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

Continuous Quality Improvement Collaborative in the Caribbean

Since 2013, I-TECH has led quality improvement (QI) collaboratives in the Caribbean region, enabling multidisciplinary teams at health facilities to work toward a common goal of improving care and treatment for HIV-positive patients ...
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Case Finding and Retention in Care in Mozambique

I-TECH works with the Mozambique Ministry of Health (MISAU) to expand a pilot project to provide an assisted partner services intervention. The project is aimed at encouraging patients newly diagnosed with HIV infection to disclose their status to their partners, and bring them to the clinic for testing ...
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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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Site-level Data Improvement and Use in Namibia

I-TECH continues to focus efforts on the improvement of data quality and use of data to improve clinical decision making. I-TECH works at the site level to build awareness and buy-in for data quality and use among site-level management and health care workers. On-site I-TECH Monitoring and Evaluation (M&E) Officers ...
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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

Improving Laboratory Quality in Cambodia

I-TECH’s laboratory program began in Cambodia in 2013 with the goal to improve operations and regional biosurveillance and biosecurity through improved laboratory quality assurance and management practices. In collaboration with the Cambodian Ministry of Health, the World Health Organization (WHO), and the U.S. Centers for Disease Control and Prevention (CDC), ...
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Key Populations Preceptorship Program in Trinidad and Tobago

Reducing stigma and discrimination toward vulnerable groups in health care settings can have a positive impact on enrollment in care, retention in care and treatment, and viral suppression of HIV. The Key Populations Preceptorship (KPP) program is a simulated one-on-one patient-provider training program that brings together a health care provider ...
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Laboratory Quality Stepwise Program in Cambodia

From September 2013 to September 2016, I-TECH conducted an implementation science research project to improve laboratory quality in Cambodia. The primary objective of the project was to implement a mentored laboratory quality stepwise implementation (LQSI) program to strengthen the quality and capacity of Cambodian hospital laboratories. As a result, target ...
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Nursing Efficiency and Task-Sharing in Tanzania

I-TECH Tanzania led the development of the task-sharing policy guidelines for Health Sector Services approved in 2016 as well as the policy’s operational plan. While task-sharing is a widely known HIV service delivery efficiency strategy, still there is continues gaps between national strategies and actual implementation at the site-level [1,2] ...
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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

Using Innovative Technology for Better Data in Zimbabwe

The ZimPAAC consortium has supported high-quality health care worker (HCW) knowledge and skills in Zimbabwe with technologies such as applications with clinical resources for clinicians, tablet-based data collection, and self-study modules. Through the use of self-study courses, HCWs complete learning activities using case scenarios in either prevention of mother-to-child transmission ...
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Using Project ECHO in Malawi

The Extension for Community Healthcare Outcomes (ECHO) Project® was developed by the University of New Mexico to improve care for underserved populations using a hub-and-spoke approach of knowledge-sharing by video-conferencing technology. The Lighthouse ECHO project provides a platform for sharing critical, timely, and life-saving information and data with health care ...
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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

Technical Support to the National HIV Response in Malawi

I-TECH seconded staff work in collaboration with government officers and program managers, and bring technical expertise to efforts to strengthen health systems ...
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Two-Way Texting for Post-Operative VMMC Follow-Up RCT in Zimbabwe

Voluntary medical male circumcision (VMMC) is considered safe and the vast majority of men heal without complication. However, guidelines require multiple follow-up visits, which can burden staff and facilities with clients who are typically healing well. With funding from the National Institutes of Health (NIH), ZAZIC recently conducted a prospective ...
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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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