In response to an identified need for clinical workforce development in the Solomon Islands, ASHM International has developed the ‘Hepatitis B in Health Settings’ training package. The overall aim of the training was to increase the knowledge, skills, and confidence of the health workforce in Honiara, both in prevention of new hepatitis B infections (safe injections, blood safety, prevention of mother to child transmission and vaccinations programs) and in the care and treatment of people living with hepatitis B. Trainings were delivered once a week for a two hour period for five weeks, facilitated by Dr Nicole Allard from the Victorian Infectious Diseases Laboratory at the Doherty Institute, and Professor Gail Matthews from the UNSW Kirby Institute. There were 14 participants including medical practitioners, obstetricians and gynecologists from the Solomon Islands National Referral Hospital in Honiara, nurses, lab technicians, pharmacists, and members of the Ministry of Health STI, HIV and Hepatitis Units.
There were nine modules delivered which included:
- Introduction to the liver
- Introduction to Hepatitis B
- Transmission and Prevention
- Testing, Diagnosis and Assessment
- Monitoring and Management of hepatitis B
- Hepatitis B and pregnancy
- Advanced liver disease
- Coinfection and Immunosuppression
- M&E Action Planning
Training modules incorporated theoretic and applied learning components and included fictional and real case studies for group discussion on the clinical management of hepatitis B. Group discussions were lively and participants welcomed the opportunity to share their knowledge and discuss the current strengths and weaknesses in service provision. A significant amount of time was spent on teaching participants on the best ways to calculate an APRI score and interpreting the results.
There was consensus from participants that the training was extremely useful but further mentoring and support is needed in the following areas:
- Case management of asymptomatic individuals.
- Management of complex cases and coinfection.
- Complications arising in pregnancy and when to start treatment.
- Training health workers in provincial areas and outer islands.
- Creating referral pathways.
- Updating of clinic guidelines.
- Community awareness raising.
- The potential for stigma and discrimination.
- Managing stockouts.
Dr Nicole Allard and Dr Gail Matthews will continue to mentor participants on an as-needed-basis for the remainder of 2021.