Reflections on the Training of Counsellors in Motivational Interviewing for Programmes for the Prevention of Mother to Child Transmission of HIV in Sub-Saharan Africa

Within the Southern African prevention of mother to child transmission (PMTCT) programmes, counsellors talk with pregnant mothers about a number of interrelated decisions and behaviour changes. Current counselling has been characterised as ineffective in eliciting behaviour change and as adopting a predominantly informational and directive approach. Motivational interviewing (MI) was chosen as a more appropriate approach to guide mothers in these difficult decisions, as it is designed for conversations about behaviour change. MI has not previously been attempted in this context. This paper reflects on how MI can be incorporated successfully into PMTCT counselling and what lessons can be learnt regarding how to conduct training with counsellors. From the dialogue with the action researchers, nine recommendations were made to guide the development of future training programmes. [from abstract]