Skip to content
I-TECH

Category: Countries

Scott Barnhart

Scott Barnhart, MD, MPH, has an extensive background as Professor of Global Health and former Director of Global Health Programs for I-TECH at the University of Washington. He has had responsibility for leading nine country offices, projects in 14 countries, and more than 500 staff. This experience and training has included extensive clinical work, research and program management in pulmonary and environmental and occupational medicine, and more than eight years as Medical Director of a safety net/Level 1 Trauma Center hospital.

Ensuring health systems can quickly detect and respond to emerging health threats is a critical challenge in both domestic and global health. Dr. Barnhart’s major implementation projects include scale-up of voluntary medical male circumcision (VMMC) in Zimbabwe and Malawi, OpenMRS, and laboratory information systems. Dr. Barnhart deploys his expertise in multiple African countries and Haiti to strengthen health systems and health care.

A goal of Dr. Barnhart’s work is to promote country-led, country owned sustainable development. Consistent with the principles of the Paris Declaration, the goal is to transition the bulk of development work and the associated leadership, ownership, technical direction and control of funding into the countries where development occurs. This approach ensures that the entire continuum of skills necessary for development (technical expertise, administration (human resources, operations, and management and accountability for funds) is transitioned to local partners. A key indicator is to have 75% or more of a grant’s funding expended in-country on local programs and local citizens and to support the local economies in these highly resourced constrained countries. Dr. Barnhart has worked closely to advance this model through projects in Haiti with a goal to shift the majority of a project to a local organization and in Zimbabwe where the VMMC program is largely run through local partners.

Program Highlights

No posts found.

 

Health Information Systems in Haiti

Post categories: DIGI Haiti Health Information Systems HIV Care and Treatment Human Resources for Health Laboratory Systems Nancy Puttkammer Scott Barnhart
Posted on

Electronic medical record (EMR) systems have the capacity to improve clinical decision making and quality of care at site level but can also be leveraged to make data-driven, population-level public health decisions. At the request of the MSPP Continue reading “Health Information Systems in Haiti”

Continuous Quality Improvement in Haiti

Post categories: Haiti Health Information Systems Nancy Puttkammer Quality Improvement Scott Barnhart
Posted on

In partnership with CDC, CHARESS helps the Haitian MSPP to implement the national care improvement program, HealthQual, by training providers on quality improvement concepts and using data from the EMR, iSanté, for clinical decision making and improved care. Continue reading “Continuous Quality Improvement in Haiti”

Clinical Mentoring in Haiti

Post categories: Clinical Mentoring Haiti HIV Care and Treatment Human Resources for Health Nursing/HCW Cadres Scott Barnhart
Posted on

I-TECH introduced its clinical mentoring program in Haiti in 2006. A team of physicians, nurses, and psychologists provide technical assistance to 20 sites in the MSPP care and services network to help strengthen HIV- and AIDS-related services. During site visits, CHARESS mentors conduct clinical rounds Continue reading “Clinical Mentoring in Haiti”

Haiti

In partnership with the Ministère de la Santé Publique et de la Population (MSPP) and the local nongovernmental organization (NGO) Centre Haïtien pour le Renforcement du Système de Santé (CHARESS),  I-TECH implements programs to improve HIV services via a trained health workforce and robust health information systems (HIS) in Haiti. In June 2018, I-TECH successfully transitioned the country office in Haiti to the fully independent NGO, CHARESS, after years of strategic planning. Since the conversion to CHARESS, all of I-TECH’s activities are executed through the NGO.

Through CHARESS, I-TECH provides technical assistance to ensure that both national-level entities and health care sites are able to effectively use the integrated systems iSanté, the electronic medical record system, OpenELIS, the laboratory information system, and TrainSMART, the training participant management database. These allow for better decision making by providers, differentiated care for patients, and improved clinical performance through continuous quality improvement.

At the national level, the MSPP and the donor, the U.S. Centers for Disease Control and Prevention (CDC) through the President’s Emergency Plan for AIDS Relief (PEPFAR), are able to conduct national-level public health analysis using data from the systems. These analyses are used to modify policies and target assistance for better care and treatment of patients.

Currently, I-TECH focuses on three of the six World Health Organization health systems building blocks: health service delivery, health workforce, and HIS. Previously, I-TECH also supported the other three building blocks of leadership and governance, access to essential medicines, and health systems financing through the Centers of Excellence project that ended in September 2016.

Program Highlights

No posts found.

 

I-TECH Ukraine Conducts ARVs for Epidemic Control Workshop

Post categories: Health Systems Strengthening HIV and STI Prevention HIV Care and Treatment Human Resources for Health Ukraine
Posted on
Dr. Michael Martin, Dr. Elliot Marseille, and Dr. Juliana de Fatima da Silva served as keynote speakers.

In early April, the International Training and Education Center for Health (I-TECH) conducted a five-day workshop on “Antiretroviral Drugs for Epidemic Control” for more than 50 chief doctors and deputy chief doctors from Regional AIDS Centers in Ukraine.

Workshop participants learned about evidence-based, international best clinical practices and the cost-effectiveness of strategies for using antiretroviral therapy (ART) to control HIV epidemics. International keynote speakers included:

  • Dr. Jeremy Penner, International Clinical Advisor in Ukraine to I-TECH/University of Washington (UW);
  • Dr. Elliot Marseille, Consultant to I-TECH/UW and the Center for Global Surgical Studies at the University of California, San Francisco;
  • Dr. Michael Martin, U.S. Centers for Disease Control and Prevention (CDC) Senior Technical Advisor for HIV/AIDS care and treatment in Thailand; and
  • Dr. Juliana de Fatima da Silva, Epidemic Intelligence Service Officer at the CDC.

The pool of facilitators also included nine national experts from the Ministry of Health’s Center of Public Health (CPH).

The workshop aimed to support the development of efficient strategies to achieve the UNAIDS 90-90-90 goals: 90% of HIV-positive people know their status, 90% of those are on treatment, and 90% of those are virally suppressed. To this end, the workshop covered national situational analysis, national clinical recommendations, and service delivery models with the highest potential for adaption in country.

Progress on ART optimization in Ukraine was shared, and participants were able to discuss their experiences and ideas for improving HIV-related services. The presentations and group discussions were particularly timely, given the development of complex new HIV clinical guidelines currently under way in Ukraine – they also provided much needed evidence to support this process.

Similar workshops were requested by the CPH and leaders of the Regional AIDS Centers, and I-TECH plans to meet this request by conducting two workshops in June and September 2017.

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.

Guyana Revamps Its Health Information System with I-TECH Support

Post categories: Guyana Health Information Systems Health Systems Strengthening
Posted on
Guyana Ministry of Public Health’s Deputy Chief Medical Officer, Dr. Karen Boyle. Photo courtesy of Kaieteur News.

The International Training and Education Center for Health (I-TECH) recently partnered with the Ministry of Public Health in Guyana and the U.S. Centers for Disease Control and Prevention (CDC) to launch a new health information system (HIS) that will protect patients’ privacy, maintain confidentiality, and provide security for sensitive data.

In an article in Guyana’s Kaieteur News, Deputy Chief Medical Officer, Dr. Karen Boyle, described how health officials hope to reduce health service quality inequities between coastal regions and other parts of the country as part of the national 2020 plan, in part by reducing waiting time for medical services and improving patient health literacy. Dr. Boyle stated they expect to “improve access to health information” and allow for “shared responsibility” for health care decision-making by providers and patients.

The health information upgrade is also being supported by PAHO (the Pan-American Health Organization), UNAIDS, and local collaborating partners such as the University of Guyana, e-Government, the National Insurance Scheme, and the Government Technical Institute (GTI).

CUGH 2017: Text Messaging and Tablets for Training

Post categories: eLearning/Distance Learning Health Systems Strengthening HIV Care and Treatment Namibia Tanzania Zimbabwe
Posted on

On April 6, the International Training and Education Center for Health (I-TECH) headed to the 8th Annual Consortium of Universities for Global Health (CUGH) Conference in Washington, D.C. I-TECH Zimbabwe presented among many colleagues in the University of Washington’s Department of Global Health, including staff of the department’s E-Learning Program (eDGH), which has worked closely with I-TECH on a number of e-learning and blended learning training programs.

This year’s conference theme was “Healthy People, Healthy Ecosystems: Implementation, Leadership & Sustainability in Global Health,” and I-TECH’s entries highlighted its sustainable workforce development work worldwide.

I-TECH Zimbabwe presenter Vivian Bertman (front) and eDGH presenters — and Zimbabwe co-authors — Leslie Wall and Anya Nartker (back)

I-TECH Zimbabwe’s Vivian Bertman shared results on the use of text messaging as a low-cost, sustainable platform for building health care worker skills and knowledge to care for children and adolescents with HIV.

The research, titled “Health Worker Text Messaging for Training Peer Support, and Mentoring in Pediatric and Adolescent HIV/AIDS Care: Lessons Learned in Zimbabwe,” assessed the use of WhatsApp in a blended learning program. Participants used the app for peer-to-peer learning and support, generating over 300 entries, continuing discussions after course completion, and creating spin-off groups, including a support group for teens.

Highlighting the flexibility of cost-effective e-learning approaches was an oral presentation by eDGH’s Leslie Wall and Anya Nartker titled “No internet? No problem! Creative approaches to cost-effective e-learning delivery in resource-constrained settings.” The research looked at five tablet-based training programs developed by eDGH, in partnership with I-TECH, and delivered in Namibia, Tanzania, and Zimbabwe.

For participants, time spent off the job decreased from four days to less than one day, and within training programs that used text messaging to keep learners engaged, all participants finished in the time allotted. The team plans to expand learning activities and incorporate additional real-time interactions via text-message-based discussion groups or added face-to-face interactions.

Caitlin O’Brien-Carelli

Caitlin O’Brien-Carelli, an MPH graduate from the UW Global Health program, explored additional sustainable training models. O’Brien-Carelli presented her MPH thesis work on behalf of I-TECH: “Training Healthcare Workers on the Use of Electronic Medical Records in HIV Clinics in Kenya: An Evaluation of Three Training Models.”

During I-TECH Kenya’s first years of training health care workers to use the KenyaEMR system, the team adjusted its training from 5 days to 3 days, and moved the training from off-site to on-site, to increase sustainability and maintain effectiveness. Results confirmed that with the adjustments, training quality was maintained, more people in more facilities were trained, and costs were reduced significantly.

Detailing innovations on the operations front, I-TECH HQ Managing Director Rob Lindsley presented at a conference satellite session titled “Global Operations 2017: Tools for Faculty & Administrative Leaders.” Lindsley’s presentation, “It’s About How Hard You Can Get Hit and Keep Moving Forward: Global Support and PLC Registration in India,” outlined I-TECH’s complicated, creative pathway to country office registration in India.

 

Ukraine’s HIV/AIDS Clinics Embrace ClASS Approach

Post categories: Health Systems Strengthening HIV and STI Prevention HIV Care and Treatment Quality Improvement Ukraine
Posted on
Workshop participants were particularly interested in team problem solving.
Workshop participants were particularly interested in team problem solving.

This month, the International Training and Education Center for Health (I-TECH), working with the Ministry of Health (MOH) in Ukraine, sensitized heads and other managers of HIV/AIDS clinics and centers on how to implement continuous quality improvement (CQI) by applying an approach known as the Clinical Assessment for Systems Strengthening, or ClASS, model.

The MOH’s Center of Public Health and I-TECH Ukraine held a two-day ClASS sensitization workshop for HIV clinicians from seven regions of Ukraine that are new to ClASS. The ClASS approach addresses CQI and identifies areas for improvement and assessment as well as detailed follow-up actions.

Presentation of the model was supplemented by reports and success stories shared by teams from Cherkasy, Kyiv, Chernivtsi Oblast, and Kryviy Rig City AIDS Centers, along with other sites that participated in ClASS between 2014 and 2016. The exchange of this experience proved effective in ensuring buy-in from new regions and raised their interest in and excitement about the model and its potential impact.

I-TECH's Irina Yuryeva presents the ClASS model to the workshop.
I-TECH’s Iryna Yuryeva presents the ClASS model to the workshop.

I-TECH Ukraine Program Director Iryna Yuryeva, who presented the ClASS model, said she was encouraged by the response to the workshop. Perceptions among the new audience shifted “amazingly quickly” she said, “from extreme concern, anxiety, and belief that almost nothing can and should be improved at their health care facilities to sincere and passionate interest and impatient anticipation of ClASS visits in the coming months.”

Participants expressed keen interest in the ClASS approach, which emphasizes team problem-solving and joint identification of ways to improve assessment, develop operational and strategic plans, and seek technical assistance when needed to address gaps. In addition, ClASS  could also be helpful for health care facilities preparing for formal accreditation by addressing assessment-based practical recommendations.

The “real-life cases and improvements” reported by the participating clinicians, and their ability to exchange experiences and proactively tackle main areas for improvement, were highlights of the training. This is all part of the ClASS methodology, a process that I-TECH’s Yurveya says demonstrates a “natural and evolutionary continuous quality improvement.”

I-TECH Ukraine will continue to support the MOH by promoting the ClASS approach as part of the CQI process in Ukraine, in particular by conducting additional ClASS trainings in seven new regions in 2017.

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.

Lab Managers in Zambia Earn Certificate in Leadership and Management

Post categories: Health Systems Strengthening Laboratory Systems Leadership & Management Zambia
Posted on
Mentor Dailes Nsofwa from CDC Zambia presents a certificate of completion to Kenneth Ngoma from Kasama General Hospital Laboratory.
Mentor Dailes Nsofwa from CDC Zambia presents a certificate of completion to Kenneth Ngoma from Kasama General Hospital Laboratory.

At a December ceremony in Lusaka, Zambia, a group of health laboratory supervisors completed the Certificate Program in Laboratory Leadership and Management, a blended-learning course developed and conducted by faculty and staff the International Training and Education Center for Health (I-TECH) at the University of Washington. The program was implemented in partnership with the American International Health Alliance (AIHA), the U.S. Centers for Disease Control and Prevention, and the Zambian Ministry of Health (MOH).

Effective leadership and management in laboratory settings are critical to providing timely detection, surveillance, and response to infectious diseases. Strengthening these skills has a direct, positive effect on quality of care and the capacity of low-resource countries to reach epidemic control.

The 16 managers, recruited from MOH public health laboratories, participated in nine months of online learning, face-to-face meetings, and mentorship. Courses covered leadership and management skills, and also topics related to implementing diagnostic technology, managing and communicating laboratory information. Participants also designed and implemented a capstone project designed to improve their laboratories’ operations. Online modules were developed with support from the UW Department of Global Health’s E-Learning Program (eDGH).

This certificate program is intended for middle- to senior-level clinical and public health laboratory leaders such as managers and directors, medical technologists, health scientists, and physician scientists interested in improving medical laboratory operations and evidence-based health policymaking. The blended-learning format allows participants to remain employed during their studies.

This project was 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.