Category Archives: Countries

HIV Impact Assessment Shows Significant Progress in Malawi

Tiwonge Chimpandule, I-TECH Malawi’s Strategic Information Officer, presents the results of the 2020/21 Malawi Population-based HIV Impact Assessment (MPHIA) to guest of honor Chrissy Kalamula Kantaso, Deputy Minister of Health (right). Looking on are Jeremy Neitzke, Deputy Chief of Mission, U.S. Embassy (center) and Dr. Rose Nyirenda, Director, HIV and AIDS Department in the Ministry of Health (left). Photo credit: I-TECH Malawi

On World AIDS Day, December 1, staff from the International Training and Education Center for Health (I-TECH) convened with the Ministry of Health (MOH), Columbia University’s ICAP, and other national stakeholders in Malawi to present the results of the 2020-21 Malawi Population-based HIV Impact Assessment (MPHIA). The commemoration, with the theme of “End Inequalities, End AIDS, End Pandemics,” was held at Bumba Primary School grounds in Rumphi District.

The assessment, led by the MOH and ICAP, shows that the national HIV testing program, supported by I-TECH, has achieved a significant increase in the awareness of status among HIV-positive adults—from 77% in 2016 to 88% in 2020-21.

Malawi has also made great strides toward reaching the UNAIDS 95-95-95 Fast Track targets, surpassing both the second 95 (results indicate that 98% of those who know their status are initiated on treatment) and third 95 (results indicate 97% of those on treatment are virally suppressed).

The assessment will be critical to informing future programming, says Dr. Rose Nyirenda, Director of the Ministry of Health’s HIV and AIDS Department. “The 2020-21 MPHIA has produced a wealth of information that will be critical for tailoring our services and to refine strategies for closing the remaining gaps,” says Dr. Nyirenda.

The HIV and AIDS Department also exhibited commodities (antiretroviral medications, testing kits, opportunistic infection (OI) and sexually transmitted infection (STI) medicines, condoms, voluntary medical male circumcision kits) that are procured and managed through the Supply Chain and Logistics Unit.

Correction: A previous version of this article misstated the organization that conducted the 2020-21 Malawi Population-based HIV Impact Assessment. This assessment was led by the Malawi Ministry of Health and Columbia University’s ICAP.

Improving Data Quality and Strengthening Capacity in Côte d’Ivoire

Through a five-year cooperative agreement with the United States (US) Health Resources and Services Administration (HRSA) under the US President’s Emergency Plan for AIDS Relief (PEPFAR), I-TECH recently began implementing the Quality Improvement (QI) Solutions for Sustained HIV Epidemic Control (QISSEC) project in Côte d’Ivoire. This project aims to support Côte d’Ivoire in reaching the UNAIDS 95-95-95 Fast-Track Targets, which to date have not been consistently achieved with specific populations faring worse than others.

The QISSEC approach supports Côte d’Ivoire’s National AIDS Council, Côte d’Ivoire’s International Training and Education for Health (I-TECH CIV), and other implementing partners to help close HIV-related service delivery gaps across clinics and communities, aiming to reach the UNAIDS 95-95-95 targets. Initially focused on 60 priority sites throughout the country, QISSEC will work closely with local clinic- and community-based partners to implement customized site-level QI interventions; integrate community or civil society groups into QI approaches; establish national QI learning networks; and disseminate QI successes and lessons learned across the learning networks. Using this patient-centered approach, QISSEC aims to ensure a facility-owned and locally-led response to persistent challenges in patient testing, retention, and suppression.

HIV Care and Treatment in Ukraine

Since 2018, I-TECH has supported the Ukraine Ministry of Health (MOH), through the MOH Public Health Center, in introducing and adopting WHO-recommended safe and effective antiretroviral therapy (ART) regimens.

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Assisted HIV Partner Notification/Index Testing in Ukraine

Since 2019, I-TECH has provided increased technical assistance for 39 state healthcare facilities in eleven high HIV burden regions of Ukraine to advance assisted partner notification/services and index testing as a sustainable strategy for HIV case finding.

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HIV Pre-Exposure Prophylaxis (PrEP) in Ukraine

The Government of Ukraine prioritized pre-exposure prophylaxis (PrEP) as part of combination prevention for HIV in 2019.1 Since 2020, I-TECH has focused its programmatic efforts in Ukraine on improving PrEP services uptake and strengthening PrEP delivery at selected stat healthcare facilities.

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I-TECH Remembers Transgender Activist and Leader Brandy Rodriguez

Brandy Rodriguez gives feedback to a clinician during the pilot training of I-TECH’s Key Population Preceptorship program in Trinidad & Tobago. Photo credit: Lauren Dunnington/I-TECH.

In honor of Transgender Awareness Week (November 13-19), the International Training and Education Center for Health (I-TECH) pays tribute to Trinidad & Tobago transgender activist and esteemed community leader Brandy Rodriguez, who passed away in late October.

Ms. Rodriguez leaves a legacy of leadership as president of the Trinidad and Tobago Transgender Coalition and a member of the Pan Caribbean Partnership against HIV and AIDS. She improved countless lives among those she supported in her many years as a peer navigator at the Family Planning Association of Trinidad and Tobago. Countless more lives were touched – and perspectives broadened – through her tenacity and compassion.

Staff at I-TECH are honored to have worked with Ms. Rodriguez, who served as a patient-trainer for I-TECH Caribbean’s Key Populations Preceptorship program in Trinidad & Tobago.

“A tireless champion for the trans community, Brandy held an open door and a willing ear to any lost children of our LGBTQ tribe,” says Conrad Mitchell, I-TECH’s Program Coordinator in Trinidad & Tobago. “Her fiery tongue and sharp wit kept us all in check, whilst her warm heart overflowed with a love that was unsurpassed. Her fearlessness was legendary both within the community and across local, regional, and international platforms. We are shaken to the core by this loss. The world is forever a little less ‘fierce’ with Brandy gone.”

The Key Populations Preceptorship program’s intensive trainings use targeted role-play scenarios to build clinicians’ capacity to provide nonjudgmental, high-quality comprehensive HIV care to communities most at risk: men who have sex with men, transgender people, and sex workers. Through this work with I-TECH, Ms. Rodriguez contributed to critical efforts to break down stigma and barriers to care experienced by marginalized communities. The first physician trained as part of the program in Trinidad & Tobago, Dr. Vedavid Manick, shared his experience with Ms. Rodriguez beautifully in a Trinidad and Tobago Newsday letter to the editor.

To learn more about the impact Ms. Rodriguez’s work, see these tributes at Trinidad and Tobago Newsday and UNAIDS.org.

Finance, Operations, and HR Leaders Across the I-TECH Network Share Experiences

By Chelsea Elkins

Operations management, including general operations, finance, and human resources (HR) work, are vital to any organization. They are particularly important in the complex landscape of public health programming, where they form the backbone of life-saving services. The International Training and Education Center for Health (I-TECH) network is grateful for the expertise and leadership of finance, HR, and operations professionals across the globe who keep the organization running smoothly and responsibly. We asked several I-TECH Finance, Operations, and HR Managers to share a little bit about what drives their work, as well as their experiences as leaders within the public health field.

Yves-Alain Tanoh

Yves-Alain Tanoh
Finance Manager, I-TECH Côte d’Ivoire

I have been working in the I-TECH Côte d’Ivoire Finance Department for more than 3 years. Prior to I-TECH, I worked on several development projects in Côte d’Ivoire for 14 years.

I am really dedicated to this work.

Since my childhood, I have always had compassion for people in need. I have been affected by the way refugees were struggling for life during the Liberia and Sierra Leone wars. This led me to work with a development non-governmental organization (NGO). Already working in the humanitarian field, I told myself that I could make my modest contribution in a health NGO. I got the opportunity to join I-TECH and have really enjoyed my job since.

Being a leader is not easy. In addition to having a full to-do list, I face many unforeseen circumstances every day. Being competent does not mean knowing everything, but you need to understand each topic well enough to be able to make informed decisions and ask the right questions if information is missing.

I am focusing more and more on building the right team, along with a sustainable human strategy and a culture of innovation. This will be their contribution to I-TECH.

Tannia Toivo

Tannia Toivo
HR Manager, I-TECH Namibia

I joined the HR field because of my love of working with and helping people. Naturally, I was drawn to the public health field and specifically to I-TECH because of its work in addressing the challenge we are facing with HIV in Namibia.

I first joined I-TECH Namibia as an HR Officer for a short period in 2012 and 2013. I was very fortunate to join the team again in May 2016 as an HR Manager.  It has been so rewarding as I interact with professionals and experts from diverse backgrounds and experiences, therefore learning every day.

Generally, the HR field is woman-dominated, and it is great to see the impact that women have in the corporate world. It is a challenging field that is always growing and changing; requiring one to work very hard and to have strong job knowledge in order to succeed. My work as an HR Manager also means that I am involved in Affirmative Action activities, which place an importance in making sure that women are provided equitable employment, training, and job advancement opportunities amongst others. Through my work, I play a part in empowering other women. 

Angela Amondi

Angela Amondi
Operations Lead, I-TECH Kenya

My operations work was initially with general nonprofits, but as I evolved in my field, I began specializing in public health nonprofits.

I have found that being the Operations Lead for the I-TECH Kenya office has been extremely fulfilling. The organization provides professional support and development to help employees learn on the job and enhance their professional skills. A few of my I-TECH career highlights include when I supported the startup for the Kenya office and led the subsequent scale-up when we received additional funding. Within a period of two years, the office grew from having six employees to 17. While leading the operations scale-up, I set up the business operations support and created all operational policies and procedures.

I-TECH practices and emphasizes work/life balance, including having policies that support new mothers and, even before the onset of the COVID-19 pandemic, including telecommuting as part of the organizational policies. These policies have allowed for peace of mind to focus on the work and achieve the objectives at hand.

Gerald Hiwa

Gerald Hiwa
Finance Manager, I-TECH Malawi

The public health sector needs to be occupied by personnel who have a strong background in finance and can provide strong leadership to oversee financial and grants management. Working in the public health field allows me to answer that call of providing strong leadership so that donors and funders become more confident on how the funds are being utilized and that the intended beneficiaries are benefitting from various health programs.

Analyzing the impact of health interventions compared to the funding investment has been another factor that has enabled me to remain in the public health space for the past 9 years.

My role at I-TECH Malawi as a Finance Manager has been quite educative and impactful. Educative in the sense that I have gained additional knowledge by working with a diverse group of people with different backgrounds. I have also learned to appreciate other people’s perspective regarding work culture. The experience working with I-TECH senior management in Malawi and at headquarters has taught me to focus on the core objective of the various programs and link deliverables to budget monitoring.

My role has been impactful in the sense that I supervise two Finance Officers. Together we have managed to have clean audits with no findings for the past 5 years during annual external audits. Our Finance Department has maintained the first position for three consecutive years during the Global Finance Excellence award, a rating used to gauge policy compliance and accurate financial reporting. My role has had an impact by ensuring that all payments are in compliance with policy and reporting deadlines are met.

Candida Angula

Candida Angula
Senior Finance Manager, I-TECH Namibia

I was introduced to finance work within the public health field by accident, you might say. I started work as an accountant at an IT company, where I mostly did bank reconciliations and invoices and also worked with debtors. After 8 years I felt like I was stagnating and not really growing much as a professional; then the opportunity to join I-TECH Namibia presented itself. I saw the job ad in the paper, decided to go for it, applied, and the rest is history…

I have had so many wonderful experiences, including when I went to work in the South African country office’s Finance Department. I was tasked with assisting them to set up their systems and sharing my expertise and experiences. I liked working in a different set-up, learning the different South African cultures, and interacting with new people.

Another favorite experience is working with people from all over the world, networking and learning from their experiences, as well as sharing mine with them. Back home in the Namibian office, I also like that I get to interact with field staff, which is rare; finance people in general tend to be more office-based. But every now and then I go out into the field and conduct fiscal inventory verifications where I get to learn more about the operations in the field and interact with my fellow colleagues.

A highlight in my work was when I acted as Finance Director for over six months. The experience really shaped my career and confidence and challenged me in ways that made me grow as a professional.

Even though the finance field is generally male-dominated (especially here in Namibia), I’m not conscious of being a woman in my position as a Senior Finance Manager. Instead, I see my position as both an opportunity and a challenge; an opportunity to inspire more young women to join the field, and a challenge to demonstrate that women can excel in any field.

 

Kayla Cody-Lushozi Reflects on I-TECH’S Global Health Leadership Development Program

Kayla Cody-Lushozi

By Chelsea Elkins

For the past 10 months, Kayla Cody-Lushozi has served as the inaugural Global Health Program Officer for I-TECH’S Global Health Leadership Development Program. The aim of this program is to support the development of skills in global health program implementation, management, and leadership for recent master’s degree graduates with diverse backgrounds who are transitioning into the public health field.

This program is structured to directly support the programmatic needs of multiple I-TECH projects while providing the Program Officer with mentorship across the I-TECH network and supporting the transition into a non-temporary global health position. In 2019, Cody-Lushozi received her Master’s in Social Work (MSW) from the University of Washington (UW) and has used this background, along with her unique experiences and expertise, to inform her work at I-TECH.

During her time as a Program Officer, Cody-Lushozi has worked with three teams across the I-TECH network, plunging into a few of the many areas of work I-TECH implements and supports. In collaboration with partners from FHI 360 and leaders from the Cambodian Ministry of Health, Cody-Lushozi supported a health informatics program, working to streamline databases and strengthen health systems in Cambodia. Additionally, she explored how to revive Community Advisory Boards for people living with HIV (PLHIV) in Jamaica in a sustainable and community-centered way with I-TECH network partner the Caribbean Training and Education Center for Health (C-TECH). She worked with community partners in Zimbabwe, as well, exploring the support systems in place for case managers supporting young PLHIV. This work was done with I-TECH partner the Zimbabwe Technical Assistance, Training and Education Center for Health (Zim-TTECH).

September marks the end of Cody-Lushozi’s time with I-TECH. Below, she shares some reflections on her time in the Leadership Development Program, as well as what might come next.

What has the experience of being a Program Officer at I-TECH meant to you?

This has been an incredible experience, and it came at a perfect time. Right before I-TECH, I was working at the Washington State Department of Social and Health Services doing direct service social work with economically marginalized clients with mental and physical health needs. While I enjoyed this role and understood its importance, this was not the type of social work practice that I wanted to pursue in the long run.

My passion and interests lie in research, especially community-centered research that allows me to work directly with Black communities in improving access to health justice. I-TECH came along at the right time and allowed me to dive deeper into the world of global health implementation.

The projects I’ve done at I-TECH have been really varied, and I’ve gotten an inside look and experience across different areas. I am constantly learning at I-TECH. I-TECH does a million things, which might have been overwhelming to a new person entering the organization, but I always felt very supported by my teams. They made it clear that I didn’t need to have all the answers.

I also appreciate that this program aims to attract a diversity of experience, background, and perspective. It encourages more than just a singular lens. I’ve been able to share my unique background and experiences as a Black woman social worker in global health. I’m excited to see where this program goes and how it continues to support I-TECH’s evolution.

This has been a beautiful experience for me. Working at I-TECH served as a great affirmation that this is the area of work that I want to continue to grow in.

How has your background in social work shaped how you’ve entered the global health field?

Before getting my MSW I already had an interest in public health, even before I was calling what I was doing public health. I wanted to use the framework and the lens that social work provides within a public health setting. I always gravitate toward work that is community-centered and centers the voices and expertise of those in the margins. These are some of the values that I bring with me into the global health space and that I hold very close to my professional and personal practice.

These values have helped me in this field because public and global health work is not always operating from the pillars of anti-oppressive practice. There’s so much historical and contemporary discourse that needs to be addressed and often isn’t in this field. You can’t be ahistorical if you’re truly trying to get to the root causes of global health inequity and injustice. Many of the issues that we see in global health are connected to issues of global white supremacy, imperialism, and resource extraction. It’s a tension that I hold in this field but something I try to do my part to shed light on.

You have done a lot of meaningful work during your time with I-TECH. What does your life look like when you’re not working?

I’ve gone through a lot of life changes these past 10 months. I’m a newlywed; I got married in June to my now husband Mawande. Being a new wife is really exciting.

A big chunk of my husband’s and my time outside of work is dedicated to our small homemade skincare business, K+M Homemade Skincare, that we officially launched during COVID. We do a lot of farmer’s markets and pop-ups on the weekends. Ask anyone and they can tell you that we love making and talking about our skincare.

In what direction do you see yourself moving after I-TECH?

After I-TECH, I see myself continuing to engage in global and public health spaces that are truly committed to community work and radical racial and social justice transformation. I am not comfortable doing this work in the absence of working directly with community members and local stakeholders. Top-down approaches have colonial and imperialist roots. I believe in doing “with” and not doing “to” and actively partnering with communities for long-term sustainability and quality health care reform.

I will be packing up and moving to South Africa in 2022 and am currently open to a position that will allow me to continue to practice in this exciting field. My interests lie in research, project management, and implementation work related to HIV care and treatment, maternal and child health, and mental health. I am also contemplating pursuing an MPH or a PhD in global health and implementation science sometime in the future. It’s been an incredible past 10 months with I-TECH and I am excited to stay in contact with this global network. I thank everyone who has been part of this journey with me!

The I-TECH network thanks Kayla Cody-Lushozi for her work and wishes her well as she continues to forge her path in global health!

If you are interested in participating in the Global Health Leadership Development Program, more information is available here.

I-TECH Network Minimizes Disruptions in Treatment Access for PLHIV During COVID-19

By Chelsea Elkins

Members of a Community Adherence Refill Group in Zimbabwe

In a time of increased barriers, disruptions, and restrictions due to the COVID-19 pandemic, the International Training and Education Center for Health (I-TECH) and its network partners have implemented new approaches and adapted existing programs to support continued access to antiretroviral therapy (ART).

As a result of the pandemic, many organizations and health systems have had to shift to offering virtual care, which allows ART initiation and other HIV services to persist while minimizing patients’ risk of exposure to COVID-19. However, not all patients have access to the technology that makes virtual services possible, and additional approaches are needed to support ART treatment access during this time.

“Globally, the pandemic has generated innovative responses from communities and health systems that are striving to keep people connected to care,” says Dr. Pamela Collins, I-TECH Executive Director. “One challenge is to recognize how (or when) some adaptations increase disparities in access. We’ve learned that the right combinations of technological and no-tech solutions can also be innovative if they help provide the care that’s needed.”

One way I-TECH has helped to provide innovative care during the pandemic is by centering solutions within the affected communities themselves. A few of the community-oriented approaches that the I-TECH network has implemented include decentralized ART centers, community outreach, home delivery, community adherence refill groups (CARGs), and multi-month dispensing (MMD) of antiretroviral (ARV) medication.

Decentralized ART Refill Sites and Community Outreach

Decentralized refill sites have been an essential strategy during lockdown restrictions for I-TECH’s network partners because they allow ART to be distributed at more convenient locations, minimizing travel and treatment interruptions. Some programs have also started providing mobile outreach to improve ART access during the pandemic, at times even providing doorstep delivery to those who are unable to go to a clinic or refill center.

I-TECH’s network partner in India, the UW International Training & Education Centre for Health Private Limited (I-TECH India) launched the ARTMitra helpline in Mumbai, an outreach effort designed to map the location of unreachable PLHIV and aid in planning decentralized ART refill sites. SMS messages were delivered to 13,103 PLHIV who had missed appointments during the pandemic, resulting in the identification of 42 decentralized ART refill centers in Mumbai in 2020. A similar helpline was launched in five districts of the state of Mizoram in partnership with the State AIDS Control Society. In total, I-TECH India, in close coordination with government partners in the PEPFAR states in Northeast India and in Mumbai, has ensured uninterrupted ART delivery through 145 decentralized ART refill sites.

Through outreach efforts, clients were notified about how they could access medication, and which decentralized ART refill site they should visit. Additionally, ART home delivery was provided to 255 PLHIV living in Mumbai who were unable to pick up their medication.

Thank you for calling and informing me about the availability of medicine at the nearby ART Centre, as I had no idea whom to contact and how to collect medicine.

—an ARTMitra client in Mumbai

I-TECH network partner the Zimbabwe Technical Assistance, Training and Education Center for Health (Zim-TTECH) has also utilized community outreach to support PLHIV during the pandemic. Zim-TTECH has supported the Zimbabwe Partnership to Accelerate AIDS Control (ZimPAAC) consortium—along with PEPFAR partners and in close collaboration with national efforts—to provide mobile HIV care, including prevention services and integrated services at ART events. In the Harare District, 8,257 clients were supplied ART during outreach events from 28 March through 17 July 2021.

Community Adherence Refill Groups and Multi-Month ART Dispensing

Through CARGs, a community of PLHIV access treatment more easily by sending a representative to receive ARVs for the entire group. The I-TECH network implements CARGs in a number of countries, using the person-centered approach to simplify HIV care and reduce the need for in-person services. This approach is often used in tandem with MMD, allowing a group to access multiple months of medication at a time.

While ARVs have traditionally been prescribed monthly, MMD allows patients to pick up medication for 2 to 6 months and reduces traditional barriers, such as access to transportation and taking time off work, as well as barriers specific to COVID-19, such as lockdown restrictions and limited capacity of health care facilities. I-TECH and its network partners have scaled up MMD in many programs during the COVID-19 pandemic, effectively minimizing the number of in-person visits and encouraging ART adherence.

In response to COVID-19, the Ministry of Health and Social Services (MoHSS) in Namibia introduced a new MMD policy in April 2020 for eligible ART patients, making more people eligible for this service than ever before. In addition to policy support, I-TECH Namibia is engaged in technical support to the national HIV/AIDS program through clinical mentors who work in more than half of Namibia’s health districts. This national engagement has contributed to a rapid increase in the number of eligible ART patients who now receive between 2 to 6 months’ supply of ARVs at a time.

‘’As the number of ART patients on MMD increased, waiting areas in Namibia’s health facilities have rapidly decongested, enhancing COVID-19 infection prevention and control measures,” says Dr. Norbert Forster, I-TECH Namibia’s Country Director. “At the same time, our HIV clinicians now have more time to focus their care on patient engagement and on enhancing viral load suppression and other interventions.”

I-TECH’S WORK IN INDIA IS SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) UNDER U91HA06801, THE INTERNATIONAL AIDS EDUCATION AND TRAINING CENTER (IAETC). THE CONTENT OF THIS POST IS THE AUTHOR’S AND SHOULD NOT BE CONSTRUED AS THE OFFICIAL POSITION OR POLICY OF, NOR SHOULD ANY ENDORSEMENTS BE INFERRED BY HRSA, HHS OR THE U.S. GOVERNMENT.

Despite COVID-19 Challenges, I-TECH Supports Progress Toward Cervical Cancer Elimination

The World Health Organization (WHO) Global Strategy to Accelerate the Elimination of Cervical Cancer, launched in November 2020, calls for a world where cervical cancer—which kills more than 300,000 women per year—is eliminated. To achieve this, the strategy proposes ambitious 90-70-90 targets over the next decade.

However, the COVID-19 pandemic has severely hindered critical work on cervical cancer interventions, including reduced clinic flow, training opportunities, and outreach.

Due to agile programs and dedicated staff, several teams within the International Training and Education Center for Health (I-TECH) network, despite the challenges presented by COVID-19, have continued to make strides toward the WHO cervical cancer elimination goal.

Record-breaking cervical cancer screening in Namibia

The I-TECH Namibia program focuses on cervical cancer screening services for women living with HIV (WLHIV). Namibia’s national antiretroviral therapy (ART) program has rapidly adjusted to COVID-19 and the need to decongest public health facilities through multi-month dispensing (MMD) of ART. While this has helped with ART access, it has significantly reduced opportunities for performing facility-based services, since the frequency of health facility visits by women on ART has declined rapidly.

In close collaboration with the Namibia Ministry of Health and Social Services (MoHSS), I-TECH is implementing enhanced facility-based screening campaigns to increase access and rapidly reach more women. For these enhanced screenings, clients within a district are mobilized and given paced appointment times at several facilities in-line with COVID-19 restrictions. Service providers are then assigned to the specific sites where they provide screening services.

From 8-12 February, 805 women were screened through visual inspection with acetic acid (VIA) or Pap smear, 95% of whom were women living with HIV (WLHIV). Of the 137 women screened VIA positive, 98% received treatment. This campaign broke national records by achieving the highest recorded number of women screened in a 5-day campaign, as well as the highest number of women screened in a single day (210).

“As the COVID 19 pandemic rages on, and preventative restrictions limit client screening, the downtime should be used in planning for catch-up screening activities,” says Dr. Laura Muzingwani, I-TECH’s Cervical Cancer Lead Physician in Namibia. “Resource and client mobilization are both key to prepare for any window of opportunity when COVID restrictions are relaxed to enable rapid mass screening.”

Mentoring and training continues in Mozambique via videoconferencing technology

In close collaboration with the Ministry of Health (MOH) and the University of Texas MD Anderson Cancer Center—a Project ECHO® “superhub” for oncology—I-TECH has continued its monthly cervical cancer ECHO sessions in Mozambique, with an additional focus on COVID-19 safety and risk reduction. An average of 40 participants attend each session, and topics have included cervical changes in older women; relevance of normal and abnormal colposcopic findings; and hygiene, disinfection, and asepsis of materials.

“Although the emergence of the COVID-19 pandemic was sudden, it was possible to adapt quickly using remote information and communication technologies,” says Dr. Ernestina David, Program Manager for the I-TECH Cervical Cancer Prevention Program. “The ECHO videoconference sessions made it possible to bring together providers across the country to address uterine cancer and diagnose and treat pre-cancerous lesions, using local cases and looking for ways to approach and treat them.”

In addition, the Mozambique team has continued its regional cervical cancer trainings in a blended format (both virtual and in-person components). I-TECH has implemented three trainings using a model spearheaded by MD Anderson, wherein a two-day LEEP and colposcopy training was adjusted so that trainers could join via Zoom in lieu of traveling to Mozambique.

While some participants join only the Zoom sessions, others are able to watch the sessions from a classroom setting and then work through skills-building demo stations, followed by practice on patients at a provincial hospital.

Access to services increase through health communication in Malawi

Despite the Malawi government indicating cervical cancer screening, care, and treatment as priority services, after the COVID-19 pandemic hit the country, most facilities did not include cervical cancer services on their priority lists. Facilities either completely suspended or heavily reduced screening and treatment. This, coupled with fears among targeted women about contracting COVID-19, marginalized access to services.

To combat these challenges, I-TECH delivered health talks within communities on how women can protect themselves as they access services (social distancing, hand washing, use of face masks, etc.). Those reached were encouraged to pass on information to others.

I-TECH also engaged district health officers and those in charge of affected facilities on the need to continue providing cervical cancer services, in line with MOH COVID-19 prevention guidelines. Presenters emphasized the burden of cervical cancer and how it would worsen should services be interrupted for the entirety of the pandemic. Discussion also touched on including cervical cancer providers on the rotation roster and ensuring that commodities were available.

In Malawi, 391 health facilities are currently providing cervical cancer screening services, and 80% of those health facilities are also providing treatment services. More than a quarter of a million women were screened between January 2020 and June 2021, 57% of whom were WLHIV.

Zimbabwe consortium takes measures to blunt the impact of COVID-19

I-TECH and its network partner the Zimbabwe Training, Technical Assistance and Education Center for Health (Zim-TTECH) implement cervical cancer screening and treatment via the local Zimbabwean consortium ZimPAAC.

By March 2021, ZimPAAC had achieved 53% of the annual target for the number of women on ART screened for cervical cancer. ZimPAAC implemented several measures to mitigate the impact of COVID-19 on continuity of cervical cancer screening services, including:

  • Training of all health care workers on COVID-19 safety and security, transmission, and prevention;
  • Support to ensure infection prevention and control (IPC) and triage at health facilities through training, procurement and distribution of personal protective equipment (PPE), hand washing stations/commodities, face masks for both staff and clients in need; and
  • Procurement and distribution adequate PPE for use by health care workers at facilities.