Facility-Based HIV Testing Services in Namibia

Posted on July 3, 2019

As a key component of I-TECH’s support to HIV care continuum strengthening in Namibia, I-TECH supports the Ministry of Health and Social Services in efforts to achieve the UNAIDS target of “90% of people living with HIV will have a known status.” I-TECH supports above-site HIV testing activities at region-and national-levels, as well as technical assistance and direct service delivery at the site-level across 78 facilities in 6 regions in Namibia.

I-TECH implements evidence-based HIV-testing strategies to maintain efficient programs while increasing HIV-positive yield including optimized provider-initiated testing and counseling (PITC) and index testing.

I-TECH’s clinical and technical teams place emphasis on offering PITC to high-risk populations including STI patients, clients attending family planning services, presumptive and confirmed TB cases, and patients attending in-patient hospital services. In addition, efforts will be made to increase testing among men through the above strategies, as well as encouraging more flexible hours for HIV testing through extended hours of operation.
I-TECH participates in the national-level index testing work group, helping to finalize paper tools and training materials for national deployment. At the site level, I-TECH strategic information staff ensure complete documentation of partner status of all enrolled patients, with testing offered to identified partners. I-TECH in Namibia is also working with I-TECH country offices across the network to leverage expertise in index testing training and monitoring and evaluation. I-TECH is currently supporting discussions at the national-level concerning the role of self-testing as an extension of services offered to facility-based clients, as another option for ensuring that more partners are tested.

I-TECH is currently supporting facilitation of stepped training for HIV recency testing in 5 high-volume districts in Namibia. Recency testing provides insight into the timeline of a client’s HIV infection. As Namibia approaches epidemic control, identifying, and targeting efforts and interventions to hard to reach populations most at risk for HIV acquisition will be essential.

Health and Wellness National Survey of Youth in Namibia

Gabrielle O'Malley HIV and STI Prevention Namibia

Posted on July 3, 2019July 3, 2019

Since 2017, I-TECH worked closely with the Ministry of Gender Equality and Child Welfare, Ministry of Health and Social Services, UNICEF, Centers for Disease Control and Prevention, and the Namibia Statistics Agency to implement a nationally representative survey on youth experiences as well as HIV incidence and prevalence. Survey results will inform policy and practice to improve the overall well-being of children and young people in Namibia and further focus HIV prevention efforts.

Survey collaborators are in the process of data analysis with a final report expected in early 2020. I-TECH will continue to support these efforts as well as continue to work to strengthen HIV prevention and promote the overall well-being of youth in Namibia.

Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women (DREAMS) in Namibia

Gabrielle O'Malley Gender/Women & Girls HIV and STI Prevention Namibia

Posted on July 3, 2019September 30, 2019

In 2017, I-TECH began the DREAMS program in Khomas and Zambezi regions. The DREAMS program aims to reduce HIV infections among adolescent girls and young women (AGYW) through a core package of evidence-based interventions across health, education, and social sectors. At a safe space such as a school or community center, participants meet with a mentor who is trained to deliver a curriculum focused on the prevention of HIV and gender-based violence (GBV). Mentors help AGYW build strong social networks and empower them to make healthy and positive decisions. AGYW can also access on-site services like HIV testing, family planning, PrEP, counseling, and screening for GBV to protect against HIV infection. I-TECH has supported over 150 safe spaces since its launch and enrolled over 20,000 AGYW in the program.

I-TECH also supports programming for caregivers through the Families Matter! Program, which promotes healthy communication between parents and AGYW around HIV and GBV topics. I-TECH works closely with the Ministry of Education, Arts, and Culture; Ministry of Gender Equality and Child Welfare; Ministry of Health and Social Services; Centers for Disease Control and Prevention; and other implementing partners.

Using Data to Improve Health Service Delivery in Malawi

eLearning/Distance Learning Gabrielle O'Malley Health Information Systems Malawi Nursing/HCW Cadres

Posted on May 28, 2019June 3, 2021

The Kuunika Project: Data for Action was a four-year program implemented by a consortium of organizations, including the International Training and Education Center for Health (I-TECH), that began in 2016 to improve healthcare service delivery through the effective use of data. Consortium activities aimed to improve data systems, data use, and data governance in five districts throughout Malawi. I-TECH’s main focus was to build the capacity of healthcare workers (HCWs) to access, manage and use health data in high-burden HIV/AIDS facilities and communities.

I-TECH conducted an HCW training needs assessment with support from the Ministry of Health (MOH) in 2017. Using the assessment data, I-TECH collaborated with MOH, district health teams, local university representatives, and subject matter experts to design and develop a training curriculum that was piloted in 2018.

In January 2019, I-TECH rolled out a national training comprised of seven-day, in-person workshops and complementary eLearning modules with the goal of establishing a culture of data use, a strong base of high-quality data, and improve the availability of high-quality information to decision makers with the ultimate goal of improving health outcomes. The eLearning program, Building Effective Health Information Systems, is comprised of seven modules that introduce frontline healthcare workers and managers to health information systems. The modules include:

Introduction to Health Information Systems
Health Information Systems: Data Management Concepts
Using EMR Data for Decision Making
Improving and Maintaining the Quality of EMR System Data
Logic Models and System Classification
Overview of System Architecture
Introduction to Interoperability at the Facility Level.

An average of 150 HCWs per district were trained for an overall total of more than 800 HCWs trained across the country.

In May 2019, I-TECH launched a mentorship program designed to bridge the gap between training and practice, and to help participants apply their newly gained knowledge on the job. By the end of Phase 1, the I-TECH team had oriented over 100 district mentors to the mentorship program and tools. I-TECH’s role in the consortium concluded in August 2019 when Phase 1 of the Kuunika Project ended.

Technical Support to the National HIV Response in Malawi

Clinical Mentoring Gabrielle O'Malley Health Information Systems HIV Care and Treatment Human Resources for Health Integrating Research and Practice Malawi Tuberculosis

Posted on July 25, 2018September 29, 2023

I-TECH seconded staff work in collaboration with government officers and program managers, and bring technical expertise to efforts to strengthen health systems. Continue reading “Technical Support to the National HIV Response in Malawi”

Best Practices

To address the UNAIDS Sustainable Development Goals for elimination of HIV/AIDS, tuberculosis, malaria and other diseases by 2030, and the PEPFAR 3.0 goals, I-TECH leverages the technical expertise of its universities and partners, the broad experience of its funders, and best practices from 15 years of implementing programs.

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.

Cervical Cancer

Cervical cancer poses a serious threat to women in resource-limited settings, where an estimated 90% of all newly diagnosed cases develop.¹ In women living with HIV, the progression from cervical pre-cancer to cancer is more rapid than in women without HIV.²

From 2013 to 2014, I-TECH supported cervical cancer screening and treatment in Haiti through the organization of trainings on visual inspection with acetic acid (VIA) and cryotherapy, which helped build the capacity of providers and contributed to risk reduction in cervical cancer, as well as early diagnosis and treatment.

I-TECH currently develops high-quality curricula, organizes training programs, and uses direct service delivery to strengthen and expand access to cervical cancer screening and treatment among women living with HIV; works with the Ministries of Health to update national cervical cancer screening and treatment guidelines; and strengthens routine quality assurance, supervision, mentorship, and coordination of cervical cancer providers.

Program Highlights

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References

¹Comprehensive Cervical Cancer Control: A Guide to Essential Practice, 2^nd Ed., World Health Organization.
²Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, National Institutes of Health.

Tuberculosis

To reduce the number of new cases of tuberculosis and improve diagnosis and treatment, I-TECH collaborates with governments and ministries of health to strengthen their health systems through facilitating trainings, advising on health policy and clinical guideline updates, supporting laboratory quality management, upgrading national health information systems, and implementing integrated TB/HIV care and treatment services.

Program Highlights

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Voluntary Medical Male Circumcision

I-TECH has developed extensive capacity and expertise in voluntary medical male circumcision (VMMC) program implementation and management by providing comprehensive VMMC services and/or technical assistance across Southern and Eastern Africa in Botswana, Malawi, Mozambique, Namibia, Tanzania, and Zimbabwe. Technical focus areas include health policy and guideline development, including early-infant male circumcision and piloting and evaluating devices; external and internal quality assurance; demand creation and community mobilization; training; and direct service delivery – all built on a strong foundation of monitoring, evaluation, and learning. Since 2011, I-TECH has directly provided more than 660,000 VMMCs with an adverse event rate of less than 2%.

I-TECH promotes an integrated model, consistent with the Global Health Initiative (GHI) Principles, and supports data-driven program implementation and management. By working closely with the Ministries of Health, local partners, and communities, I-TECH ensures implementations are country-owned and foster strong health systems and sustainable programs.

Program Highlights

VMMC for HIV Prevention in Mozambique

I-TECH assists the Mozambique Ministry of Health (MISAU) to improve the quality, safety and performance of the VMMC sites through external quality assurance visits and mentoring of site staff. I-TECH has helped to design and conduct an evaluation of demand creation activities that were designed to motivate men age 15-49 ...
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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 ...
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