I-TECH provides technical assistance on the clinical care and treatment of HIV and related opportunistic infections on a continuum that ranges from direct patient service delivery, to training and mentoring health care workers, to the development of national policies and health systems infrastructure. In particular, together with ministries of health and other key stakeholders, I-TECH has developed numerous curricula and clinical mentoring programs to train health care workers to safely and effectively treat patients who have HIV and TB or other opportunistic infections at a level of care commensurate with national and international standards.
I-TECH has also assisted ministries of health to create national prevention and care and treatment guidelines for infectious diseases, which has lead to standardized care and treatment for HIV, including antiretroviral therapy (ART) dosing for adults and children.
Program Highlights
I-TECH’s extensive experience in HIV prevention, care and treatment service delivery, particularly in supporting ART scale up and innovation, make us particular well-suited to support Treat All implementation and differentiated models of service delivery to improve impact. I-TECH recognizes that different clients have different needs and that patient-centered approaches are likely to result in better clinical outcomes and in turn lead to better retention, adherence, and viral suppression. I-TECH has already worked in many countries across PEPFAR to build and support health systems and develop and implement policy at all levels from Health Ministry to local ART centers, and has designed and delivered a broad spectrum of activities to improve service delivery. I-TECH is engaged in supporting Treat All scale-up and piloting DSD models in several countries.
Program Highlights
Key populations (KP) bear disproportionate burdens of HIV infection. Globally, new infections among KPs and their sexual partners account for 36% of all new HIV infections.1 Achieving the UNAIDS “fast track” treatment targets will require a renewed and focused approach to identify most at-risk and vulnerable populations and respond to their specific needs.
Evidence suggests that KPs—notably men who have sex with men (MSM), people who inject drugs, sex workers, and transgender persons—are underserved and face violence, criminalization, ineffective policies that don’t protect their rights, and stigma and discrimination, including in health care settings. This reality prevents KPs from accessing needed HIV prevention and care services, leading to low service coverage, an important driver of ongoing HIV transmission in many resource limited settings. Young women and girls are also increasingly at risk of acquiring HIV. Acquisition of HIV is often associated with the incidence of unintended pregnancies, transactional sex, and gender-based violence.
1UNAIDS, Gap Report, 2016.
Program Highlights
UNAIDS estimates that there are 870,000 new HIV infections among women and girls each year.1 Globally, adolescent girls and young women often lack adequate health care services; access to programs that prevent and address violence; and access to HIV/STI education, testing, and treatment.
I-TECH has worked to increase access and improve health care programs and services for adolescent girls and young women through innovative in-service training in Tanzania, supporting the build of a gender-based violence database in Kenya, building clinician capacity in the Caribbean region, and starting the DREAMS program in Namibia.
1UNAIDS, 2017
Program Highlights
Demand creation is an evidence-based approach that tailors messaging and activities to specific geographic locations and communities for the most effective results. I-TECH works with the ministries of health in Mozambique, Namibia, and Botswana to scale up demand creation activities for HIV prevention, retention, and testing.
Program Highlights
I-TECH’s quality improvement approach emphasizes ongoing assessments of program aims and operations. Country projects apply continuous quality improvement (CQI) strategies targeting both programmatic and management activities. Small-scale, practical Plan-Do-Study-Act (PDSA) cycles are used to construct improvement goals, test proposed changes, and implement adjustments, leading to increased quality of operations, service delivery, and care.
Program Highlights
I-TECH’s monitoring and evaluation staff work to ensure the efficacy of health care training sessions and programs by applying their expertise in cost analysis, data collection, and measurement to rigorous evaluations of these interventions.
In addition to routine monitoring and evaluation (M&E) and continuous quality improvement (CQI), I-TECH designs and implements operations research (the application of research methodology to inform and improve program design and management) and special studies for both I-TECH country programs and our partners. These activities enable us to answer strategic questions concerning the selection and effectiveness of program interventions. The team analyzes and designs evidence-based solutions to increase relevance, access, and scope of HIV services.
Monitoring ongoing projects and programs allows for midstream corrections; key findings are communicated to managers and leaders to improve programmatic decision making. Results are disseminated through publication, when appropriate.
Additionally, I-TECH has significant capacity in the rapidly expanding field of health informatics for resource-limited clinical settings. I-TECH develops tools and systems—such as the Training System Monitoring and Reporting Tool (TrainSMART)—and provides technical assistance for electronic medical records, training management, and remote clinical diagnostic systems.
Program Highlights
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
World Health Organization guidelines for placing all HIV positive individuals on antiretroviral treatment has intensified the demand for a competent and accessible global health work force that can accommodate 90-90-90 UNAIDS targets for testing, treating, and virally suppressing HIV patients. There is an urgent need to concentrate on effective, differentiated, and cost-efficient service delivery models that embrace high quality patient-centered HIV care as countries adopt and roll out Test and Start. Achieving 90-90-90 will require substantial shifts in how HIV services are staffed and delivered; different solutions, including task sharing, are still needed to reach targets. Over the past decade, a variety of non-physician cadres, such as nurse-midwives, clinical officers, and medical assistants, have contributed to growing evidence of task sharing’s positive contributions to HIV health outcomes in resource-limited settings.
Program Highlights
