“There’s no school that trains attitude”: training and capacity-building needs of paediatric-adolescent frontline health and social providers in twelve high HIV-burden countries

Abstract

Despite growing recognition of the need for adolescent-responsive HIV and sexual and reproductive (SRH) health services, implementation remains inconsistent, especially in Africa and other low - and middle-income countries where HIV rates are highest. Frontline health and social providers play a critical role in delivering care; however, little is known about their training needs or how to strengthen their capacity in these settings. This study draws on qualitative participatory data from 801 providers across 24 sites in 12 African countries with a high HIV burden, collected during the Paediatric-Adolescent Treatment Africa (PATA) Summit in 2022. Through word association, ranking exercises, and focus group discussions, participants identified training and capacity building as their top priority for service improvement. Thematic analysis revealed three key findings: (1) providers experience training and supervision as empowering - improving their confidence and quality of care; (2) significant gaps exist in training content and capacity building, especially in adolescent-responsive, non-judgemental, and psychosocial care; and (3) training opportunities are often inequitable and lack continuity. Providers emphasized the need for ongoing and equitable access to training opportunities. The findings underscore the urgent need for integrated capacity-building strategies that combine knowledge, mentorship, and systems-level support to strengthen adolescent HIV and SRH services in resource-limited settings.