Integrating peer support into service delivery: A good practice guide

As a health provider in a busy facility you might ask what difference it would make to have peer supporters as part of the facility team and how you would plan and establish a peer support (PS) programme. You might be unsure about their role or you could be wondering how to go about recruiting, training, supporting them and making them feel a part of the team. This toolkit will help to answer these and other questions and will highlight the many benefits of PS.

The toolkit has been designed to complement an existing suite of tools developed by PATA. These include the PATA Peer Support Handbook and A Simple Toolkit for Community Health Workers and Peer Supporters (2nd Edition).

This Good Practice Guide was developed through lessons learnt across several PATA partnerships that focus on integrating peer support strategies. The development of the guide was largely informed by the Unfinished Business Initiative in South Africa (Anova Health Institute, Wits RHI, Health Systems Trust and AIDS Foundation of South Africa) and supported by the ELMA Foundation and ViiV Healthcare’s Positive Action. PATA was also able to draw upon lessons across the region through its REACH (Re-engage Adolescents and Children with HIV) programme, also supported by ViiV Healthcare’s Positive Action and implemented in Kenya, Malawi, Zambia, Cameroon and Uganda. Lastly, important lessons were also gained through the READY+ (Resilient & Empowered Adolescents & Young People) consortia led by Frontline AIDS and implemented in Zimbabwe, Tanzania, Mozambique and Eswatini.

Who is this toolkit for?

This toolkit is aimed primarily at health providers, specifically health facility managers and organisations engaging PS programmes to strengthen healthcare. It has been designed as an informative resource for the integration of PS into HIV models of care for adolescents and young people.

How do I use this toolkit?

The toolkit provides practical guidance on how to create a successful facility or community-based PS programme. It does not matter if you have an established programme or if you are just starting out. You will find information to help with important decisions plus examples of many of the tools needed to ensure that your PS programme runs smoothly, is effective and achieves its goals.

The toolkit is made up of seven stand-alone modules, enabling you to identify particular areas where you need guidance and resources (eg. supervision of peer supporters). You can go through each section or dip into different sections and choose the bits of information that are likely to help you most at any given point.

As you engage with this Good Practice Guide, you are invited to provide feedback, based on your own experiences and learnings. Please send your feedback or any updates to andile@teampata.org. Your feedback is important to us and will inform a regular review and update process every second month.

Module 1: Understanding peer support

In this module you will be familiarised with the concept of PS. You will obtain an understanding of the work of the peer supporter and learn how PS can benefit your facility programme. The benefits of PS for health providers, clients and health outcomes are also discussed, as are some of the limitations and challenges of PS programmes.

Module 2: Creating a conducive and friendly facility environment

In the first module we established the importance of the role played by peer supporters in strengthening the delivery of healthcare services to adolescents and young people. We also saw the many advantages for health providers, and of course the benefits of a PS programme for peer supporters themselves. In this module we will be focusing on the facility environment as one of the most important aspects of any PS programme. Creating a conducive client environment should ideally be addressed prior to implementation of a PS programme. The appropriate environment will contribute greatly to the success of the programme.

Module 3: Planning your peer support programme

In this module you will look at how to go about planning a PS programme. You will develop understanding on how to conduct a needs assessment regarding your target population; how to engage with the community and gain their support for your PS programme; how to go about developing a goal and objectives for your programme as well as a work plan, including logical framework, budget and timelines. This will lay a firm foundation for your ability to monitor and evaluate your programme, which will be covered later in module 7. Important to note is that at all stages, adolescents and youth should be involved in the process and can provide valuable input.

Module 4: Recruitment and selection

Now that you have planned your PS programme, you will need peer supporters to run it. This module will take you step-by-step through the process of recruitment and selection. A good recruitment process can reduce the time involved in looking for, interviewing, hiring and training a suitable peer supporter. You are much more likely to find the right person for the job if you have a successful well-planned recruitment and selection strategy.

Module 5: Training tools and guidelines

This module provides guidance on how to go about developing a training curriculum to help a peer supporter undertake their work. It addresses core modules and topics for consideration, highlighting minimum standards for peer support work and looks at steps in the development of a training agenda, the implementation of training, as well as the process of evaluation.

Module 6: Management tools and guidance

This module addresses the topic of peer supporter management, including ethical issues and conduct within the role. It discusses the importance of setting standards for professional conduct and focusses on key issues such as maintaining client confidentiality and setting boundaries. Step-by-step guidance is provided on establishing a supervision structure for peer supporters. Other supportive approaches such as mentoring, and debriefing are explored, along with motivation and incentivisation of peer supporters. The important matters of self-care and facility care and support for the peer supporter are also addressed.

Module 7: Engagement tools and guidelines

In this module of the toolkit, you will hear about community mobilisation as an important aspect of healthcare. The module focusses on the meaningful participation of peer supporters and young people in the programmes that affect them. It considers platforms that facilitate meaningful engagement and considers the important contributions that young people can make to programme development and implementation.

You will also be taken through the steps involved in monitoring and evaluating your programme. Guidance is given on the collection of data that will help determine the success of the programme and assist in report writing.

Module 8: mHealth

In this module, you will learn more about mHealth tools and approaches. You will receive an overview of the digital health landscape and how mHealth fits into this context. You will develop understanding around the value and advantages of mHealth tools, as well as some of
the disadvantages and challenges of implementing mHealth approaches. The module then provides some practical guidance on integrating mHealth into peer support strategies, through providing one on one and group support using various platforms, illustrated through some real case examples.

Appendix 1: Peer support models examples and case studies across the cascade

This appendix provides a summary of a number of different examples of peer support models in different contexts and settings, and across different stages of the HIV treatment cascade. This includes information on the purpose of each model, how it works and challenges and lessons learnt from those involved. This may assist in giving you some ideas for how you would like your peer support programme to look, or whether you wish to adopt one of these models. As you consider programme planning in Module 4, you may wish to come back to this information.

Appendix 2: Resources and toolkits for peer supporter training

You can use this to refer to further resources and toolkits for integrating peer support into service delivery.

Appendix 3: Checklists and templates

You can use this booklet to print out, fill in or work with all of the checklists and templates covered in each module.

Download the full toolkit

You can access the whole document in one, downloadable toolkit.