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I-TECH Network Presents at End-of-Year Conferences

Yao He at GDHF 2023

It was a busy fall season for teams throughout the I-TECH Network, several of which had robust representation at end-of-year conferences including the International Conference on AIDS and STIs in Africa (ICASA) 2023 the Global Digital Health Forum (GDHF) 2023.

Welcome additions to I-TECH’s regular lineup of conferences were Infectious Disease Week (ID Week) 2023 and the 40th Annual Oregon Rural Health Conference, attended by representatives of I-TECH’s new network partner, the UW Center for Stewardship in Medicine (CSiM).

Representatives from the network presented more than a dozen posters, spoke at panels and discussions, and led an interactive workshop. Read below for more details (links to presentations will be posted as they are made available).

ICASA 2023, 4-9 December, Harare, Zimbabwe

The theme of this year’s conference was “AIDS is not over: Address inequalities, accelerate inclusion and innovation.” I-TECH Network partner the Zimbabwe Technical Assistance, Training, and Education Center for Health (Zim-TTECH) and its partners Pangaea Zimbabwe AIDS Trust (PZAT) and Zvandiri presented several posters representing their work to innovate and improve access at the training and community levels.

Zim-TTECH:

  • Gloria Gonese at ICASA 2023

    Romana R Katekwe, Edson Chidovi, Frances Petracca, Batsirai Makunike, Gloria Gonese, Kerry Thomson, Zwashe Bangani, Haddi Cham, Mirriam Mugwise, Emmanuel Govha, Stefan Wiktor, “Improving Access to Quality Improvement Training through Off-line Electronic Learning: A Case Study from Zimbabwe”

  • Langalokusa Sibanda, Peace Ntini, Richard Mashapa, Gloria Gonese, Rickie Malaba, Tendayi Mharadze, Ralph Makuyana, Methembe Ndlovu, Ruth Levine, Vivian Bertman, Abigail K. Korn, Kerry A. Thomson, Owen Mugurungi, Tsitsi Apollo, Getrude Ncube, Mirriam Mutseta, Beauty Nyamwanza, Batsirai Makunike-Chikwinya, Stefan Wiktor, “DREAMS Ambassadors Increase HIV Self-Testing Uptake by Male Partners of Young Women in Zimbabwe”
  • Anjali Vasavada, Phibion Manyanga, Sandra Murwira, Lucia Gondongwe, Ponesai Nyika, Batsirai Makunike-Chikwinya, Gloria Gonese, Stefan Wiktor, George Mamire, Kerry A. Thomson, “Acceptance of Free Cervical Cancer Screening Among Zimbabwean WLHIV: Implications for Integration of HPV Testing into Routine HIV Care”
  • Rumbidzai Dhliwayo, Lennox Dziva, Ponesai Nyika, Chiedza Mupanguri, Gloria Gonese, Tsitsi Apollo, Owen Mugurungi, Talent Maphosa, Haddi Jatou Cham, Batsirai Makunike-Chikwinya, Stefan Wiktor, “Assessing Implementation and Outcomes of Screening for Advanced HIV Disease (AHD) Among Persons Living with HIV in Five Provinces of Zimbabwe”
  • Gloria Gonese, “High HIV disease burden among older clients aged ≥50years attending selected health facilities in Zimbabwe, Oct 2020 through March 2023”

PZAT:

  • Precious Moyo, Joseph Murungu, Shamiso Nyakuwa, Casper Hera, Imelda Mahaka, Blessing Mushangwe, Phibion Manyanga, Gloria Gonese, Batsirai Makunike, Takunda Sola, Getrude Ncube, Tendayi Mharadze, Rickie Malaba, Stefan Wiktor, “Key Populations Outreach Activities for Scaling Up HIV Prevention Care and Treatment Services in Harare, Zimbabwe”
  • Precious Moyo, Joseph Murungu, Shamiso Nyakuwa, Casper Hera, Imelda Mahaka, Blessing Mushangwe, Phibion Manyanga, Gloria Gonese, Batsirai Makunike, Takunda Sola, Getrude Ncube, Tendayi Mharadze, Rickie Malaba, Stefan Wiktor, “Layering Enhanced Economic Strengthening Interventions to Reduce Vulnerabilities Among Sexually Exploited Minors and Young Women Selling Sex in Zimbabwe”
  • Sitshengisiwe Ruzibe, Casper Hera, Precious Moyo, Joseph Murungu, Shamiso Nyakuwa, Imelda Mahaka, Langalokusa Sibanda, Peace Ntini, Gloria Gonese, Batsirai Makunike, Mirriam Mutseta, Getrude Ncube, Tendayi Mharadze, Rickie Malaba, Kerry A. Thomson, Stefan Wiktor, “Services for Sexually Exploited Minors and Young Women Selling Sex Enrolled in DREAMS program, Matabeleland North, Zimbabwe”

Zvandiri:

  • Vivian Chitiyo, Tanyaradzwa Napei, Billiart Tapesana, Ann Selberg, Edson Chidovi, Gloria Gonese, Kerry Thomson, Talent Maphosa, Haddi Cham, Ngwarai Sithole, Tsitsi Mutasa-Apollo, Nicola Willis, Stefan Wiktor, “Minimizing Interruption in Treatment (IIT) through Peer Connections of Adolescents and Young People Living with HIV in Zimbabwe”

 

GDHF 2023, 4-6 December, Washington, D.C.

The Digital Initiatives Group at I-TECH (DIGI), and others from I-TECH, presented their work in a number of ways at this year’s Global Digital Health Forum. GDHF is a leading global public health industry conference for technology vendors, donors, researchers, government representatives, and implementing organizations working in low- and middle-income countries.

Hannock Tweya and Caryl Feldacker at GDHF 2023

Posters:

  • Feldacker C, Murethi M, Ndhlovu D, Bisani P, Kathumba D, Samala B, Oni F, Wagaba K, Kagereki E, Wassuna B, Tweya H, “Mobile Electronic Medical Record Systems: The Community-based ART Retention and Suppression (CARES) App Design for High-Quality, Integrated Antiretroviral Therapy in Lilongwe, Malawi”
  • He Y, AbuShweimeh R, Kouabenan YR, Assoa PH, Puttkammer N, Gloyd S, Wagenaar BH, Komena P, Kamelan N, Iiams-Hauser C, Pongathie A, Kouakou A, Hoffman N, Flowers J, Abiola N, Perrone LA, “Determinants of Routine Implementation for Electronic Laboratory Information Systems in Côte d’Ivoire: a Mixed-Methods Implementation Science Study”
  • He Y, Kouabenan YR, Assoa PH, Puttkammer N, Gloyd S, Hoffman N, Wagenaar BH, Komena P, Kamelan N, Iiams-Hauser C, Pongathie A, Kouakou A, Flowers J, Abiola N, Perrone LA, “Perceptions and Experiences of Data-Driven Decision-Making and Data Dashboard for HIV Viral Load Testing and Early Infant Diagnosis in Côte d’Ivoire”
  • Gadabu O, Manyiyo B, Yiga H, Chigoriwa C, Chirowodza L, White C, Mankowski P, Mutesasira M, Gita C, Maxwell L, Muserere C, Flowers J, “A FHIR Training Workshop to Facilitate Interoperability Between the IMPILO EHR and the LIMS System in Zimbabwe”
  • Secor, A, presented by Patric Prado, “Electronic Medical Record Data Missingness and Interruption in Antiretroviral Therapy among Adults and Children Living with HIV in Haiti: A Retrospective Longitudinal Study”

Virtual Panel:

  • “Building Next-Gen Digital Health Solutions On FHIR With Open Health Stack” Presenter: Patric Prado

Individual Presentations:

  • “Efficiently Leveraging Individual-level Health Data For Population-level Data For Decision Making: A Call To Action For FHIR-based Secondary Data Use” Presenter: Piotr Mankowski
  • “Implementation of An Online Course By MOH For Health Workers In Kenya: Strategies And Lessons For Success” Presenter: Robert Oboko
  • “Applying Critical Reflection To Reimagine Global Digital Health Interventions: Introducing The (Re)imaginator” Presenter: Beth Dunbar
  • “Advancing National Health Information Systems Maturity: Lessons Learnt On Implementing The Informatics-Savvy Health Organization (ISHO) Assessment And Action Planning Framework For Health Leaders In Zambia” Presenter: Kendi Mburu
  • “Online Learning as an Innovation And Sustainability Initiative In Digital Health In Low And Middle Income Countries” Presenter: Robert Oboko

Topic Lounge Discussions:

  • “Perceptions On The Quality Of Electronic Medical Records In LMIC” Presenter: Jan Flowers
  • “Bringing Into Production A Health Information Exchange Architecture In Côte D’Ivoire: Using Open Standards And Software To Enable Cross-site Patient Histories And Real Time Dashboarding. Côte D’Ivoire HIE” Presenter: Casey Iiams-hauser

Interactive Workshop:

  • “Creating, Leading, And Managing Informatics-Savvy Health Organizations (ISHO): Concept, Principles, And Application”

 

ID Week 2023, 11-15 October, Boston, Massachusetts

IDWeek is the joint annual meeting of the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP). This year, CSiM presented:

  • “Asymptomatic Bacteriuria Underestimates True Inappropriate Prescribing for Non-Urinary Tract Infections” Presenting author: Whitney Hartlage, PharmD

 

40th Annual Oregon Rural Health Conference, 11-13 October, Sunriver, Oregon

For this year’s Annual Oregon Rural Health Conference, Rupali Jain, PharmD, and Natalia Martinez-Paz, CSiM Manager, shared lessons learned in Cohort 2 of their Intensive Quality Improvement Cohort (IQIC) program and how Critical Access Hospitals can approach QI in the post-COVID-19 healthcare environment.

  • Session title: “Case Study: Asymptomatic Bacteriuria Quality Improvement Projects in Critical Access Hospitals”

I-TECH and Partners Fête Quality Improvement Teams in Côte d’Ivoire

Honorees from well-performing sites in the QISSEC project

In late February, the International Training and Education Center for Health (I-TECH) hosted an awards ceremony for the 10 best-performing health facility-based quality improvement teams focused on improving HIV prevention, care, and treatment services in Côte d’Ivoire. I-TECH currently operates in 80 HIV care and treatment (C&T) health facilities throughout Côte d’Ivoire.

Out of a total of 20 points, and using strict criteria, 10 sites received scores greater than or equal to 18 and were honored at the ceremony. Awards included computer equipment, printers, video projectors, blood pressure monitors, and other vital office equipment.

The ceremony was part of the U.S. Health Resources and Services Administration (HRSA)-funded Quality Improvement Solutions for Sustained Epidemic Control (QISSEC) project, which seeks to improve interventions such as the  provision of pre-exposure prophylaxis (PrEP), decreasing treatment interruption, and improving viral load testing coverage and suppression.

“This ceremony was a way to applaud the enthusiasm from the teams, demonstrate an understanding of the methodology, and share the projects that have so far been implemented,” said Dr. Nathalie Krou Danho, QISSEC Project Director.

PEPFAR Coordinator Bibola Ngalamulume

In addition to Dr. Danho, ceremony attendees included the National AIDS Control Program (PNLS) Director, PEPFAR Coordinator Bibola Ngalamulume, HRSA representatives, QISSEC Principal Investigator Ellen MacLachlan, CDC and USAID Country Directors, and representatives from the regions, districts, and sites.

“It is important that we put an accent on service quality,” said Ms. Ngalamulume. “The CQI project that is being implemented by I-TECH is an initiative that is extremely important because not only does it ensure that we improve access to care for all the HIV population–those who are infected and affected–but also it gives us the opportunity to create some kind of a mentorship network between health facilities that are performing well and facilities that need support. [This ceremony] is going to drive even more innovation moving forward.”

Within the QISSEC project, I-TECH has been working closely with the Ministry of Health and Public Hygiene (MSHP) and implementing partners to strengthen provider and community counselor capacity in quality improvement to ensure HIV epidemic control.

I-TECH’s methodology is to build a culture of quality improvement from central, to regional, to site levels. Importantly, I-TECH supports sites to work with the community to center their needs, and patient needs, in providing quality care.

One of the sites honored, an urban health center in Libreville, had set a goal to increase individuals on PrEP from 23 in December 2021 to 78 in June 2022. Their root cause analysis revealed that training in PrEP was insufficient. After orienting prescribers and clinical advisors to PrEP, and organizing community awareness sessions where eligible individuals were identified, the site surpassed their goal by 200%, initiating 230 individuals on PrEP by June 2022. The site continued to increase that pace, reaching 353 by August of that year.

“It’s been a lot for the teams to do this work on top of their day-to-day jobs: to form a quality improvement team, brainstorm, and think of ideas on how to implement the changes,” said Dr. MacLachlan, “but they have taken great care in this work. The quality of HIV care in Côte d’Ivoire will be better for it.”

THIS PROJECT 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.

Transitioning OpenELIS Training and Implementation to Local Professionals in Côte d’Ivoire

For nearly a decade I-TECH has worked in Côte d’Ivoire in collaboration with the US Centers for Disease Control and Prevention to develop and implement an electronic laboratory information system (LIS) in key laboratories. In order to respond to evolving data needs and ensure timely access to quality laboratory data, an electronic LIS requires ongoing development and continuous user training and technical support.

Previously, from 2015-2017 I-TECH worked closely with the Ivorian Ministry of Health and Public Hygiene (MSHP)’s Directorate of Informatics and Sanitary Information (DIIS) to identify, develop and reinforce the capacity of local professionals to lead and conduct LIS training, deployment, and maintenance activities in anticipation of national roll-out of the LIS at 96 general hospital laboratories. As part of this effort, and in collaboration with the DIIS, I-TECH trained users and deployed LIS at 13 national and regional level laboratories. Between 2013 and 2015, the total number of local professionals competent in LIS deployment increased to 24 local LIS support providers, while the number of in-country LIS trainers increased to 27. Within ten months, local IT providers and trainers trained over 75 health care workers to use an LIS and implemented an LIS at 36 laboratories. During supervision visits to 26 laboratories, within 4 to 6 months post-installation, 25 out of 26 (96%) of laboratories were actively using the LIS.

More recently, Côte d’Ivoire International Training and Education for Health (I-TECH CIV), I-TECH’s local partner in Côte d’Ivoire, has started working directly with CDC and DIIS and continued to engage I-TECH computer developers and deployment strategists to continue the progress with LIS.

I-TECH continues to make considerable progress with code base development for OpenELIS. For more information, visit the OpenELIS Global website.

I-TECH Attends IAS 24th International AIDS Conference

Members of the I-TECH Partner Network attend the IAS AIDS Conference in Montreal, Canada 29 July through 2 August 2022. L-R: Abhina Aher (I-TECH India), Fernanda Freistadt (I-TECH), Pamela Collins (I-TECH), Blessing Mushwange (Zim-TTECH), Precious Moyo (PZAT), Yao He (I-TECH). Photo Credit: I-TECH

The International AIDS Society (IAS) hosted the 24th International AIDS Conference on 29 July – 2 August 2022 in Montreal, Canada, and virtually. The theme this year was “re-engage and follow the science” to highlight that the HIV and AIDS epidemics are not over and still require significant global support. The conference brings together HIV researchers and experts for presentations and discussions on a wide-range of HIV- and AIDS-related topics.

This year, the International Training and Education Center for Health (I-TECH) and its partner network organizations participated in a number of activities at the IAS International AIDS Conference. Pamela Collins, MD, MPH, I-TECH Executive Director, participated in a pre-conference meeting panel on HIV and non-communicable disease integration hosted by the NCD Alliance. Dr. Collins’ discussion focused on the social stigma related to HIV and mental health conditions, specifically the impact stigma has on care and the role that integration has in addressing stigma.

In addition to the panel, I-TECH representatives also presented posters from programs in Côte d’Ivoire, Tanzania, and Ukraine:

Additionally, representatives from I-TECH’s partner network organizations and the Centers for Disease Control and Prevention (CDC) presented findings from I-TECH-supported programs in India, Malawi, and Zimbabwe:

I-TECH in Côte d’Ivoire Hosts National HIV QI Conference

On 18-19 May 2022, the International Training and Education Center for Health (I-TECH), in collaboration with the Programme National de Lutte Contre le Sida (PNLS; National AIDS Control Program) under the coordination of the General Directorate of Health, hosted its first national HIV prevention, care, and treatment quality improvement (QI) conference in Abidjan, Côte d’Ivoire. The conference brought together over 100 representatives from the Centers for Disease Control and Prevention, United States Agency for International Development, the Human Resources and Services Administration (HRSA), US President’s Emergency Plan for AIDS Relief (PEPFAR), and PEPFAR implementing partners from around the country to agree on a national approach to QI; update the national strategic plan for improving Quality, Health, and Safety; and learn about the unique QI approach being implemented by I-TECH through the Quality Improvement Solutions for Sustained Epidemic Control (QISSEC) program.

Dr. Nathalie Krou Danho
I-TECH QISSEC Project Director, Dr. Nathalie Krou Danho, describes the QISSEC approach at the National HIV QI Conference. Photo Credit: I-TECH

“This is an historic workshop. [There have been] many conversations and meetings with the PNLS/Ministry of Health and USG agencies [over the years] to gather all the stakeholders to harmonize QI interventions,” says Dr. Jean T. N’Guessan, QISSEC QI Consultant. “This national QI workshop was a success because the leadership was carried by the PNLS, the national Program to fight AIDS, and supported by I-TECH.”

The goal of the conference was to elevate QI practices on a national level and work with stakeholders to adopt and integrate the QISSEC QI approach into their own HIV prevention, care, and treatment programs to improve HIV services while identifying and addressing gaps in care (e.g., viral load monitoring, antiretroviral therapy uptake).

“In Côte d’Ivoire, all hospitals—both public and private—are required to implement continuous quality improvement for all care and services, which can lead to a one-size-fits-all approach to QI,” explains Dr. Nathalie Krou Danho, I-TECH QISSEC Project Director. “This workshop made it possible for us to identify gaps in national standards for the prevention, care, support, and treatment of HIV infection, while also providing an effective QI framework that helps clarify the roles and responsibilities of the stakeholders implementing QI initiatives across the country.”

QI interventions are often applied unilaterally across all sites regardless of analysis of the sites’ specific needs, but I-TECH’s approach tailors each QI intervention and related activities to the needs of the site according to self-identified gaps by the sites. This approach allows sites to be involved in each step of the process, reinforces skills and knowledge, and ultimately creates a sustainable approach to QI. By using the QISSEC approach, HIV programs around Côte d’Ivoire will be able to align their QI work and substantially improve HIV services, while also fulfilling PEPFAR priorities and targets.

“Since I-TECH’s approach works in collaboration with all levels (national, district, and site) of the health system pyramid, we are able to coach sites to develop a QI plan based on the identified gaps, implement it, as well as monitor and evaluate it,” says Dr. Nathalie Krou Danho. “Through data analysis of MER indicators and SIMS data, the approach takes into account the organizational improvement of the quality and the services offered to the patients.”

The QISSEC project, a five-year cooperative agreement with HRSA under PEPFAR, works with local partners to implement customized site-level QI interventions using patient-centered approaches in clinics to ensure a facility-owned and locally led response to the persistent challenges seen in HIV prevention, care, and treatment programs (e.g., HIV testing, retention, suppression, PrEP, TB prevention) and support Côte d’Ivoire in reaching the UNAIDS 95-95-95 targets. The project has initially been focused on 60 priority sites throughout the country but plans to expand to Abidjan’s 75 high-impact sites next year, bringing the total number of sites to 101.

“The QISSEC project aims to strengthen ownership of continuous QI at all levels of the health system pyramid,” says Dr. Nathalie Krou Danho. “To do this, I-TECH collaborates with all national stakeholders, including PEPFAR implementing partners and civil society organizations who can help motivate beneficiaries to take part in QI efforts and extend its QI approach to the community.”

I-TECH’S WORK IN CÔTE D’IVOIRE IS SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) UNDER 1 U1NOA45176-01-00 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.

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 implements the Quality Improvement (QI) Solutions for Sustained 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 Program, 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. Focused on 80 priority sites throughout the country, QISSEC works 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.

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.

 

MetaECHO Conference Examines New Frontiers in TeleHealth

Liz Blanton, M&E advisor at I-TECH, presents her poster at MetaECHO.

On March 13-16, Liz Blanton, Monitoring and Evaluation Advisor at the International Training and Education Center for Health (I-TECH), joined more than a thousand clinicians, funders, academic leaders, government officials, and public health experts for the MetaECHO™ conference in Albuquerque, New Mexico. The University of New Mexico’s Project ECHO® model aims to bring specialized health care and expertise to rural and underserved communities in the U.S. and worldwide.

Blanton presented a poster titled “An Evaluation of Pilot Project ECHO in the Republic of South Sudan and Implications for Implementation in Fragile States.” The evaluation, still in its early stages, will assess the feasibility and acceptability of the model, which is implemented by Columbia University’s ICAP and is the first of its kind in a fragile state.

It will also gauge the impact of the ECHO model – based on telementoring and case presentation from a panel of experts – on providers’ sense of self-efficacy and professional satisfaction, as well as assess outcomes at the facility and systems levels.

“It’s the outcomes piece that really interested people,” said Blanton, pointing out that most of the outcomes studies to date have been fairly small. “It’s something a lot of people at the conference were talking about: how effective is Project ECHO at improving health outcomes?”

In light of this year’s theme of “Infinite Possibilities,” there were also deep discussions about the evolution of the model and how it might be adapted to improve communication between providers and patients, not just among providers. “There were several ‘ECHO Talks’ – TED-style talks – that were really moving,” said Blanton. “Some of the best were by patient advocates,” who highlighted the need for patient-centered care.

A fireside chat with keynote speaker Dr. Don Berwick, President Emeritus and Senior Fellow at the Institute of Healthcare Improvement, underscored the question: how can ECHO teams best deliver what patients need?

Today, Project ECHO operates more than 220 hubs for more than 100 diseases and conditions in 31 countries. The MetaECHO community encompasses all those dedicated to reaching the collective goal of touching 1 billion lives by 2025.

Project ECHO at I-TECH

Several programs at I-TECH utilize the Project ECHO model as a mentoring tool and force multiplier:

  • The first I-TECH-supported ECHO program in the Caribbean was established in January 2018, with the hub site in Jamaica. In that initial year, 41 ECHO sessions were provided, with participation by nearly 300 health care workers. Topics centered on viral load suppression and also included a series on TB prevention, diagnosis, and treatment in people with HIV; tenofovir toxicity; and HIV and lymphoma. During an I-TECH assessment, it was found that the majority of complicated cases presented during ECHO sessions in the Caribbean involved patients with mental health and substance use disorders that negatively impact their ability to adhere to medication and care. Plans are under way to include a psychiatrist/mental health specialist on the ECHO expert panel, and one Wednesday per month will be focused on HIV/mental health co-morbidities. The Jamaica Ministry of Health has also requested that I-TECH include an additional 20 HIV care and treatment sites, as well as a small group of private practitioners, in the current HIV ECHO program community of practice. In service of this request, I-TECH will support the development of a second ECHO program based in Trinidad, which will be launched this month.
  • I-TECH is implementing ECHO to build the capacity of laboratory staff and improve the quality of lab services in Côte d’Ivoire. Sessions include up to 17 laboratories and nearly 30 participants apiece; topics have included management of non-conformities in laboratories. laboratory equipment preventive maintenance, best practices in HIV serology, and external quality assurance.
  • In Malawi, I-TECH supports Project ECHO in partnership with the U.S. Centers for Disease Control and Prevention (CDC), the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), and Lighthouse Trust. The program has more than 40 participants from five different sites, and case presentation topics have ranged from tuberculosis to HIV encephalitis to Kaposi’s sarcoma. Benefits of the program include not only increased engagement of providers to discuss difficult cases, but also an improved referral system between clinics.
  • ECHO is installed and supported by I-TECH at 41 sites in Namibia, and monthly participation reaches up to 400 subject matter experts and staff. Dozens of topics were discussed during the pilot period (November 2015 to September 2016) alone – the most widely attended were on HIV disclosure to children, PMTCT Option B+, and presentation of tuberculosis. In an evaluation of the Namibia pilot, nearly 80% of participants cited that access to the expertise of HIV specialists and inter-disciplinary consultation was a major area of need for them and their clinics. Ninety-three percent of the participants reported that the presentations during the pilot ECHO sessions provided them with useful, up-to-date knowledge.

 

I-TECH Presents Laboratory Systems Strengthening Data at ASLM 2018

Representatives from the International Training and Education Center for Health (I-TECH) attended the fourth international African Society for Laboratory Medicine (ASLM) conference in Abuja, Nigeria, on 10-13 December 2018.

The theme this year focused on the role of laboratories in preventing and controlling the next pandemic. I-TECH had seven abstracts accepted at the conference that highlighted the laboratory systems strengthening work done by I-TECH in Cambodia, Côte d’Ivoire, and Zambia. The full abstracts presented by I-TECH can be found in the ASLM 2018 Conference Abstracts Conference Book.

Below is a summary of I-TECH presentations:

I-TECH Laboratory Systems Strengthening Team at ASLM 2018.
I-TECH Laboratory Systems Strengthening Team at ASLM 2018. Pictured (L to R): Sitting – Lucy Perrone, Felicity Golopang, Larissa Koffi; Standing – Sylvestre Kone, Nayah Ndefru, Siew Kim Ong.

Oral Abstracts

  • Siew Kim Ong, I-TECH Cambodia Project Coordinator, was lead author and presenter for the “Improved Laboratory Compliance to Quality Standards in Cambodian Laboratories through On-site Trainings.” This abstract reviewed the effect of training in 12 I-TECH-mentored laboratories in Cambodia on laboratory processes (Page 27).

Poster Sessions

  • Nayah Ndefru, I-TECH Seattle Laboratory Strengthening Specialist, presented an abstract titled, “Effectiveness of Using a Mixed Approach of On-site Mentoring and Tele-mentoring for Improving Laboratory Quality Management Systems: Lessons From Cambodia.” The presentation looked at the lessons learned in the implementation of a Quality Management System (QMS) in 12 national hospital laboratories throughout Cambodia and the 2018 pilot approach to addressing the QMS gaps identified in an earlier baseline survey (Page 55).
  • Larissa Koffi, I-TECH Côte d’Ivoire RTCQI Specialist, presented two posters: One titled, “Analysis of EQA HIV Serology Data in Côte d’Ivoire Reveals Gaps in Quality Testing.” The second poster was “Analysis of HIV Point of Care Testing Sites in Côte d’Ivoire Reveals Gaps in Tester Competence.” The posters displayed the results of a retrospective study that can inform strategies and interventions for improved quality at HIV testing sites (Page 200).
  • Sylvestre Kone, I-TECH Côte d’Ivoire Laboratory Quality Specialist, presented a poster titled “Improving Quality and Capacity of the Laboratory System in Côte d’Ivoire.” The poster detailed the work the team is doing to train and mentor laboratory staff in hospital laboratories towards achieving international quality standards (Page 242).
  • Felicity Gopolang, I-TECH Laboratory Mentor Consultant, presented a poster titled, “Implementation of a Professional Development Program in Laboratory Leadership and Quality Management in Zambia from 2016-2018.” The poster outlined the impact of the Program on quality improvement (Page 206).
  • Pat Sadate-Ngatchou, I-TECH Seattle Senior Laboratory Advisor, was lead author on the poster titled “Improvement of Quality Practices within HIV Point-of-Care testing (POCT) Sites in Côte d’Ivoire Through Implementation of the Rapid Test Continuous Quality Improvement (RTCQI),” which explored the impact of the implementation of RTCQI in POCT site audits (Page 246).

About ASLM
The mission of ASLM is to improve clinical and public health outcomes in Africa by enhancing professional laboratory practice, science and networks. Based on five strategic pillars, ASLM serves the community of laboratory professionals and promotes the value of strong medical laboratories to key stakeholders such as the Ministries of Health, research laboratories, and universities. ASLM is an independent, non-profit organization endorsed by the African Union and headquartered in Addis Ababa, Ethiopia.

http://www.aslm.org/

Certificate Program in Laboratory Leadership and Management

The I-TECH Certificate Program in Laboratory Leadership and Management (CPLLM) was a nine-month course that trained laboratory staff in supervisory positions leadership and management skills to make substantive and impactful improvements in laboratory testing quality and operations. The program was developed in 2013 and first piloted in 2014.

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