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Pre-exposure Prophylaxis (PrEP)

Pre-exposure prophylaxis (PrEP) is a medication to prevent HIV infection in HIV-negative people. PrEP can stop HIV from taking hold and spreading throughout the body, and when taken daily, oral PrEP is highly effective for preventing HIV from sex or injection drug use. Additionally, expectant mothers who are HIV-negative can take PrEP to prevent infection, and thus prevent mother-to-child transmission (MTCT), during the critical periods of pregnancy and breastfeeding.[1] PrEP and the prevention of MTCT greatly contribute to the UNAIDS “fast-track” targets for prevention, which aims to reduce the number of new HIV infections in 2030 to fewer than 200,000.[2]

Despite scale-up of HIV testing and treatment in Africa, adolescent girls and young women (AGYW), as well as individuals in sero-discordant relationships, have high incidence of HIV. I-TECH supports PrEP delivery at HIV care and treatment clinics for partners of individuals receiving antiretroviral therapy (ART). In addition, I-TECH’s work in PrEP coincides with its efforts to support programs that provide for the physical and mental health of AGYW.

In partnership with the Elizabeth Glaser Pediatric AIDS Foundation, I-TECH faculty Jeff Lane and Aaron Katz prepared the briefs in the sidebar, which outline policy considerations for the scale-up of PrEP for adolescent girls and young women (AGYW) in Kenya, South Africa, and Uganda.

  1. World Health Organization (WHO). WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP). Policy Brief. November 2015.
  2. UNAIDS. Understanding Fast-Track: Accelerating Action to End the AIDS Epidemic by 2030. June 2015.

Program Highlights

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Transition & Sustainability

The International Training and Education Center for Health (I-TECH) works in partnership with host country governments, universities, professional associations, non-governmental organizations, private sector groups and funding agencies to strengthen local capacity and build sustainable health systems.

I-TECH follows a partnership model that guides the provision of technical services and technical assistance toward local ownership and sustainability, creating projects and programs that can be readily transitioned into national systems.

Based at the University of Washington, I-TECH draws upon a strong global network of public health professionals. The approach described in this document is customized in each country to respond to local needs and priorities. In addition, each I-TECH country office team aligns the model with the unique Partnership Framework Implementation Plans of the partner host government.

1. IDENTIFY NEEDS in consultation with host country governments

I-TECH works with host country governments to assess existing health systems and identify specific areas where the delivery of health care could be improved. This early collaboration helps to ensure that technical assistance accurately reflects the country’s specific health strategies and priorities.

2. STRUCTURE PARTNERSHIPS that integrate projects into existing systems

In each partnership, I-TECH develops roles, responsibilities, and timelines based on a long-term vision of integrating projects into existing national systems. As part of this vision, I-TECH recognizes and leverages the strengths and resources of national systems, building on and maximizing these efficiencies. The partnerships that emerge are attuned to the needs, realities, and structure of host country systems. Thus, they build and maintain lasting capacity within host country systems, maximize cost-effectiveness, and produce projects that can be more readily scaled up to meet national goals.

3. SECURE TECHNICAL RESOURCES from affiliated universities, partners, and the I-TECH network

As a center based at the University of Washington, I-TECH has direct access to a wide variety of technical specialists. In addition, I-TECH draws upon a robust global network of locally based public health professionals. These specialists provide a wide range of technical expertise to meet project needs.

4. PROVIDE TECHNICAL ASSISTANCE AND SERVICES tailored to actual needs and resources

I-TECH is committed to technical services and technical assistance approaches that build upon and support the existing strengths of local health systems. In addition, I-TECH prioritizes the use of local and regional expertise, an approach that builds the capacity of local experts to meet locally determined needs.

5. MONITOR PERFORMANCE; evaluate achievement of objectives and measure outcomes

I-TECH implements projects within a quality improvement framework designed to track progress in institutional capacity building and guide successful implementation. Using the framework, implementers monitor the progress of each project against specific benchmarks of success; for example, the progressive transfer of skills and capacity to local institutions. This methodology ensures that objectives are met and provides data to adjust approaches as projects evolve.

6. TRANSITION PROJECT into national systems to ensure sustainability

The ultimate goal of I-TECH’s partnership model is to improve health outcomes by strengthening local capacity and building sustainable health systems. I-TECH’s technical services and technical assistance are tailored from the initial planning stage to produce projects that can be successfully absorbed into national systems within mutually determined and realistic timeframes. Recognizing that a successful transition takes time, I-TECH offers transition support in a variety of technical areas including quality improvement and grant management.

Leadership & Management

Training on leadership and management in health is a major focus of I-TECH’s health systems strengthening efforts. I-TECH works in close collaboration with the Department of Global Health’s E-Learning Program (eDGH) to ensure that training content on leadership and management can be offered at low cost in even remote areas by using e-learning approaches and technologies to expand the reach of its training programs.

Program Highlights

Improving Laboratory Quality in Cambodia
I-TECH’s laboratory program began in Cambodia in 2013 with the goal to improve operations and regional biosurveillance and biosecurity through improved laboratory quality assurance and management practices. In collaboration with the Cambodian Ministry of Health, the World Health Organization (WHO), and the U.S. Centers for Disease Control and Prevention (CDC), ...
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Laboratory Quality Stepwise Program in Cambodia
From September 2013 to September 2016, I-TECH conducted an implementation science research project to improve laboratory quality in Cambodia. The primary objective of the project was to implement a mentored laboratory quality stepwise implementation (LQSI) program to strengthen the quality and capacity of Cambodian hospital laboratories. As a result, target ...
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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, ...
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Implementation Science

I-TECH specializes in developing appropriate research designs and methods for application in resource-limited settings, to get answers to research questions in real time. A university-based program, I-TECH draws from experts in qualitative and quantitative methods in a wide range of theoretical and practical disciplines, including health economics, anthropology, health sciences, medicine, and education.

Program Highlights

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Health Policy & Regulatory Strengthening

The International Training and Education Center for Health (I-TECH) has broad expertise in strengthening health care regulatory systems in low- and middle-income countries. I-TECH’s approach to regulatory strengthening emphasizes the importance of sustainability and country ownership, by working with ministries of health, health professional councils, and health professional associations to:

  • Conduct sound situational analyses and needs assessments;
  • Develop standard operating procedures to efficiently operationalize and scale key regulatory activities;
  • Develop regulatory information management systems;
  • Develop standards to establish consistent expectations for high quality health services; and
  • Develop continuing professional development frameworks and guidelines.

Program Highlights

Formulating Guidelines and Operating Procedures in India
I-TECH India PL is part of various national ART and testing guideline groups of NACO in India, including Journey of ...
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HIS Leadership and Governance in Kenya
As a key member of the Kenya electronic medical record (EMR) system technical working group, I-TECH works to implement and ...
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HIS Strategic Planning in Cameroon
National strategies, policies, and governance define the implementation environment for health information systems (HIS) and are recognized as a foundational ...
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Nursing Efficiency and Task-Sharing in Tanzania
I-TECH Tanzania led the development of the task-sharing policy guidelines for Health Sector Services approved in 2016 as well as ...
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