberculosis (TB) is spread from person to person.
2. Understand the difference between active TB and inactive TB.
3. Know the types of people most at risk of getting TB.
4. Name the three tests used to detect TB.
5. Explain the interaction between HIV/AIDS and TB.
6. Name eight symptoms of TB.
7. Describe four ways to prevent the spread of TB.

Time Required

2 hours, 45 minutes

Unit Overview

Key Points

• Tuberculosis (TB) lives and grows in the lungs and other parts of the body.
  
• TB can be spread from person to person through droplets in the air.
  
• If people in the community have TB symptoms, they should go to the clinic to get tested.
  
• Inactive TB is not contagious, but it can turn into active TB.
  
• With medication, TB can be cured.
  
• TB symptoms are: fatigue, chills, night sweats, fever, coughing, chest pain, weight loss, and loss of appetite.

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual - English (4.3 MB) | Kinyarwanda (4.4 MB) | Kreyol (5.25 MB) | Sesotho (5.31 MB) | Chichewa (4.43 MB) 
• Participants' Handbook (pdf) - English (6.4 MB) | Kinyarwanda ( 3.61 MB) | Kreyol (3.96 MB) | Sesotho (4.02 MB)| Chichewa (3.62 MB) 
• Visual Aid (Powerpoint/pdf) - English [Flipchart (4.3 MB) / Slides (3.8 MB)] | Kinyarwanda (2.74 MB) | Kreyol (8.28 MB) | Sesotho (2.91 MB) | Chichewa (3.51 MB) 
• Visual Aid Notes (pdf) - Kinyarwanda (1.71 MB)| Kreyol (2.53 MB) | Sesotho (1.81 MB)
  

Unit 12: Tuberculosis Treatment and Side Effects

Background

The aim of this unit is to teach participants about the medicines used to treat tuberculosis (TB) patients and the side effects they may cause. Accompagnateurs will learn how to talk to members of their community about the importance of treatment.

Objectives

By the end of the unit, participants will be able to:

1. Explain when to take tuberculosis (TB) medicine, how much, and how often for treating active and inactive TB.
2. Discuss the importance of adherence to TB medicine and the danger of multidrug-resistant tuberculosis (MDR-TB) as a consequence of non-adherence.
3. Explain the complicating factors that arise when a patient has both HIV and TB.
4. Describe the accompagnateur’s role in helping patients take their TB medicine and provide support and counseling for HIV-positive patients with TB.
5. Recognize urgent side effects to TB medicines that need immediate medical attention at the clinic.
6. Recognize non-urgent side effects of TB medicines that need medical attention at the clinic within a week.
7. Recognize normal side effects of TB medicines that do not need medical attention.

Time Required

2 hours, 35 minutes

Unit Overview

Key Points

• People must take medicine for many months if they have TB.
  
• TB can become resistant to medicine if patients do not take it correctly, so it is very important that patients not miss any pills and not stop taking their medicine early.
  
• Patients may experience side effects to TB medicine.
  
• Every day, accompagnateurs should ask patients how they are feeling. Every week, they should ask patients if they are experiencing any side effects, asking specific questions about relevant symptoms.
  
• If patients have urgent side effects, they should go to the clinic immediately.
  
• If patients have non-urgent side effects, they should go to the clinic within one week.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (3.8 MB) | Kinyarwanda (3.63 MB) | Kreyol (5.22 MB) | Sesotho (5.2 MB)| Chichewa (3.08 MB)
  
• Participants' Handbook (pdf) - English (3.5 MB) | Kinyarwanda (2.58 MB) | Kreyol (2.96 MB) | Sesotho (3.13 MB) | Chichewa (2.17 MB) 
• Visual Aid (Powerpoint/pdf) - English [Flipchart (1.5 MB) / Slides (11 MB) | Kinyarwanda (1.2 MB) | Kreyol (3.13 MB) | Sesotho (890.52 KB)| Chichewa  (950.48 KB)
  
• Visual Aid Notes (Powerpoint) - Kinyarwanda (666.4 KB) | Kreyol (893.36 KB) | Sesotho (609.59 KB) 

Unit 13: Roles and Responsibilities of Accompagnateurs

Background

Throughout the first 12 units, accompagnateurs learned their roles and responsibilities regarding the treatment of HIV/AIDS, other sexually transmitted infections (STIs), and tuberculosis (TB), and dealing with stigma and discrimination. They have also learned about the other sources of clinical, psychological and social support who all work together to treat patients. This unit brings together the many facets of the accompagnateur’s job, clarifying logistics and identifying clinical team members with whom they work.

Objectives

By the end of the unit participants will be able to:

1. Describe the roles and responsibilities of accompagnateurs within the areas of directly observed therapy (DOT), education, psychological and social support, and serving as the link between the clinic and the community, and what to do during a home visit.
2. Describe behaviors and actions that are inappropriate for accompagnateurs.
3. Identify any additional needs of patients, their families, and other community members, such as food, shelter, and so on.
4. Explain how accompagnateurs can help patients, their families, and other community members get access to health care, education, food, water, and shelter.
5. Name members of the clinical team and understand the difference between their various roles.
6. Refer patients at the appropriate time to the appropriate clinical staff member.
7. Fill out the Accompagnateur Form correctly.

Time Required

4 hours, 30 minutes

Unit Overview

Key Points

• Accompagnateurs have a big role to play in supporting patients and communities, including: providing directly observed therapy (DOT), educating patients and community members, providing psychological and social support, serving as the link between the clinic and the community, and performing home visits.
  
• Accompagnateurs work as part of a large clinical team of doctors, nurses, pharmacists, and social workers. They should seek information from other team members when necessary.
  
• Accompagnateurs notice the needs of their patients, their patients’ families, and other community members and make referrals to appropriate clinic staff when necessary.
  
• It is important to record information accurately on the Accompagnateur Form.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (MB, pdf) - English (5.5 MB) | Kinyarwanda (10.1 MB) | Kreyol (11.27 MB) | Sesotho (11.36 MB) | Chichewa (11.88 MB)
• Participants' Handbook (6.5 MB, pdf) - English (6.5 MB) | Kinyarwanda (5.31 MB) | Kreyol (6.27 MB) | Sesotho (6.32 MB) | Chichewa (7.42 MB)
• Visual Aid (Powerpoint/pdf) - English [Flipchart (2.7 MB) / Slides (1.8 MB)] | Kinyarwanda (5.98 MB) | Kreyol (8.31 MB) | Sesotho (5.88 MB) | Chichewa (6.89 MB) 
• Visual Aid Notes (Powerpoint) - Kinyarwanda (4.8 MB) | Kreyol (6.13 MB) | Sesotho (4.88 MB)
  

Unit 14: Challenges Faced by Accompagnateurs

Background

The work of an accompagnateur is one of solidarity — of truly walking with people who are suffering. To be in solidarity with those suffering is to listen, to provide emotional support, and to understand the underlying factors of sickness and the barriers to good health. Accompagnateurs notice the needs of their patients, advocate on their behalf, and help them to develop a voice so that they can advocate for themselves. People living with HIV/AIDS, tuberculosis (TB), and other chronic illness are not suffering only from their disease — they are often suffering from extreme poverty, depression, lack of support, and perhaps even grief at having lost loved ones. Because of this, their home situations may be quite sad or strife-ridden. To do this work, it is very helpful to know the realities of the patients’ lives. That is why it is so important that accompagnateurs come from the communities that they serve. The job of an accompagnateur can be rewarding, because this relationship can bring great improvement in people’s lives, yet it can also be stressful. When accompagnateurs develop a trusting relationship with someone, they will hear many problems that families face, far beyond the medical sphere. To prevent burnout, accompagnateurs need strong collegial networks, problem solving abilities, and coping skills. This unit introduces some of the challenges they face while at the same time encouraging them to recognize their own strengths and the support they can offer each other.

Objectives

By the end of this unit participants will be able to:

1. List five things they have in common with other accompagnateurs.
2. Describe the meaning of solidarity between accompagnateurs and patients.
3. Name, discuss, and identify common challenges faced by accompagnateurs dealing with confidentiality, accompagnateur/patient relationships, patient care, stigma, and discrimination.
4. Know when to ask for help, who to ask, how soon to get help, and what kind of help is needed.
5. Reinforce and encourage communication and problem solving among accompagnateurs.

Time Required

2 hours, 40 minutes

Unit Overview

Key Points

• Accompagnateurs face many challenges, but they are not responsible for dealing with all of these challenges by themselves.
  
• There are key people and resources to help accompagnateurs, such as nurses, doctors, social workers, psychologists, and other accompagnateurs.
  
• Accompagnateurs are part of a support system with other accompagnateurs, and they should act as a resource for each other.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (1.2 MB) | Kinyarwanda (1000.67 KB) | Kreyol (1.64 MB) | Sesotho (1.79 MB) | Chichewa (997.73 MB) 
• Participants' Handbook (pdf) - English (0.2 MB) | Kinyarwanda (375.54 KB) | Kreyol (523.88 KB) | Sesotho (536.02 KB)| Chichewa (399.55 KB)
  
• Visual Aid (Powerpoint/pdf) - English [Flipchart (0.5 MB) / Slides (0.2 MB)] | Kinyarwanda (108.23 KB) | Kreyol (124.93 KB) | Sesotho (113.23 KB)| Chichewa (91.07 KB)
  
• Visual Aid Notes (Powerpoint) - Kinyarwanda (62.23 KB) | Kreyol (1.64 MB) | Sesotho (68.02 KB)

Unit 15: Summary and Evaluation

Background

There are two key questions to ask at the end of any training course: First, was the training content delivered in a manner conducive to learning? And second, was the content of the training internalized by participants so that they can apply their new skills? Before they take their new skills into the field, participants need to practice in a comfortable environment. This unit is designed to assess whether participants absorbed the content of the training and to evaluate their ability to analyze information in order to solve problems and support the mission of Partners In Health (PIH).

Objectives

By the end of the unit, participants will be able to:

1. Demonstrate their knowledge of HIV/AIDS, tuberculosis (TB), sexually transmitted infections (STIs), and other diseases covered throughout the training.
2. Analyze scenarios related to treatment and support of people living with HIV/AIDS and TB.
3. Demonstrate their knowledge of the role of the accompagnateur as a link between the clinic, the patient, and the community, and as a source of psychological and social support to patients, especially those living with HIV/AIDS and TB.
4. Demonstrate their knowledge of the mission and vision of Partners In Health (PIH).

Time Required

4 hours and 10 minutes

Unit Overview

Key Points

• Accompagnateurs are not expected to memorize medications or symptoms. Instead, they should focus on danger signs and symptoms that indicate the need for attention at the clinic.
  
• Scenarios involving treatment and support for people living with HIV/AIDS should be looked at from the viewpoint of the patient, the accompagnateur, the clinic, and the community.
  
• Consider the psychological and social and practical aspects of any situation carefully before deciding what to do.
  
• Anticipating commonly encountered situations will help accompagnateurs to be prepared for dealing with ambiguous or difficult situations.
  
• Accompagnateurs need practice communicating about sensitive issues and answering technical questions about disease and treatment.
  

Download Files

To use this unit, you may download any or all of the four components:

• Facilitators' Manual (pdf) - English (4 MB) | Kinyarwanda (2.48 MB) | Kreyol (87.22 KB) | Sesotho (5.12 MB)| Chichewa (1.43 MB)
  
• Participants' Handbook (pdf) - English (9.1 MB) | Kinyarwanda (2.67 MB) | Kreyol (3.31 MB) | Sesotho (3.34 MB) | Chichewa (1.08 MB)
  
• Visual Aid (Powerpoint/pdf) - English [Flipchart (0.9 MB) / Slides (0.1 MB)] | Kinyarwanda (153.66 KB) | Kreyol (184.31 KB) | Sesotho (168.72 KB) | Chichewa (136.45 KB)
  
• Visual Aid Notes (Powerpoint) - Kinyarwanda (72.1 KB) | Kreyol (87.22 KB) | Sesotho (106.52 KB)