PLOS ONE Publishes IDCAP Facility Performance Results

Posted on August 26, 2014May 1, 2017

The International Training and Education Center for Health (I-TECH) is proud to have been a partner on the first randomized trial of educational outreach and continuous quality improvement (CQI) in Africa. The evidence in a new IDCAP Overview article published in PLOS ONE — “Improving Facility Performance in Infectious Disease Care in Uganda: a Mixed Design Study with Pre/Post and Cluster Randomized Trial Components” — by Dr. Marcia Weaver et al. supports I-TECH’s work in three ways:

The pre/post comparisons showed that high quality training, educational outreach, and CQI significantly improved the quality of care for emergencies, malaria, and pneumonia, and enrollment in HIV care.

IDCAP demonstrates I-TECH’s capacity to measure the effects of training and other interventions to improve care and treatment, such as case scenarios/clinical vignettes, clinical observation, facility performance measures, and population-based mortality.

The Overview article reports that efforts to improve data collection had an independent effect on the quality of care for two facility performance indicators. In other words, improving health information systems also serves as an intervention to improve the quality of care.

“I am grateful for the curriculum development ‘dream team,'” said Dr. Weaver, “including Ann Miceli and Lisa Rayko Farrar from I-TECH, for outstanding implementation by the Infectious Diseases Institute and University Research Co, LLC, and to Accordia Global Health Foundation for project leadership and Sarah Burnett’s excellent data management and analysis.”

The following recap was first published in AccordiaNews, Aug. 26, 2014.

In a new paper, published today, Professor Marcia Weaver and colleagues report an overview of the findings from the Integrated Infectious Disease Capacity-Building Evaluation (IDCAP).

Accordia Global Health Foundation, with funding from the Bill & Melinda Gates Foundation, launched IDCAP to better equip mid-level practitioners to manage infectious diseases and to advance the global health community’s understanding of the cost-effectiveness of innovative training approaches. IDCAP created a state-of-the-art package of training interventions that incorporated three key elements: 1) a focus on mid-level practitioners, 2) integration across infectious diseases, and 3) on-site support.

The impact of training was tested on three levels: individual clinician capacity and practice, facility performance, and patient health outcomes. Professor Weaver’s article, entitled Improving Facility Performance in Infectious Disease Care in Uganda: a Mixed Design Study with Pre/Post and Cluster Randomized Trial Components, describes the impact of the IDCAP interventions on 23 facility performance indicators.

IDCAP improved the quality of care in several areas with a combination of infectious disease training, on-site team training and mentoring, and quality improvement interventions. The IDCAP interventions resulted in statistically significant improvements in six facility performance indicators related to emergency triage, assessment and treatment (ETAT), malaria diagnosis and treatment, pneumonia assessment, and enrollment in HIV care. However, the on-site support intervention alone, significantly improved performance in only one of the 23 facility indicators.

Kelly Willis, Accordia’s Executive Director and a co-author, explained, “The majority of research in medicine and public health focuses on a single disease and a single outcome, which is often appropriate. This vertical focus however, may sometimes be to the detriment of professional training and processes of care at a clinic. Accordia is proud to be at the forefront of exploring the integration of training and clinical care.”

I-TECH and DGH Leadership Visit I-TECH Ethiopia, Speak at Outpatient Clinic Launch

Posted on July 28, 2014August 1, 2017

Dancers prepare to perform at the University of Gondar’s Diamond Jubilee.

Earlier this month, a distinguished group from the University of Washington’s International Training and Education Center for Health (I-TECH) and Department of Global Health (DGH) visited Addis Ababa and Gondar, Ethiopia, for several days of discussion, workshops, events, and celebration — including the University of Gondar’s 60th anniversary Diamond Jubilee and the inauguration of the University of Gondar Comprehensive Outpatient Center.

Workshops and discussion at the I-TECH Ethiopia offices

I-TECH has had a presence in Ethiopia since 2003, and in that time, has become a guiding force in antiretroviral therapy service delivery and human resources for health, building the capacity of the Regional Health Bureaus (RHBs), universities, and health facilities; introducing innovative initiatives such as task sharing; activating effective monitoring and evaluation interventions; advocating for and implementing TB prevention programs, including MDR-TB; and building the capacity of health facilities and regional labs. The team acts in close partnership with the RHB offices of the Ministry of Health in Afar, Amhara, and Tigray and will be transitioning most of its programs to the RHBs in September 2014.

In advance of this transition, Dr. King Holmes, Chair of the DGH, and Dr. Ann Downer, I-TECH Executive Director, met with staff in Addis Ababa during a July 4 coffee ceremony. The meeting was an opportunity to say farewell to some incredibly valuable members of the I-TECH Ethiopia team who are leaving as projects are transitioned to the RHBs and discuss highlights of more than a decade of outstanding work in Ethiopia.

Bryan Verity, I-TECH HQ Director of Human Resources, was earlier on hand to facilitate a four-day career transition series with materials adopted from the UW career center. The series was co-facilitated by Tigist Dagne, Human Resources Manager at I-TECH Ethiopia.

“We had a great level of involvement by the staff, especially during the ‘assessing personal strengths’ workshop,” said Verity. During this exercise, a staff member shared experiences, while “listeners” tracked skills/strengths that the speaker employed during the experience.

The series also covered writing curriculum vitae (CV), conducting a job search, and strengthening interview skills. In addition, Verity presented a 60-minute training on personal financial management.

“It’s been a tremendous honor to work with such a dedicated and talented group of people,” said Dr. Downer. “I am so pleased that King and I had the opportunity to express our gratitude in person for the fine work this team has done to combat HIV/AIDS in Ethiopia. Everywhere we went in Ethiopia we heard about the positive reputation and valued contributions of our I-TECH Ethiopia team.”

Much to celebrate at the University of Gondar

Ethiopian Prime Minister Hailemariam Desalegn

Speaking alongside Ethiopian Prime Minister Hailemariam Desalegn and U.S. Ambassador to Ethiopia Patricia Haslach, Dr. Holmes delivered a keynote address at the inauguration of the Gondar Comprehensive Outpatient Center on July 6. The launch was bookended by the university’s graduation ceremony and its 60th anniversary Diamond Jubilee conference.

The center was a collaborative effort of I-TECH, UW, the University of Gondar, and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) representatives in Ethiopia: the U.S. Centers for Disease Control and Prevention (CDC) and the Health Resource and Services Administration (HRSA).

The construction of this center was critical to address the significant burden and impact of disease in Ethiopia to comply with the Ethiopian Ministry of Health’s (MOH) mandate to increase the number of health care workers and to support the goal of PEPFAR to improve delivery of acute and preventive services related to HIV, TB, and malaria.

To meet these goals, the building can provide care to approximately 350,000 patients per year and serve as a training center for clinical outpatient care in TB, infectious disease, adult medicine, surgery, pediatrics, and emergency care. It houses a state-of-the-art TB facility.

Dr. Holmes visits his namesake CPD center.

I-TECH and the UW, through funding from PEPFAR, were instrumental in the conception and execution of the center, serving as consultants for both facility design and curriculum development. In this work, I-TECH helped to ensure that the facility allows for the integration of clinical care, teaching, and training. Dr. Scott Barnhart, an I-TECH principal investigator and a UW professor of medicine and global health, brought in Christine Kiefer, a Harborview Medical Center architect, to consult on the project.

In the days following the inauguration, Dr. Holmes and Dr. Downer led conference sessions on Innovations in Global Health and Effective Teaching, respectively.

Dr. Holmes also had the opportunity to visit a namesake training hall at the University of Gondar: the King Holmes Continuous Professional Development Center. “What a wonderful and humbling experience,” Dr. Holmes said of the visit. “And what a great way to end the trip.”

I-TECH Presents at AIDS 2014 in Melbourne

Health Systems Strengthening HIV and STI Prevention HIV Care and Treatment Namibia

Posted on July 17, 2014May 1, 2017

AIDS2014image

On July 20-25, the biennial International AIDS Conference, AIDS 2014, will be held in Melbourne, Australia. Dr. Gabrielle O’Malley, I-TECH’s Director of Implementation Science, is heading down under to present two posters:

Evaluating the Effectiveness of Patient Education and Empowerment to Improve Patient-Provider Interactions at ART Clinics in Namibia, lead authored by Dr. Ellen MacLachlan, I-TECH Senior Research and Publications Advisor

“If I Take My Medicine, I Will Be Strong”: Evaluation of an Innovative Pediatric HIV Disclosure Intervention in Namibia, lead authored by Dr. O’Malley

For full versions of these posters, contact Anne Fox, Communications Officer, at foxanne@uw.edu.

As always, the conference is a tremendous opportunity for those working in the field of HIV, policy makers, civil society, and persons living with HIV to share perspectives and knowledge — with a focus on the diversity of response in the Asia Pacific region.

The theme of AIDS 2014 is “Stepping Up the Pace,” and speakers including former President Bill Clinton; new U.S. Global AIDS Coordinator Deborah Birx; and Dr. Tony Fauci, Director of the National Institute of Allergy and Infectious Disease, will examine scientific developments, human rights, and lessons learned in the effort to map our next steps in the fight against the pandemic.

Read more about the conference — as well as the 2012 Melbourne Declaration in support of human rights in the march toward an AIDS-free generation — at www.aids2014.org.

Ukrainian Medical University Delegation Visits I-TECH HQ

Health Systems Strengthening HIV and STI Prevention HIV Care and Treatment Human Resources for Health Nursing/HCW Cadres Quality Improvement Ukraine

Posted on July 8, 2014May 2, 2023

Ukraine_MOU_image

From L to R: Dr. King Holmes, Dr. Olga Vystoska, and Dr. Ann Downer present the signed MOU.

On June 12 and 13, representatives from Ukraine’s Bogomolets National Medical University (NMU) visited I-TECH HQ offices at Harborview Medical Center and the University of Washington (UW) Department of Family Medicine.

NMU is the leading medical school in Ukraine, with more than 150 years of history. This visit formally launched the partnership between NMU and the UW’s I-TECH, Department of Global Health, School of Nursing, School of Medicine, and Family Medicine Department. Steps toward partnership began this spring, with a Memorandum of Understanding (MOU) signed by all parties.

The visit started off with a two-hour planning meeting, during which Dr. King Holmes, chair of the UW Department of Global Health (DGH), gave an introduction to the department. This was followed by presentations by Olga Vystoska, Director of the Ukrainian Family Medicine Training Center at NMU, and other UW department representatives, who explored possible areas of collaboration. The meeting wrapped up with the exchange of signed originals of the MOU.

The Ukrainian delegation particularly appreciated the opportunity to meet I-TECH’s Executive Director, Dr. Ann Downer, and staff; learn about I-TECH’s activities; and tour the UW’s Family Medicine Clinic and Harborview Madison Clinic, which provides medical care and social services for persons living with HIV/AIDS. The group was especially impressed by a tour of the UW Institute for Simulation and Interprofessional Studies (ISIS) lab at Harborview, and Dr. Vystoska expressed interest in starting a similar lab at NMU.

The delegation also had a working meeting with Dr. Chris Behrens to discuss next steps in developing an HIV in-service training curriculum for family practitioners that I-TECH plans to pilot in Kyiv in October with Dr. Behrens’s co-facilitation.

The new Project Director of I-TECH Ukraine, Anna Shapoval, was a driving force behind this collaboration and visit.

“The I-TECH Ukraine team is excited to promote the HIV response and health care reform in Ukraine,” said Ms. Shapoval, who added that she was very pleased with how the meetings went. “We look forward to growing I-TECH’s presence in country, focusing on the most urgent issues of streamlining HIV into primary health care, advancing quality assurance and quality improvement models — as continuation of its unique experience with CLASS.”

Other potential areas of collaboration include joint research activities, publications, and library exchanges; the exchange of faculty members and students for study, teaching, and research; and joint hosting of distance education broadcasts and online courses and seminars.

Julie Stein, Technical Officer for Training Development on the I-TECH Ukraine team, expressed enthusiasm as well. “This visit was incredibly fruitful,” said Ms. Stein. “The meetings and tours generated a lot of excitement from everyone about possible future collaboration.”

I-TECH Presents at CUGH 2014

eLearning/Distance Learning Haiti Health Information Systems Health Systems Strengthening HIV Care and Treatment Kenya Laboratory Systems Leadership & Management South Africa

Posted on May 5, 2014July 25, 2017

I-TECH staff will head to Washington, D.C., this week to the Fifth Annual Consortium of Universities for Global Health (CUGH) Conference, which will take place at the Washington Hilton from May 10-12. More than 1,300 participants from 50 countries are expected to attend the conference, co-hosted by the George Washington University and Stanford University.

This year’s theme is “Universities 2.0: Advancing Global Health in the Post-MDG Era,” and I-TECH teams will present on forward-looking topics ranging from the implementation of electronic medical records to partnership with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

Confirmed speakers include President of the World Bank Jim Kim; former Head of UNAIDS and current Director of the London School of Hygiene and Tropical Medicine Peter Piot; and Head of the Earth Institute at Columbia University Jeff Sachs. Dr. King Holmes, I-TECH Principal Investigator and 2013 Gairdner Global Health Awardee, will also speak at CUGH’s Gairdner Lecture on May 12.

For those planning to attend the conference, don’t forget to check out the University of Washington Department of Global Health table — and to stop by the I-TECH presentations, listed below.

Kenya

Electronic Medical Record (EMR) Implementation at Scale in the Public Health Sector: Lessons Learned in Kenya

Haiti

Using an electronic medical record system to identify factors associated with attrition from the HIV antiretroviral therapy program at two hospitals in Haiti
Before and After the Earthquake: A Case Study of Attrition from the HIV Antiretroviral Therapy Program in Haiti

South Africa

Successes and challenges in liaising with PEPFAR partners and stakeholders in the TB/HIV Management Program
Evaluation of a comprehensive HIV prevention program in North West Province, South Africa: results from the pilot
Integrating research into program design: Conducting a situational analysis to inform comprehensive HIV prevention and care in North West Province, South Africa
Mystery patients: Training actors to serve as unannounced standardized patients to evaluate training outcomes for sexually transmitted infections in South Africa

Lab Leadership and Management

Certificate Program in Clinical and Public Health Laboratory Leadership and Management

Contact Anne Fox in Communications to see any of these completed posters.

About CUGH:

Founded by leading North American university global health programs, CUGH aims to:

Define the field and discipline of global health;
Standardize required curricula and competencies for global health;
Define criteria and conditions for student and faculty field placements in host institutions;
Provide coordination of projects and initiatives among and between resource-rich universities and less-developed nations and their institutions.

CUGH is dedicated to creating balance in resources and in the exchange of students and faculty between institutions in rich and poor countries, recognizing the importance of equal partnership between the academic institutions in developing nations and their resource-rich counterparts in the planning, implementation, management and impact evaluation of joint projects.

The Bill & Melinda Gates Foundation provided the leadership and funding to plan this consortium. The Rockefeller Foundation provided a grant to help develop the organizational structure of CUGH in its first year of existence.

HRSA Delegation Witnesses I-TECH’s Vital Work in South Africa

Health Systems Strengthening Nursing/HCW Cadres South Africa

Posted on April 17, 2014May 1, 2017

Members of the HRSA delegation and officials from a Department of Correctional Services (DCS) health facility in Witbank, South Africa

In late March, I-TECH South Africa hosted a delegation from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA).

Led by Dr. Mary Wakefield, HRSA Administrator, the delegation also included Ambassador Jimmy Kolker, Assistant Secretary for Global Affairs, U.S. Department of Health and Human Services (HHS); Dr. Austin Demby, Director – PEPFAR, Office of Global Affairs, HHS; and Dr. Jose Rafi Morales, Director HRSA/HAB PEPFAR Global HIV/AIDS Program.

The group was accompanied in-country by Steven T. Smith, Health Attaché and HHS Regional Representative for Southern Africa; Dr. Nancy Knight, CDC Country Director; Rehmeth Fakroodeen, CDC HSS lead and HRSA Activity Manager; and the I-TECH Senior Management Team.

The purpose of the visit was to observe the following activities, funded by HRSA through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

Training Correctional Health Workers

With 165,000 inmates incarcerated in 237 correctional facilities, South Africa has the fourth-highest global incarceration rate, and the country’s facilities are operating at 137% of intended capacity.[1]Overcrowding leads to insufficient ventilation and poor physical and mental health, all of which fuel the spread of HIV and tuberculosis (TB). HIV prevalence in these facilities is as high as 34.6%,^[2] and the reported TB cure rate is less than 40%, compared to 70% in the general population.[3]

Ensuring adequate skills among health care providers in correctional facilities is essential to fight the spread of HIV and other communicable diseases. During its first visit, to a DCS health facility in Witbank, the HRSA delegation witnessed first-hand I-TECH’s work to conduct a situational analysis and support the training of health care workers on the care and management HIV and AIDS, tuberculosis, and sexually transmitted infections (STIs). This work was conducted in two regions: Limpopo, Mpumalanga, and North West (LMN) and KwaZulu-Natal.

Supporting Continuing Professional Development for Nurses

In 2012, the SANC started the process of developing a Continuing Professional Development (CPD) Program for the 262,000 nurses in South Africa[4]; however, due to funding constraints and lack of capacity, I-TECH South Africa was asked to support them in the program’s development. Through the CPD Program, nursing practitioners will be required to attain a minimum number of CPD points as a prerequisite for annual renewal of their license to practice.

The HRSA delegation met with the Chair of the Board of Directors of SANC and its Registrar, as well as representatives from the National Department of Health and academic institutions. Members of the delegation were briefed on achievements to date, which include technical assistance to establish a CPD technical working group and a draft CPD framework for nurses, a situational analysis of feasibility and acceptability of CPD, and a CPD pilot study outline developed for two provinces.

[1] Institute of Medicine. Key Populations, Key Solutions – A Gap Analysis & Recommendations for Key Populations and HIV in South Africa. Accessed 17 March 2013. http://southafrica.iom.int/publication/key-populations-key-solutions-a-gap-analysis-recommendations-for-key-populations-and-hiv-in-sa/

[2] South African Department of Correctional Services. 2007 Prevalence Survey for HIV.

[3]Verbal communication with South African National Department of Correctional Services on 28 March 2013.

[4] South African Nursing Council Licensure Register.

I-TECH Helps to Fight Cervical Cancer in Haiti

Haiti Health Systems Strengthening Human Resources for Health Noncommunicable Disease

Posted on March 28, 2014May 1, 2017

I-TECH's Dr. Jean Guy Honoré and nurses assess supplies.

On International Women’s Day, March 8, Radio France Internationale’s Atelier de Medias posted a piece highlighting I-TECH’s work to fight cervical cancer in Haiti. The following is a summary of the post.

According to the World Health Organization (WHO), cervical cancer is the second most common cancer in women worldwide and remains a leading cause of death, with approximately 86% of new cases and deaths occurring in middle- and low-income countries.¹ Among women who die from this disease, the percentage of them from developing countries has increased from 80% in 2002 to 88% in 2008, and it may reach 98% by 2030.²

Haiti — a country with limited resources and a population of 10 million — is no exception. Currently, it is estimated that, every year, 568 women are diagnosed with cervical cancer in Haiti, and 353 of them succumb to the cancer.³ According to the WHO, if nothing is done by 2025, there will be an approximately 55% increase in cases of cervical cancer in Haiti.

In answer to this threat, the Haitian Ministry of Public Health and Population (MSPP), through the Direction of Family Health (DSF), launched a Cervical Cancer Prevention program in Haiti. Since 2011, I-TECH — with funding from the U.S. Health Resources and Services Administration through the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR — has supported DSF/MSPP in facilitating the training of trainers (ToT) and participating actively in the drafting of standards for screening and treatment of precancerous lesions on the cervix.

In March 2013, I-TECH in collaboration with Dr. Frantz Montès from MSPP and two other Haitian experts, Dr. Christophe Millien and Dr. Eddy Jonas from Partners in Health/Zanmi Lasante, conducted a training in visual inspection with acetic acid (VIA) and cryotherapy for caregivers from these institutions.

This program grew under the leadership of I-TECH’s Technical Director Dr. Jean Guy Honoré. In December 2013, I-TECH began to assist institutions in implementing the program, and in the months that followed, it was launched at six institutions across the country. This has resulted in hundreds of patients screened, several of whom have received cryotherapy and cervical biopsies.

The full text of the article (in French) can be found at http://atelier.rfi.fr/profiles/blogs/halte-au-cancer-du-col-en-ha-ti-i-tech-s-investit.

Sources:

1. Human Papillomavirus and Related Cancers in Haiti. Summary Report 2010. World Health Organization / ICO Information Centre on HPV and Cervical Cancer HPV (HPV Information Centre), 2012. Accessed on May 25, 2014.

2. Strategies for cervical cancer prevention using visual inspection with acetic acid and cryotherapy treatment screening. Report of the PAHO workshop for Latin America and the Caribbean. Guatemala City, June 1-2, 2011. Washington, DC: Pan American Health Organization, 2011.

3. Globocan 2008: Cancer Incidence and Mortality Worldwide. International Agency for Research on Cancer / World Health Organization, 2010.

New Course Highlights Core I-TECH Principles

Uncategorized

Posted on March 7, 2014May 1, 2017

ethics_screenshot I-TECH is proud to announce the launch of a new online course, Ethical Conduct & Academic Integrity: Protecting Human Subjects in the Global Health Setting. The course will be required for all I-TECH staff involved in research, program management, monitoring and evaluation, data collection or analysis, or publication activities.

The goal of this course is to instruct members of the I-TECH team on the organization’s expectations of ethical conduct in research and evaluation activities. These expectations include conducting ethical and responsible research and programmatic work; protecting participants in studies, evaluations, and data collection activities; appropriately publishing original work; and avoiding academic misconduct.

“The principles of integrity and quality work form the foundation of everything we do,” said Ann Downer, I-TECH Executive Director. “The Ethical Conduct & Academic Integrity course will not only instruct us on the practical application of these principles, but also help us keep these values at the forefront of our thinking. It is essential to effectively — and ethically — implement our health systems strengthening projects that are affecting the lives of so many around the world.”

Created by a team led by Research and Publications Manager Ellen Wilcox and E-Learning Specialist Leslie Wall, the course is divided into four half-hour “modules,” or lessons:

Module 1: Overview
Module 2: IRB and Ethics Committees
Module 3: Human Subjects and Informed Consent
Module 4: Academic Integrity

The modules present the learner with scenarios that describe potential misconduct, definitions, historical background, helpful tips and reminders, and, finally a quiz captured by Canvas, the University of Washington’s learning management system (LMS).

The course in its entirety is publicly available in the Canvas LMS at https://canvas.uw.edu/courses/889645. The modules are also published on the University of Washington Department of Global Health E-learning portal at http://edgh.washington.edu/series/ethical-conduct-academic-integrity.

Moving forward, I-TECH will also require staff to take a yearly training on ethics and academic integrity. To this end, starting in 2015, I-TECH will offer an annual webinar to give staff the opportunity to discuss ethical issues and to ask questions about the UW Internal Review Board and ethics oversight process.

Launch of HIV Programs in Zimbabwe Hits the Right Note

Clinical Mentoring Demand Creation eLearning/Distance Learning Health Systems Strengthening HIV and STI Prevention Male Circumcision Monitoring & Evaluation Scott Barnhart Zimbabwe

Posted on February 20, 2014July 25, 2017

To the brass beats of the Prince Edward School Jazz Band, on Feb. 6, a crowd of approximately 150 government officials, health professionals, and members of the press celebrated the launch of three programs in Zimbabwe, two of which are implemented by I-TECH Zimbabwe and partners. These vital programs aim to build local capacity and provide comprehensive services to prevent and combat HIV/AIDS in the country.

Speaking at the festivities were David Bruce Wharton, U.S. Ambassador to the Republic of Zimbabwe; Dr. Owen Mugurungi, director of the AIDS and TB Unit at the Ministry of Health and Child Care (MOHCC); Dr. King Holmes, Chair of the Department of Global Health at the University of Washington; Dr. Ann Downer, Executive Director of the International Training and Education Center for Health (I-TECH); and Dr. Batsirai Makunike-Chikwinya, Country Director of I-TECH Zimbabwe.

“Preventing the spread of HIV/AIDS is important to all of us, as is providing the best level of care to those living with this disease,” said Amb. Wharton. “Today we celebrate the launch of programs that will help us reach these goals together – programs that were designed together, by dedicated teams of collaborating partners from Zimbabwe and from the United States.”

In this spirit of collaboration, the programs, totaling $65 million over five years, support the Zimbabwe MOHCC with grant funding by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), technical support from the Centers for Disease Control and Prevention, and implementation by local and U.S.-based partners. These partners include I-TECH; Zimbabwe Association of Church-Related Hospitals; Zimbabwe Community Health Intervention Research Project; Compre Health Services; The Newlands Clinic and Newlands Clinic Training Centre; Pangaea Global AIDS Foundation, Zimbabwe; and the University of Zimbabwe-University of California, San Francisco Collaborative Research Programme.

The Training and Mentoring Program seeks to develop and deliver in-service training on antiretroviral therapy, including the medical management of HIV/AIDS, women’s reproductive health, tuberculosis (TB), and TB/HIV co-infection to 8,000 health care workers across the country over five years. A mentorship component will also provide health care workers with access to ongoing learning and feedback on clinical issues. Health workers will receive refresher trainings via distance learning technologies, and the effectiveness of the program will be measured through a training database.

Also celebrated – and accompanied by a ribbon-cutting and presentation of 17 new vehicles – was the launch of the Voluntary Medical Male Circumcision Program. The program, building on work that started last spring, seeks to deliver services to 412,000 men in Zimbabwe between the ages of 15 and 49 years over the next five years. Medical male circumcision has proved very effective in preventing the spread of HIV. Randomized controlled trials in Uganda, Kenya, and South Africa have shown that this intervention reduces the risk of female-to-male sexual transmission of HIV by approximately 60%.

“Together, these two programs will improve the effectiveness and quality of prevention, treatment, and care services for those affected by HIV/AIDS – and create better health systems for all Zimbabweans,” said Dr. Holmes.

New Article Examines Effect of Training Approaches on Malaria Case Management

Health Systems Strengthening Human Resources for Health Malaria Uganda

Posted on January 31, 2014August 1, 2017

Martin Mbonye

In Uganda, the country with the world’s highest malaria transmission rate, effective training of frontline health workers is especially critical. A new article reports the positive effects of the Integrated Infectious Disease Capacity Building Evaluation (IDCAP)’s training approaches on malaria case management in the country.

“Effect of Integrated Capacity-Building Interventions on Malaria Case Management by Health Professionals in Uganda: A Mixed Design Study with Pre/Post and Cluster Randomized Trial Components” was lead-authored by Martin K. Mbonye, Msc., a researcher at the Infectious Diseases Institute (IDI) in Kampala, Uganda, and published in open-access journal PLOS ONE on Jan. 8; the full text is available online.

“This project made huge strides toward improving the capacity of health workers,” said Mbonye. “These findings have positive implications for Uganda’s increasing ability to take ownership of its malaria interventions and better fight infectious diseases – which account for the majority of the disease burden in the country.”

The IDCAP provided classroom training, distance learning, and on-site support to mid-level practitioners through two interventions: the Integrated Management of Infectious Disease (IMID) training program and on-site support, which integrated site visits and continuous quality improvement. Building on the work of the Joint Uganda Malaria Program (JUMP), IDCAP tackled a wider scope, including malaria, pneumonia, tuberculosis, HIV, and related infectious diseases. (Read more about the interventions and other results here.)

The evaluators then measured the effects of the interventions and the performance of 36 facilities. The results were promising; the combination of interventions was found to improve emergency triage, assessment and treatment processes, and malaria care, a topic of particular importance in Uganda, where steady temperatures and rainfall enable high levels of malaria transmission year-round.

As the IDCAP’s monitoring and evaluation team specialist, and then as program manager, Mbonye oversaw the project’s data surveillance system. He reported improvements in the use of diagnostic tests for malaria suspects, the prescription of the appropriate antimalarials for patients who were determined to need one, and a reduction in the prescription of antimalarials among patients who tested negative for malaria. This decrease in presumptive diagnosis is an important element in reducing drug stockouts and resistance.

I-TECH was one of four partners in the now-completed IDCAP grant to the Accordia Global Health Foundation, and University of Washington professor Marcia Weaver is the IDCAP principal investigator. This article is one of the first in a series of papers describing the study’s results.