I-TECH recently began to support MISAU’s National TB Program to update its national guidelines for TB, as well as the development of standard operating procedures so that clinical sites can integrate TB diagnosis, care and treatment (including of drug-resistant TB) into HIV services.
I-TECH’s long engagement with clinician education in Mozambique includes support for improvements to the national undergraduate (“pre-service”) curriculum for laboratory technicians (Técnicos Medio de Laboratório) to make the content more current and reflect the health care priorities of the country, including advances in HIV diagnostics and treatment monitoring. The curriculum is now standardized so that students at all health training institutes (HTIs) are taught using the same material and methods. Continue reading
I-TECH works with the Mozambique Ministry of Health (MISAU) to expand a pilot project to provide an assisted partner services intervention. The project is aimed at encouraging patients newly diagnosed with HIV infection to disclose their status to their partners, and bring them to the clinic for testing. Continue reading
I-TECH assists the Mozambique Ministry of Health (MISAU) to improve the quality, safety and performance of the VMMC sites through external quality assurance visits and mentoring of site staff. I-TECH has helped to design and conduct an evaluation of demand creation activities that were designed to motivate men age 15-49 years to choose VMMC.
I-TECH provides assistance to MISAU in implementation of the national Quality Improvement for HIV Services (QIHS) Strategy, with the goal of improving HIV clinical care through the training of clinicians in QI cycles (Plan-Do-Study-Act) and mentoring to improve weak performance indicators. To expand the impact of its programming, ART Committees and distance learning have been used to reach health workers in more rural settings.
I-TECH continues to focus efforts on the improvement of data quality and use of data to improve clinical decision making. I-TECH works at the site level to build awareness and buy-in for data quality and use among site-level management and health care workers.
On-site I-TECH Monitoring and Evaluation (M&E) Officers and Program Assistants monitor completeness and accuracy of service delivery documentation from the point of patient encounter to the point of final data capture in Ministry of Health and Social Services electronic databases. M&E Officers promote the use of data by clinicians and facility management for systems improvement and performance enhancement.
I-TECH supported the Ministry of Health and Social Services in 2017 and 2018 in the development and dissemination of the national Cervical Cancer Prevention Guidelines including algorithms for screening, referral, and post cryotherapy instrument disinfection, and monitoring and evaluation tools. Continue reading
I-TECH in Namibia spearheaded use of distance learning for HIV care and treatment through the establishment of a digital video conferencing network to link Windhoek with training sites and hospitals throughout the country starting in 2008. Building off that foundation, Namibia became the first country in Africa to implement the Project ECHO model, a tele-health platform started at the University of New Mexico, whereby clinicians in remote areas connect with rotating subject matter experts and clinicians a robust virtual community of practice to build health care worker capacity, support peer-to-peer cross-facility learning and reduce feelings of professional isolation.
Working with the Ministry of Health and Social Services (MoHSS) to roll out treatment in the country, I-TECH supported the training of physicians to provide antiretroviral therapy (ART) soon after the first national ART guidelines were published in 2003. I-TECH subsequently began supporting the training of nurses in both ART (2006) and Integrated Management of Adolescent and Adult Illness (IMAI, 2007) to increase health system capacity to expand delivery of ART services.
In 2010, I-TECH implemented a task shifting demonstration project to determine whether nurse-initiated management of antiretroviral treatment (NIMART) is a feasible alternative to doctor-led models. I-TECH subsequently supported an evaluation of this project which confirmed its feasibility for use in certain countries. In Namibia, NIMART was adopted by the MoHSS for use nationwide in 2013. I-TECH continues to hold NIMART trainings: five were held in 2016, with 125 health care workers trained.
I-TECH assists the Ministry of Health and Social Services with the expansion and provision of voluntary medical male circumcision (VMMC) as an HIV prevention option. This support started in 2008 with the development of national guidelines and training materials, followed by national trainings of health care workers. In 2015, this support expanded to include direct service delivery in the Oshana and Zambezi regions, as well as Karas region from 2017 onward. Since 2016, I-TECH has also supported demand creation with a network of community-based mobilizers and recruiters using a human-centered design approach to actively engage communities and stakeholders to increase the number of men voluntarily electing medical circumcision. The program has performed over 36,000 VMMCs in Namibia.
I-TECH has trained physicians, nurses, and community counselors to ensure that adequate skills and experience are in place to deliver safe, high-quality male circumcision services.