The ARCAN cascading model: Enhancing nursing capacity in East Africa

The African Regional Capacity Building Network for HIV/AIDS Prevention, Treatment, and Care (ARCAN) initiative is a World Bank project. It aims to complement the efforts of the Kenyan, Tanzanian and Ethiopian governments by training nurses and other professions to manage the adverse effects of the AIDS epidemic. Aga Khan University Advanced Nursing Programme is among six institutions given the responsibility of conducting training of trainers (TOT) courses for nurses in the three countries. The training is on HIV/AIDS prevention, management and care, TOT skills development and HIV/AIDS project development and management. Aims and method: To increase the number of trained healthcare providers and impart the training skills as broadly as possible, ARCAN and the various HIV and AIDS Control Councils are implementing a cascading TOT project for nurses to provide quality care for patients suffering from HIV and AIDS in order improve quality of life, achieve leadership competence, and sustain nursing knowledge and skills through continuing education. Trainers develop skills in implementing, monitoring, and managing pre-identified projects that are developed whilst they are attending the course. Results: A total of 403 TOT nurses were trained between 2006 and 2008, with 64% coming from the public sector - in line with the fact that the public sector provides 60% of healthcare services in this region. Despite a lack of disbursement of funds for cascading trainings, some TOT nurses have already implemented the planned training in the workplace. Conclusion: Nurses are capable of developing projects that address the HIV/AIDS pandemic. The TOT nurses have networked to enable cascading of the training. This approach can be used to rationalise the involvement of nurses in HIV/AIDS training activities in developing countries with high prevalence of HIV/AIDS.