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.

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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Quality Improvement

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

Strengthening Health Service Delivery in India

I-TECH India PL has successfully designed and implemented four differentiated ART service delivery models, including models for key population clients, in collaboration with other stakeholders in states of Maharashtra, Nagaland, Manipur and Mizoram to develop a proof of concept for the national level scale up;
Improved delivery of health ...
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Innovative Training Models in Tanzania

I-TECH Tanzania has implemented many pre- and in-service training initiatives and materials, as well as adopted TrainSMART ...
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Differentiated HIV Service Delivery Models in Tanzania

In October 2016, the Government of Tanzania adopted the World Health Organization’s (WHO) Treat All recommendations. The adoption of WHO recommendations, coupled with the Government of Tanzania’s acceptance of the UNAIDS 95-95-95 targets represents a significant commitment to the fight against HIV in Tanzania ...
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Improving HIV Care and Treatment across the Caribbean

I-TECH supports a variety of activities aimed at improving HIV care and treatment in the Caribbean region, such as on-site clinical mentoring, development of training curricula, and providing clinical support materials to improve care and treatment for HIV/AIDS in the Caribbean region ...
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Human Resources for Health

The effective diagnosis, care, and treatment of infectious diseases require a skilled and motivated health care workforce, and sustainable systems to educate and train those workers. I-TECH uses a systemic approach to build the skills and knowledge of, and foster attitude changes in, health care staff and those who train and educate them.

The following model outlines I-TECH’s human resources for health-based approach to achieving comprehensive patient-centered care. Each component of the model, including a strong enabling environment, supports an optimized health workforce as the foundation of an effective service delivery system.

Program Highlights

Health Information Systems in Kenya

In 2012, I-TECH designed and developed an electronic medical records (EMR) system, KenyaEMR, to support the care and treatment of HIV/AIDS. KenyaEMR is built on the OpenMRS platform. I-TECH supported the implementation of KenyaEMR in over 300 health facilities throughout Kenya—one of the largest open source EMR rollouts in Africa ...
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Human Resources for Health in Mozambique

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 ...
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Human Resources for Health in Ukraine

A key focus for I-TECH in Ukraine is strengthening the capacity of local partners to develop and deliver high-quality clinical trainings and expand the supply of skilled health care workers ...
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Improving HIV Care for Key Populations in the Caribbean

Key, at-risk populations in the region include men who have sex with men (MSM), bisexual men, transgender women, and sex workers. In Jamaica, HIV prevalence among MSM was estimated at 32.8%,1 as compared to an estimated prevalence of 1.8% in the general adult population in 2017.1 Among transgender women, the ...
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e-Learning/Distance Learning

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.

Program Highlights

Innovative Training Models in Tanzania

I-TECH Tanzania has implemented many pre- and in-service training initiatives and materials, as well as adopted TrainSMART ...
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Quality Improvement (QI) of HIV Care and Treatment, and Expanded Clinical Mentoring 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 ...
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Training through Distance Learning in Namibia using the Project ECHO Model

I-TECH in Namibia spearheaded use of distance learning for HIV care and treatment through the establishment of a digital video conferencing network to link Windhoek with training sites and hospitals throughout the country starting in 2008. Building off that foundation, Namibia became the first country in Africa to implement the ...
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Using Data to Improve Health Service Delivery in Malawi

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, ...
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Global Health Security

The COVID-19 pandemic has highlighted the critical importance of strong national disease surveillance systems that can detect disease threats in a timely fashion and provide actionable information for public health action. I-TECH focuses on preventing the likelihood of disease outbreaks, improving the efficiency and accuracy of the detection of communicable diseases, strengthening surveillance capacity for rapid and effective responses, and enhancing infection prevention and control practices to prevent the emergence and spread of pathogens and antimicrobial resistant bacteria.

In response to the COVID-19 pandemic, I-TECH provided technical assistance on the prevention and control of COVID-19 that ranges from training healthcare workers and facilities in infection prevention and control best practices to supporting the development of national policies and standard operating procedures. Throughout the COVID-19 pandemic, I-TECH has worked with Ministries of Health and other local stakeholders to ensure that laboratories, health facilities, clinics, and providers are being trained in and implementing procedures to prevent and control the spread of COVID-19.

Program Highlights

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Kenya

Since 2005, I-TECH has drawn on expertise from the University of Washington and the University of California, San Francisco, to support the Ministry of Health (MOH) in advancing priorities in the areas of health information systems (HIS), HIS leadership and governance, Global Health Security (GHSA), and evidence-based Infection Prevention and Control (IPC) practices.

I-TECH Kenya’s programs aim to improve the quality of patient care and enable health care facilities to meet their health information, data collection, and reporting needs. I-TECH Kenya’s GHSA funded programs aim to advance the Global Health Security Agenda through strengthening information systems and reporting, and improving IPC in health care facilities.

In all efforts, I-TECH Kenya works closely with the MOH and local partners to develop and implement programs that can be successfully transitioned to local ownership, ensuring sustainable progress toward Kenya’s long-term health goals.

Program Highlights

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Health Information Systems

I-TECH’s Health Information Systems Team lies within the Health Systems Strengthening division. The team has significant capacity in the rapidly expanding field of Health Information Systems for resource-limited clinical settings. I-TECH develops and deploys systems and provides technical assistance and training on electronic medical records, laboratory information management, disease surveillance, national eHealth architecture design, national standards for data transfer and system interoperability, and data use for improved clinical service delivery.

Program Highlights

Layering Research and Practice in Haiti

The EMR iSanté enables research on population health in Haiti, including the implementation of Option B+. This work was presented at the International AIDS Society Conference in 2015 ...
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National Data Warehouse and Dashboards in Botswana

I-TECH has worked with the Ministry of Health and Wellness, Centers for Disease Control and Prevention, and other implementing partners in Botswana to develop and implement robust national health information system that enable greater efficiency and accountability and strategic use of information. I-TECH’s work on the National Data Warehouse ensures ...
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Strategic Information in Ukraine

I-TECH in Ukraine has worked to implement the Training System Monitoring and Reporting Tool (TrainSMART) via its partners, supporting adaptation of the tool per partners’ specifications and training stakeholders on its use since 2013 ...
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Strengthening the HIV Care Continuum and ART Adherence in Namibia

In accordance with the HIV Care Continuum, I-TECH supports direct HIV care and treatment service delivery as well as on-site clinical mentoring and technical assistance in 81 facilities in five regions of Namibia. I-TECH supports key evidence-based strategies such as provider-initiated HIV counseling and testing, eMTCT, and decentralization of ART services ...
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