I-TECH’s distance learning and e-learning projects provide opportunities for health care professionals in resource-limited settings to gain knowledge and skills while minimizing their need to leave the workplace.
I-TECH distance learning projects typically have four goals:
- Increase the capacity of health care workers in resource-limited settings to deliver high quality care and treatment while allowing them to remain in their workplaces to provide services at their sites.
- Build the capacity of ministries of health and governmental institutions to use learning technologies and design blended learning, e-learning, and distance learning programs for health care workforce development.
- In collaboration with the UW Department of Global Health’s E-Learning Program (eDGH), provide technical assistance in effectively using e-learning, blended learning, and distance learning for health care workforce development.
Examples of I-TECH’s e-learning products are available in eDGH’s E-Learning Library.
Clinical mentoring is a critical component of I-TECH’s comprehensive approach to training, as it provides a bridge between didactic training and independent clinical practice. Clinical mentoring enables health care workers (HCW) to practice new skills in clinical settings with the support and guidance of a more specialized and experienced clinician. Intensive, practical training is especially important in HIV care and treatment given the diversity of illnesses associated with AIDS and the complexities of antiretroviral therapy (ART).
Typically, the clinical mentor is an experienced clinician-trainer who provides onsite training and consultation on complex cases; supports and enhances high level problem solving, diagnostic, and decision-making skills; leads case discussions; and addresses issues of quality assurance and continuing education. These mentoring activities take place in the context of an ongoing, two-way relationship between the mentor and the clinicians working at the site.
The I-TECH approach to mentoring includes five key components:
- Relationship building. The establishment of a trusting, receptive relationship between the mentor and mentee(s) that evolves and grows over the course of mentorship is the foundation of effective mentoring practice.
- Identifying areas for improvement. Observation and assessment of existing systems, practices, and policies leads to the identification of areas for improvement. I-TECH has developed a number of tools for use during the assessment phase. Information obtained during an assessment helps to inform the establishment of goals and objectives for the mentorship.
- Responsive coaching and modeling of best practices. Mentors must demonstrate proper techniques and model good clinical practice. Targeted activities with mentees may include demonstrating appropriate examination techniques, modeling proper infection control measures, and setting examples for establishing good rapport with patients.
- Advocating for environments conducive to quality patient care and provider development. This component relates to technical assistance in support of systems-level changes at a site. Mentors work with colleagues to enhance the development of clinical site infrastructure, systems, and approaches that can support the delivery of comprehensive HIV care.
- Data collection and reporting. Mentors support the utilization and integration of patient data into clinical practice by encouraging staff to adopt documentation practices that promote effective chronic disease management. Mentors can help demonstrate the utility of data collection and reporting to mentees during mentorship.
The ultimate goal of I-TECH’s clinical mentoring programs is to build the skills of local clinicians to become clinical mentors themselves. Ideally, as the pool of expert HIV/ART clinicians in each country expands, a network of local HIV clinical mentors will emerge to support and train other HIV clinicians with less experience.
I-TECH’s long engagement with clinician education in Mozambique includes support for improvements to the national undergraduate (“pre-service”) curriculum for laboratory technicians (Técnicos Medio de Laboratório) to make the content more current and reflect the health care priorities of the country, including advances in HIV diagnostics and treatment monitoring. The curriculum is now standardized so that students at all health training institutes (HTIs) are taught using the same material and methods. Continue reading “Human Resources for Health in Mozambique”
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.
Continue reading “Quality Improvement (QI) of HIV Care and Treatment, and Expanded Clinical Mentoring in Mozambique”
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.
I-TECH has worked in Namibia since 2004 to support a robust and sustainable health care system, and to address key health challenges including high HIV prevalence and a critical shortage of skilled health care workers.
Based in the capital city, Windhoek, I-TECH in Namibia has a long history of successfully supporting the Ministry of Health and Social Services (MoHSS); the Ministry of Education, Arts, and Culture; the University of Namibia; and the Ministry of Defence/Namibia Defence Force with programs to improve the prevention, care, and treatment of HIV. I-TECH’s flagship work in Namibia included the training of physicians, pharmacists, nurses, and community counselors in a wide range of subjects including sexually transmitted infections, tuberculosis, and pediatrics. In 2015, the program has expanded its focus to include direct service delivery across the HIV clinical continuum including multiple prevention programs such as DREAMS, pre-exposure prophylaxis (PrEP), and voluntary medical male circumcision (VMMC).
Successes include the establishment of nurse-initiated and managed ART services, support of the use of distance learning technologies (digital video conferencing, Project ECHO) to train Namibia’s dispersed health workforce, and delivery of VMMC services aimed at keeping boys and men HIV-negative. In 2017, I-TECH began implementing HIV prevention activities aimed at keeping adolescent girls and young women HIV-negative, including through the provision of PrEP.
I-TECH has also implemented a successful national survey focusing on the health and wellness of adolescents and young adults in Namibia in partnership with the Ministry of Gender Equality and Child Welfare, UNICEF, MoHSS, Namibia Statistics Agency, and the U.S Centers for Disease Control and Prevention.