Abstract

Tanzania has been severely affected by the HIV epidemic, with an estimated 6% of the population infected. Although treatment and prevention efforts have stemmed the spread of
HIV, there remain over 2.3 million Tanzanians infected.

One of the main challenges to the HIV/AIDS response in Tanzania is the shortage of health care workers. It is estimated that Tanzania has a 68% deficit of health workers, meaning that the current workforce must nearly double, with a tenfold increase in physicians, in order to adequately address health needs in the country.

The HIV/AIDS epidemic has necessitated the inclusion of a pre-service curriculum for medical students focused specifically on caring for those infected with the virus as well as on counseling patients on how to protect themselves and others. In order to streamline and standardize this
curriculum, the Government of Tanzania is working closely with Jhpiego—an affiliate of Johns Hopkins University—through support from the United States Agency for International Development(USAID)/President’s Emergency Plan for AIDS Relief (PEPFAR), to ensure that all medical students are prepared to respond appropriately to the epidemic. Project activities will include an assessment of training needs in the country’s five medical universities, provision of teaching equipment, development of core competencies, capacity building of staff, development
of materials and standards, integration of updated content into the curriculum, quality improvement of overall education and strengthening of clinical practice sites.

As the final product of a two-day workshop, core competencies for HIV/AIDS in pre-service medical training were drafted in collaboration with faculty from all five medical universities. The core competencies were developed in direct response to the results of a needs assessment carried
out in the medical universities that sought to identify the strengths and weaknesses of the existing curriculum and teaching methodology in relation to HIV/AIDS.

Core competencies are defined as essential knowledge, understanding, skills and attitudes for providing comprehensive HIV/AIDS services that follow current national policies and guidelines. These are the domains that enable a graduating health care provider to be fit for his/her
position’s intended purpose. Unless one has all the necessary competencies, s/he will not be able to deliver quality health care. The core competencies help focus the learning objectives around the knowledge, skills and attitudes a student must possess in order to achieve the desired capacity
in HIV/AIDS service delivery. The goal of developing core competencies is not only to facilitate standardization of training, but also to promote clarity, streamline monitoring and quality assurance, and improve the overall quality of HIV/AIDS education.

The five areas of core competencies are as follows:

1. Scientific Foundation (Basic Science) and Clinical Care of HIV/AIDS: Provide comprehensive HIV/AIDS prevention, care and treatment services using the chronic care model and evidence-based medicine.

2. Communication Skills and Psychosocial Aspects of HIV/AIDS Care: Effectively communicate with individual clients, couples, families and the community at large while providing HIV/AIDS clinical care, information, education and communication/behavior change communication and counseling—taking into account the physical, psychological,
social and cultural context, clients’ rights and ethical principles.

3. Management of HIV/AIDS Programs and Community Interventions: Plan, organize, coordinate and manage implementation of priority community and clinical HIV/AIDS
services and programs or projects in line with national policies, guidelines and regulations.

4. Monitoring, Evaluation and Operational Research: Collect, compile, analyze, interpret, communicate and use HIV/AIDS-related data for clinical and community programs in line
with the national monitoring and evaluation framework, and conduct clinical and community-based HIV/AIDS research.

5. Professionalism and Ethics: Be able to be a lifelong learner, work in a multidisciplinary team and apply the professional code of conduct that includes ethical and legal principles.