I-TECH provides assistance to MISAU in implementation of the national Quality Improvement for HIV Services (QIHS) Strategy, with the goal of improving HIV clinical care through the training of clinicians in QI cycles (Plan-Do-Study-Act) and mentoring to improve weak performance indicators. To expand the impact of its programming, ART Committees and distance learning have been used to reach health workers in more rural settings.
Category: Countries
Site-level Data Improvement and Use in Namibia
I-TECH continues to focus efforts on the improvement of data quality and use of data to improve clinical decision making. I-TECH works at the site level to build awareness and buy-in for data quality and use among site-level management and health care workers.
On-site I-TECH Monitoring and Evaluation (M&E) Officers and Program Assistants monitor completeness and accuracy of service delivery documentation from the point of patient encounter to the point of final data capture in Ministry of Health and Social Services electronic databases. M&E Officers promote the use of data by clinicians and facility management for systems improvement and performance enhancement.
Cervical Cancer Screening and Treatment in Namibia
I-TECH supported the Ministry of Health and Social Services in 2017 and 2018 in the development and dissemination of the national Cervical Cancer Prevention Guidelines including algorithms for screening, referral, and post cryotherapy instrument disinfection, and monitoring and evaluation tools. Continue reading “Cervical Cancer Screening and Treatment in Namibia”
Training through Distance Learning in Namibia using the Project ECHO Model
I-TECH in Namibia spearheaded use of distance learning for HIV care and treatment through the establishment of a digital video conferencing network to link Windhoek with training sites and hospitals throughout the country starting in 2008. Building off that foundation, Namibia became the first country in Africa to implement the Project ECHO model, a tele-health platform started at the University of New Mexico, whereby clinicians in remote areas connect with rotating subject matter experts and clinicians a robust virtual community of practice to build health care worker capacity, support peer-to-peer cross-facility learning and reduce feelings of professional isolation.
Continue reading “Training through Distance Learning in Namibia using the Project ECHO Model”
Strengthening National Health Systems through Task Shifting and Training in Namibia
Working with the Ministry of Health and Social Services (MoHSS) to roll out treatment in the country, I-TECH supported the training of physicians to provide antiretroviral therapy (ART) soon after the first national ART guidelines were published in 2003. I-TECH subsequently began supporting the training of nurses in both ART (2006) and Integrated Management of Adolescent and Adult Illness (IMAI, 2007) to increase health system capacity to expand delivery of ART services.
In 2010, I-TECH implemented a task shifting demonstration project to determine whether nurse-initiated management of antiretroviral treatment (NIMART) is a feasible alternative to doctor-led models. I-TECH subsequently supported an evaluation of this project which confirmed its feasibility for use in certain countries. In Namibia, NIMART was adopted by the MoHSS for use nationwide in 2013. I-TECH continues to hold NIMART trainings: five were held in 2016, with 125 health care workers trained.
VMMC for HIV Prevention in Namibia
I-TECH assists the Ministry of Health and Social Services with the expansion and provision of voluntary medical male circumcision (VMMC) as an HIV prevention option. This support started in 2008 with the development of national guidelines and training materials, followed by national trainings of health care workers. In 2015, this support expanded to include direct service delivery in the Oshana and Zambezi regions, as well as Karas region from 2017 onward. Since 2016, I-TECH has also supported demand creation with a network of community-based mobilizers and recruiters using a human-centered design approach to actively engage communities and stakeholders to increase the number of men voluntarily electing medical circumcision. The program has performed over 36,000 VMMCs in Namibia.
I-TECH has trained physicians, nurses, and community counselors to ensure that adequate skills and experience are in place to deliver safe, high-quality male circumcision services.
Support for Pediatric HIV Care and Treatment in Namibia
I-TECH works to strengthen the quality of pediatric HIV care and treatment in Namibia through the development of a “model” pediatric HIV clinic and supporting decentralization of quality pediatric care to other facilities. In collaboration with the Ministry of Health and Social Services, I-TECH developed an innovative, structured, culturally-relevant intervention to help guide health care workers and caregivers of HIV-positive children through the process of disclosing a child’s HIV-positive status to the child.
An evaluation of the disclosure program showed that it increased health care worker and caregiver confidence and communication in pediatric disclosure, as well as demonstrating improved viral suppression, adherence, and HIV knowledge among pediatric patients. I-TECH clinicians have also worked at the site level to support the development, implementation, and monitoring of strategies to improve adolescent HIV services and transition of adolescents from pediatric to adult care.
Evaluating Laboratory Systems to Move toward Accreditation in Côte d’Ivoire
In 2017, in collaboration with the Côte d’Ivoire Ministry of Health and Public Hygiene (MSHP), the National Public Health Reference Laboratory (LNSP), and a local accreditation organization, the Regional Center for Health Evaluation and Accreditation (CRESAC), I-TECH conducted a baseline assessment of laboratory services at 50 laboratories across Côte d’Ivoire.
The purpose of the joint assessment was to determine the laboratory’s capacity to provide HIV and clinical diagnostic services. More specifically, I-TECH aimed to determine the number of laboratorians and HIV counseling and testing staff trained and certified in HIV testing; the quality and timeliness of HIV and clinical diagnostic tests; and the status of each laboratory in order to prepare them for laboratory accreditation under the SLIPTA (WHO’s Stepwise Laboratory Improvement Process Towards Accreditation) scheme.
Strengthening Laboratory Policy in Côte d’Ivoire
In 2017, Côte d’Ivoire’s National Public Health Reference Laboratory (LNSP) and I-TECH convened a series of strategic planning meetings with the objective of reviewing and updating the vision, mission, and objectives of the previous National Laboratory Strategic Plan. These meetings and collaboration with various partners resulted in a revised plan, the 2017-2022 National Laboratory Strategic Plan.
The five-year strategic plan was agreed upon by representatives from key ministry structures, donors, and other stakeholders with influence on the laboratory system. Their joint actions resulted in a common mission: “To provide a biological diagnosis of quality to the populations living in Côte d’Ivoire by using reliable tests, carried out according to national and international guidelines, in compliance with quality assurance procedures, biosafety procedures, biosecurity and bioethics.”
Strengthening the HIV Care Continuum and ART Adherence in Namibia
In accordance with the HIV Care Continuum, I-TECH supports direct HIV care and treatment service delivery as well as on-site clinical mentoring and technical assistance in 81 facilities in five regions of Namibia. I-TECH supports key evidence-based strategies such as provider-initiated HIV counseling and testing, eMTCT, and decentralization of ART services to the clinic.
In collaboration with the MoHSS, I-TECH is implementing “Treatment for All” guidelines (December 2016), an HIV care and treatment approach that initiates patients on lifelong antiretroviral therapy as soon as they test HIV-positive. I-TECH has developed an interactive education and counseling intervention, ARVs and Healthy Me, for health care workers to support HIV-positive patients in attaining good adherence and engagement in care.
To improve the quality of data for use in clinical decision-making, I-TECH actively participates in national technical working groups and advisory committees, and conducts rigorous monitoring and evaluation (M&E) to build awareness and buy-in for data quality and date use among site-level managers and health care workers.