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I-TECH

Category: PIs

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

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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, 2nd 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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Mental Health

Mental health and substance use disorders are a growing global burden that is responsible for one out of every ten lost years of health. Additionally, people living with HIV experience higher rates of common mental health conditions, such as depression, which can pose a threat to the success of treatment programs and contribute to decreased antiretroviral therapy adherence.

In South Africa, I-TECH worked with local partners and the National Department of Health to integrate mental health services into routine primary and chronic care as a way to increase access to care, ensure treatment adherence, and improve patient engagement through the Mental Health Integration (MhINT) program.

Past Programs

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 Presentations

Malaria

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

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HIV Co-infection

Program Highlights

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HIV and STI Prevention

Program Highlights

Reducing HIV through Voluntary Medical Male Circumcision in Zimbabwe
Since 2013, the ZAZIC Consortium has been implementing Voluntary Medical Male Circumcision (VMMC) as part of a combination HIV prevention package approved by the Ministry of Health and Child Care (MoHCC) in Zimbabwe. Unlike other VMMC programs in the region, the ZAZIC model uses an integrated approach, blending local clinic ...
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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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HIV Counseling and Testing

Index testing, including partner notification services (PNS), is a key strategy to identify and support those most at risk of acquiring HIV: sexual contacts, needle-sharing partners, and biological children of newly diagnosed HIV+ individuals.[1] Its implementation is critical to controlling the HIV epidemic and meeting the UNAIDS target that 95% of people living with HIV will know their status. Evidence from Cameroon, Kenya, Malawi, and Mozambique has demonstrated PNS is feasible, safe, and highly effective.[2-6] Additional data suggest PNS improves HIV prevention uptake, linkage to treatment, and sustained engagement in HIV care.[7-9] In December 2016, the World Health Organization issued guidelines recommending that PNS “be offered as part of a comprehensive package of testing and care offered to persons with HIV.”[10] PEPFAR has since supported efforts to bring PNS to scale across supported countries.

I-TECH and the University of Washington have extensive experience in index testing research and programming including direct service delivery; quality improvement; training; policy and guideline development; and monitoring and evaluation. I-TECH promotes evidence-based index testing and counseling strategies focused on reaching recent sexual contacts and all biological children, placing them at the forefront of HIV case identification programs to reach epidemic control.

  1. Golden M, et al. Partner notification for sexually transmitted infections including HIV infection: an evidence-based assessment. Sexually transmitted diseases. 4th edn. McGraw-Hill; New York, NY: 2007.
  2. Brown LB, et al. HIV partner notification is effective and feasible in sub-Saharan Africa: opportunities for HIV treatment and prevention. J Acquir Immune Defic Syndr. 2011 Apr 15;56(5):437-42.
  3. Henley C, et al. Scale-up and case-finding effectiveness of an HIV partner services program in Cameroon: an innovative HIV prevention intervention for developing countries. Sex Transm Dis. 2013 Dec;40(12):909-14.
  4. Rosenberg NE, et al. Recruiting male partners for couple HIV testing and counselling in Malawi’s option B+ programme: an unblinded randomised controlled trial. Lancet HIV. 2015 Nov;2(11):e483-91.
  5. Myers RS, et al. Acceptability and Effectiveness of Assisted Human Immunodeficiency Virus Partner Services in Mozambique: Results From a Pilot Program in a Public, Urban Clinic. Sex Transm Dis. 2016 Nov;43(11):690-695.
  6. Cherutich P, et al. Assisted partner services for HIV in Kenya: a cluster randomised controlled trial. Lancet HIV. 2017 Feb;4(2):e74-e82.
  7. Myer L, et al. Family matters: Co-enrollment of family members into care is associated with improved outcomes for HIV-infected women initiating antiretroviral therapy. J Acquir Immune Defic Syndr. 2014 Dec 1;67 Suppl 4:S243-9.
  8. Vreeman RC, et al. Disclosure of HIV status to children in resource-limited settings: a systematic review. J Int AIDS Soc. 2013 May 27;16:18466.
  9. Walcott MM, et al. Facilitating HIV status disclosure for pregnant women and partners in rural Kenya: a qualitative study. BMC Public Health. 2013 Dec 2;13:1115.
  10. World Health Organization. Guidelines on HIV Self-Testing and Partner Notification. 2016.

Program Highlights

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