Training Approaches for HIV-Associated Neurocognitive Impairment Screening in Primary Healthcare during the Fourth Industrial Revolution

The Fourth Industrial Revolution (4IR) is transforming healthcare, human capital, and economic development by driving innovations that enhance service delivery, workforce capacity, and health outcomes. Despite these advancements, co-morbidities associated with HIV remain a public health challenge in South Africa, highlighting the need for innovative and culturally responsive approaches to care and training. HIV-associated neurocognitive impairment (H-NCI) knowledge and screening practices remain limited at the primary healthcare level in low- and middle-income countries. Existing training programmes for frontline primary healthcare workers rarely shift from traditional methods which limits the accessibility of such knowledge and reduces the effectiveness of timely screening in resource-constrained settings. Drawing from an in-field H-NCI training programme piloted among a cohort of South African primary healthcare workers, this paper outlines the theoretical underpinnings, teaching methodologies, evaluation strategies, and feedback mechanisms, offering lessons and recommendations for scaling similar interventions in other low- and middle-income countries. Increasing evidence indicates that H-NCI can negatively affect people living with HIV. To address gaps in screening practices and build on existing healthcare worker knowledge, the curriculum was designed to be contextually relevant and practical. The training programme combined YouTube-based materials, interactive case learning, scenario simulations, and discussions to support the identification and management of H-NCI. Following the training, healthcare workers reported increased knowledge of H-NCI and successfully administered a screening tool two months post-intervention. Overall, the programme strengthened their contextual understanding of H-NCI and developed practical screening skills among primary healthcare workers delivering frontline HIV services.