Date –23-25 June 2008
Venue -: East London Health Resource Centre

Between the 23-25 June 2008 the East London satellite site conducted a palliative care training. The training was enriched by the presence of Dr Duma AND Mbobo who are directly involved in the development and orientation of the guidelines. Participants were encouraged to give feedback on issues on the ground as they are the implementers as this will also assist in the improvement and update of the guidelines.
It was agreed with the participants that they need to cascade the information to other health care workers hence they were given an opportunity on FACILITATION SKILLS and feedback given after presentation
Issues discussed
Stigma attached to ARV sites as people are aware of who attends to that service
Service integration, challenge as the recommendations are introduced without proper address of staff
Guidelines not available at the service points only Nkonkobe LSA has recently received the copies but no Paeds,
During the discussion it was observed that most were not aware of NSP ,Adult Guidelines and issues around ARVs(see expectations)
Step down units are admitting HIV clients who are critically ill, no admission guidelines or policy

Expectations
TB/HIV management
How to establish step down units
Drug management on critical /chronic clients including pain
Intergration –HAST
Management of treatment failure
ARVS in Children

Drug INTERACTION
PMTCT guidelines
Adherence
Management of abscess with pain
Referral centers
Strategies used is lecture, case discussions, group work and role play, including the facilitation skills sessions

Lessons learnt
Better understanding on Palliative care DEFINITION
Pain management
The key components in palliative care
Talking about death, preparing clients is also important
Teach back sessions, people able to evaluate themselves and group objectively
Recommendations
ECRTC to support participants when planning and cascading the information in their facilities.
Site coordinator to liase with provincial coordinators and ECRTC resource manager to ensure availability of the guidelines on and HCWs referring to them.
ECRTC to guide sites with step down units
Coordinator to get list of step down units from the provincial coordinators and make follow up
Participants were encouraged to consider specializing on palliative care
Evaluation
The teach back session had a tool to guide when preparing a topic, feedback was based on the tha(Dr Mbobo has full report on that)

Course evaluation was in form of pre and post test questionnaire
Scores
0-10=01
11-20=19(10-15)
21-30==9(all less than 25)
30-32=0
Post test results to be analyzed