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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”

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.

 

I-TECH Awarded Funding For COVID-19 Response and Activities

Illustration of SARS-CoV-2, the virus that causes COVID-19. Image credit: CDC

Many of the International Training and Education Center for Health (I-TECH) country offices have received supplemental funding from the U.S. Centers for Disease Control and Prevention (CDC) or pivoted portions of current CDC funding to implement and support activities related to the global COVID-19 response, such as contact tracing efforts, provider education, vaccine preparedness, and infection prevention and control (IPC).

To date, I-TECH has received over $500,000 of new funding for IPC of COVID-19 in Kenya and Malawi, while several other offices have submitted proposals for additional funding.

CDC has also redirected $83,000 of I-TECH Tanzania’s funding to support training on COVID-19 case investigation and contact tracing teams specifically for field epidemiology and training program graduates and community health care workers.

“The funding and support that we have received from CDC will allow us to apply our decades of implementation knowledge and expertise from combating the HIV epidemic to the current global COVID-19 response,” says Ivonne Butler, MPH, Associate Center Director for I-TECH. “We look forward to working with other implementing partners and local ministries of health to provide comprehensive training, technical assistance, and learn from one another to effectively respond to this evolving pandemic.”

In addition to new funding and funding shifts, I-TECH has been invited by local governments and ministries of health to collaborate in their COVID-19 responses. So far, I-TECH has aided in the creation of standard operating procedures, contributed to public pandemic preparedness materials, and supported hospitals with COVID-19 IPC. Leveraging existing processes and programs — such as warm lines and distance learning platforms — has allowed I-TECH to rapidly respond to the emerging needs of health care workers and providers.

The newly established independent local Zimbabwe office, Zim-TTECH (Zimbabwe Technical Assistance, Training, and Education Center for Health), also received $579,000 for vaccine preparedness and disease prevention for the rapid scale-up and implementation of a SARS-CoV-2 vaccine (when available) as well as IPC triaging at 250 sites throughout the country.

Ensuring Continuity of HIV Care

I-TECH’s programs are now faced with the difficult task of ensuring the continuity of HIV care and treatment for people living with HIV (PLHIV) during the pandemic. Due to the COVID-19 pandemic, some countries are facing disruptions in antiretroviral therapy (ART) medication supply, an inability for PLHIV to pick up ART medication at pharmacies or hospitals, and a diverted focus from HIV testing due to lack of personal protective equipment and safety concerns.

“Our programs are committed to continuing to provide quality HIV care and treatment while maintaining a safe environment for those for staff and patients,” says Butler. “Our teams and programs have had to adapt and bring innovative delivery of uninterrupted HIV care and treatment services to people living with HIV. They have done an outstanding job in their rapid responses during this unprecedented time.”

Some examples of the innovative way teams are delivering HIV care during the COVID-19 pandemic is through text messaging as a way to reach PLHIV, coordinating community ART refill groups, educating and training providers via distance learning platforms, and using warm lines and WhatsApp to support providers.

Jan Flowers

Jan Flowers is a Clinical Faculty member and Research Scientist in the University of Washington School of Nursing, and is faculty co-lead of the Digital Initiatives Group at I-TECH (DIGI). Her area of focus is on innovative strategies and technologies for healthcare systems strengthening in resource constrained settings through appropriate electronic collection and use of quality health data for evidence-based decision making.

She has led informatics organizations and teams for over 20 years, focused on technology policy and law, health information systems evaluation and maturity modeling, open source communities of practice building, health technology engineering and implementation, patient centered technologies and mHealth, and standards-based interoperability for improved care at the point of service, surveillance, and program monitoring.

Ms. Flowers serves on the board of directors for both OpenMRS and OpenELIS Foundations, and the founder of the OpenHIE LIS Community of Practice, which develops and shares common standards and best practices amongst the open-source LIS community. She holds an MS in Health Law & Policy from the University of California San Francisco jointly with UC Hastings Law School, and a BS in Psychology from the University of Washington.

Program Highlights

Creating a Data Warehouse to Support COVID-19 Surveillance in Mauritius
The Digital Initiatives Group at I-TECH (DIGI) worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to implement a national laboratory information system (LIMS) using OpenELIS and expanded it to create a national-level data warehouse. The data warehouse captures all the information that has been input into OpenELIS ...
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Digitizing HIV Case Management to Support Patient-Centered Care in Jamaica
In collaboration with the Caribbean Training and Education Center for Health (C-TECH), Jamaica Ministry of Health and Wellness, JASL, and technical working group members, the Digital Initiatives Group at I-TECH (DIGI) is supporting the development and implementation of a mobile health client engagement tool in Jamaica.  The tool facilitates communication ...
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Implementing a National Laboratory Information System in Mauritius
Since 2020, the Digital Initiative Group at I-TECH (DIGI)  has worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to deploy a national laboratory information management system (LIMS) using the OpenELIS platform. The LIMS connects the national reference laboratory to regional laboratories and flu clinics around the country ...
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Optimizing the COVID-19 Testing Process at the Airport in Mauritius
As a measure to help stop the spread of COVID-19, the Government of Mauritius began requiring that all arriving passengers submit to COVID-19 health screenings upon arrival in Mauritius. To rapidly process the influx of tests and quickly notify passengers of their results, the Digital Initiatives Group at I-TECH (DIGI) ...
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I-TECH’s Samantha Dolan Wins Gates Foundation Grand Challenges Explorations Award

Samantha Dolan, a Monitoring and Evaluation Advisor with the Kenya team at the International Training and Education Center for Health (I-TECH), has received the Bill & Melinda Gates Foundation Grand Challenges Explorations award. Along with I-TECH Kenya’s Ian Njeru and I-TECH PI Peter Rabinowitz, professor in the Department of Global Health, Dolan has been awarded $100,000 to conduct a project over the next 18 months to improve digital data collection and monitoring of childhood immunizations at Kenyan health facilities.

Read more about Dolan and her project on the UW Department of Global Health website–and congratulations from the I-TECH family!

Aaron Katz

Aaron Katz is a principal lecturer emeritus of Health Services, Global Health (adjunct), and Law (adjunct) at the University of Washington School of Public Health where he teaches several graduate level courses in health policy. He also has an adjunct appointment at the University of Queensland (Australia) School of Public Health. Aaron has held numerous academic leadership positions, including his current role as faculty coordinator of the Health Systems and Policy Concentration of the Health Services Master of Public Health (MPH) program and was founding director of the Leadership, Policy, and Management track of the Global Health MPH program. He was director of the UW Health Policy Analysis Program from 1988 until 2003 and editor-in-chief of the School’s biannual journal, Northwest Public Health, from 1999 to 2008.

Aaron received the American Public Health Association’s Award for Excellence in November 2006 and the Outstanding Teaching Award from the UW School of Public Health in 2004. At the 2011 “State of Reform” Washington Health Policy Conference, Aaron received the Health Reform Leadership Award.

Aaron has developed a deep understanding of the U.S. health care system and its strengths and weaknesses during a career that has spanned 40 years and four “bouts” with health care reform. He has worked in health policy and planning in Washington state since 1978, serving as a health planner, policy and planning consultant, lobbyist, and political adviser. Aaron has directed numerous policy analysis and policy development projects for legislative bodies, state and local public agencies, and private sector clients, including work on health system reform, public health reform, managed care, rural access, HIV/AIDS, workers compensation, long term care, medical economics, and services for people with low incomes. Since 1999, Aaron has collaborated on policy development and advocacy projects with colleagues in various countries in southern Asia, sub-Saharan Africa, Latin America, and Japan.

Aaron has served as a peer reviewer of articles for the International Journal for Equity in Health, Health Affairs, Journal of Health Care for the Poor and Underserved, Global Health Action, and the American Journal of Public Health. He has served on numerous community boards, including the Washington State Budget and Policy Center, Northwest Health Law Advocates, Washington Physicians for Social Responsibility, and Health Alliance International.

Aaron received a bachelor of science degree from the University of Wisconsin – Madison in 1974 and a certificate [master] of public health degree from the University of Toronto in 1975.

Leadership and Management in Health Online Course Reaches Thousands Worldwide

Treats served at an end-of-course celebration in Kenya, 2016

Training on leadership and management is a critical component of the University of Washington (UW) International Training and Education Center for Health’s (I-TECH’s) health systems strengthening efforts. To that end, I-TECH has worked closely with the UW Department of Global Health E-Learning Program (eDGH) since 2012 to offer a heavily subscribed online course on leadership and management to health care workers in low- and middle-income countries.

Designed and taught by I-TECH Executive Director and UW Professor of Global Health Ann Downer, Leadership and Management in Health (LMIH) is a 12-week course focusing on the practical leadership and management skills required for working in complex global health environments. Weekly modules include content on team building, accountability, supervision and delegation, conflict management, financial management, use of data for decision-making, and effective communication.

“I want to express my gratitude for giving me the opportunity to do the UW course on Leadership Management in Health. …I find myself going back to these documents again and again to understand and imbibe what is given. I feel that the simple narrative of the course material has made all the difference.”

–2016 course participant from India

Participants from Tunisia, 2015

The course consists of recorded lectures, required readings, a weekly online discussion forum, quizzes, self-reflection assignments, and a final verbal presentation. It is targeted to practicing health care professionals and public health specialists who already have some experience managing people. In most cases, LMIH participants gather in weekly site-specific, in-person discussion groups led by a volunteer facilitator to discuss the material and apply it to their particular linguistic, cultural, social, and political environment.

“We just finished our site discussion this afternoon and the level of contribution and application to our various office settings was wonderful. …I have told my Chief Executive … about the course and he is thinking of asking all Management Staff to do it compulsorily in the next episode.”

–2017 course site facilitator

Due to high enrollment, the course is now offered twice a year, with a completion averaging 84%. Approximately 4,500 individuals are enrolled in the latest offering of the course, representing a nine-fold increase in five years. More than 10,000 health workers in 65 countries have graduated from LMIH since 2012.

Participants from Myanmar, 2017

According to a survey conducted by eDGH, more than half of graduates from the spring 2016 cohort now mentor colleagues on leadership and management-related job tasks. In addition, 67% said they were given new responsibilities or projects as a result of course completion, and 74% reported that they had maintained contact with other students from their sites.

“We consistently hear that how empowering the course is,” said Anya Nartker, E-Learning Project Manager with eDGH. “The course uses a blended model, where participants are required to meet with their local site each week to apply what they are learning in the course, and share problems that they support each other in solving.”

 

I like the idea of all students teaming together and working together despite their backgrounds and level of education. There were many who were highly educated and some who were moderately [educated], and we all understood and accommodated each other.

–2016 course participant from Kenya

Course graduates have requested a deeper exploration of certain topics introduced in LMIH. As a result, a certificate series of three online courses is being developed that will include LMIH; a new course titled Global Project Management; and a third online course, Fundamentals of Implementation Science.

The Global Project Management online course will be offered as a stand-alone course from July-September 2018, co-taught by Dr. Downer; I-TECH Deputy Director, Chichi Butler; and I-TECH Senior Program Manager, Harnik Gulati. The certificate will be offered in 2018.

BID Initiative Partners with I-TECH to Track Vaccinations with Better Data

The following post was written in partnership with PATH‘s Better Immunization Data (BID) Initiative.

Patients at Usa River Health Center Tanzania. Photo courtesy of the BID Initiative.

The digital health landscape is rife with disconnected systems that make it challenging to aggregate information and improve the health of populations. After years of disjointed experiences, multiple organizations and governments have found that multi-platform, standardized, and connected information systems are critical to allow health care providers and decision makers access to timely and accurate information.

In this spirit, the International Training and Education Center for Health (I-TECH) joined forces with PATH’s BID Initiative to prevent disease by developing a platform to better trace vaccinations in low-resource settings. As part of its Global Health Security award, I-TECH is localizing the BID Initiative’s Zambia Electronic Immunisation Registry (ZEIR), an app powered by OpenSRP which is an open source mobile health platform, for use in Siaya County, Kenya.

I-TECH reached out to the BID Initiative last summer to hear more about BID’s lessons learned. The two teams began collaborating in earnest last December, leveraging the BID Initiative’s large scope in Zambia and Tanzania with I-TECH’s expertise in working with the OpenMRS platform.

Parallel projects with common goals

Reuben Mwanza (right) of PATH enters vaccination data into a tablet computer during a vaccination service at the Mahatma Gandhi Clinic in Livingstone, Zambia on October 17, 2016. Photo courtesy of the BID Initiative.

In Kenya, I-TECH has been tasked with building an electronic platform to capture immunizations when they happen. The aim of the project—conducted in partnership with the Kenyan Ministry of Health, the CDC Global Health Protection Division, and the CDC Global Immunization Division—is to improve immunization coverage. This is done by tracking and monitoring who is due for which vaccine, starting with population-level coverage within a single county, thus decreasing the chance of outbreaks of vaccine-preventable diseases.

Similarly, the BID Initiative has been working with the Ministry of Health and nurses in Tanzania and Zambia to develop an electronic immunization registry, among other data use tools, to ensure data becomes more accessible and useful to health workers. This, in turn, can help with decision making to prevent vaccine stockouts and enable follow-up with patients who have not returned for needed vaccines. BID’s learnings provided an opportune starting point for I-TECH’s work.

“ZEIR provides all of the workflows we need,” says Craig Appl, I-TECH Senior Technical Advisor for Health Informatics. “It already considers how users will interact with the application. It collects immunization data in a user-friendly manner, allowing health care workers to more accurately administer and record childhood immunizations and to more easily follow-up with children defaulting on their immunization schedule.”

Improvements through open source collaboration

I-TECH and BID have turned to Ona, a social enterprise based in Nairobi, Kenya, committed to fostering change by building information systems infrastructure. BID began working with Ona in January 2017 to adapt the OpenSRP system to Zambia’s national immunization program. This open source development process has been critical to the success of both teams and represents the collective knowledge of a community of developers known as the THRIVE Consortium.

“We simply couldn’t do this if OpenSRP and ZEIR software development was closed source,” says Appl. “The documentation, source code, and community wiki are all open for collaboration. Our team is able to actively track the improvements across the community, receive value where others have built features, and contribute where our projects align. Through open collaboration, we have many more individuals and teams working to improve health outcomes where we work.”

Laurie Werner, BID’s Global Director, agrees, pointing out that each new tool and iteration of the app is more adaptable and affordable than the last. “I-TECH is able to see solutions and propose solutions,” says Werner, “that’s the beauty of open source software.”

Matt Berg, CEO of Ona, views the OpenSRP app created for both projects as a customizable springboard that could potentially accommodate additional modules for antenatal care, malaria data, and maternal and child health.

“From our prior work with BID, we had this great starting point that another country or group could take and adapt and get up and running quickly,” says Berg.

Adaptability equals cost efficiency

Cost is a major driver for any implementation. Until now, it has been more cost efficient to build specific functionality on top of popular generalized information systems and tools, which decreases adaptability. Initial investments in the BID and I-TECH projects have allowed for both flexibility and specificity.

“We tend to focus too much [in the digital health field] on localization, and not on great design,” says Berg. “I think our success in Zambia and Kenya validates the importance of good design…and shows the potential of replicating in places for a fraction of what was originally invested.”

This collaborative environment and focus on adaptable design increases cost efficiency and allows the BID Initiative to fulfill the intention for its solutions to be used in multiple contexts.

“This is the core of the BID Initiative’s theory,” says Werner. “Effective electronic immunization registries have to be adapted to a country’s context and specific needs. Each time you do that, it becomes less and less of a financial investment for future countries.”

This blog post was supported by the Cooperative Agreement Number, U2GH001721, funded by the U.S. Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

Kenya Partnerships

I-TECH Kenya has collaborated with the Centers for Disease Control and Prevention (CDC)United States Agency for International Development (USAID)Family AIDS Care and Education Services (FACES), a collaboration between the Kenya Medical Research Institute (KEMRI); and the University of California, San Francisco (UCSF)the Ministry of Health; the National AIDS/STD Control Programme (NASCOP) and its Division of Health Informatics, Monitoring and Evaluation; and the Regional AIDS Training Network (RATN); National Public Health Laboratory Services (NPHLS); Palladium; PATH; Better Immunization Data Initiative Learning Network.

Global Health Security Agenda in Kenya

I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding to disease threats to health security.

For the past 8 years, I-TECH Kenya has had a cooperative agreement with US Centers for Disease Control and Prevention (CDC) to work closely with the Kenya Ministry of Health (MOH) on multiple projects related to health security. The key objectives of these activities are preventing and reducing the likelihood of disease outbreaks, improving the efficiency and accuracy of the detection of communicable diseases, strengthening surveillance capacity and national and county levels for a rapid and effective response, enhancing Infection Prevention and Control (IPC) practices to prevent the emergence and spread of pathogens and antimicrobial resistant bacteria.

Prevention

Use IPC practices to combat antimicrobial resistance (AMR) and other microbial threats:

  • Building capacity for IPC in health care facilities is a critical part of disease outbreak and AMR preparedness and prevention. In Kenya, I-TECH has partners with the CDC National Center for Emerging and Zoonotic Infectious Disease and Kenya MOH to support two model hospitals in developing capacity for quality improvement measures for strengthening evidence-based IPC practices, infrastructure, and tools including hand hygiene, waste management, injection safety, surgical site infections, and antimicrobial stewardship. As part of this IPC work, I-TECH created and piloted e-learning modules for IPC. The modules aim to build clinical skills and technical knowledge in infection prevention and control and antimicrobial stewardship among health care workers in low-resource settings, and have now been adopted by WHO.
  • With the onset of the COVID-19 pandemic, I-TECH Kenya was able to play a leadership role in the country in assessing and improving facility readiness at the national and local level to handle COVID-19 cases and maintain the health care workforce.
  • Current IPC activity is focused on surveillance for surgical site infections, an important cause of hospital acquired infections (HAIs).

Disease Prevention through Immunization Program Strengthening:

  • I-TECH collaborated with the Kenya MOH, CDC Global Health Protection Division, and the CDC Global Immunization Division, to build and roll out an online mobile platform for capturing immunization data at the point of care.

Detection

Laboratory Information Systems Strengthening:

  • In Kenya, I-TECH collaborated with the MOH and National Public Health Laboratory Services to enhance and strengthen laboratory information systems at the facility and national levels to improve timeliness and efficiency of testing and reporting results, specifically for AMR testing.

Response

Disease Surveillance and Response:

  • I-TECH supports the Kenya MOH Surveillance Unit in the rollout of trainings for health care workers to routinely and consistently use the real-time surveillance reporting system in Kenya.