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ADAPT strengthens capacity for large scale AIDS prevention trials in southern Africa
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Professor Neil Andersson, executive director of CIET Trust Botswana and ADAPT course coordinator, discusses the use of epidemiology and statistics in planning. |
In 2007, CIET launched the African Development of AIDS Prevention Trial (ADAPT) programme, aimed at strengthening the capacities of local health systems to design, conduct, and use the evidence from large-scale AIDS prevention trials in southern Africa.
This two-year initiative seeks to develop state-of-the-art, autonomous, and sustainable health measurement and planning resources for African countries to better implement and evaluate HIV/AIDS interventions –a much-needed development in all of Africa. It is a two-year CIET project funded by an HIV/AIDS Prevention Trials Capacity Building Grant from Canada's Global Health Research Initiative. (See: www.ghri.ca).
During two four-week courses, 27 participants from government, universities and NGOs from 14 countries in the region received intensive, hands-on training on the fundamentals of epidemiology and statistics for health research and planning, with a focus on randomized control trials (RCTs). RCTs are currently considered the most reliable way to obtain scientific evidence on the effectiveness of health interventions. In population-based RCTs, populations are randomly assigned to intervention and control groups. People in intervention groups are exposed to a set of programs or actions to see how effective these are –e.g. door-to-door AIDS education campaigns. Those in the control groups get either no intervention or some standard ones –e.g. school-based AIDS education -- until the effectiveness of the intervention has been demonstrated.
Between the first and the second four-week sessions of the course, ten of the 14 participating countries conducted national household and school-based evaluations of the impact of mass media on AIDS prevention. Course participants worked on training of field teams and data collection in their own countries. During the second session, they analysed their national data, learned and applied mapping and knowledge translation techniques for policy and planning, based on the results of the 10 national surveys. ADAPT training included meta-analysis and the conduct and use of systematic reviews.
In 2008, ADAPT will build on the technical training of the first year with executive training for officials at policy and senior program levels in southern African countries. CIET will continue to work with the network of researchers created across the region, consolidating skills, communicating findings from the surveys, and designing and seeking funding for multi-country AIDS prevention trials.
University partnerships across the region and with Canada are a cornerstone of this program. CIET runs ADAPT in partnership with the Department of Population Studies at the University of Botswana in Gaborone. Teachers from the University of Botswana, National University of Namibia, Witwatersrand University and the University of the Western Cape in South Africa, the University of Zambia, Zimbabwe's Masvingo State University and Ifakara Health Research and Development Centre participate to update their teaching on AIDS prevention trials. Prof Lehana Thabane of McMaster University collaborated in the RCT module.
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