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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.

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

HIS Strategic Planning in Cameroon
National strategies, policies, and governance define the implementation environment for health information systems (HIS) and are recognized as a foundational building block for health system goals, including universal health coverage and control of HIV and other infectious diseases. I-TECH is supporting Cameroon’s Ministry of Health (MOH) to develop a national ...
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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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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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Strengthening Laboratory Policy in Côte d’Ivoire
In 2017, Côte d’Ivoire’s National Public Health Reference Laboratory (LNSP) and I-TECH convened a series of strategic planning meetings with the objective of reviewing and updating the vision, mission, and objectives of the previous National Laboratory Strategic Plan. These meetings and collaboration with various partners resulted in a revised plan, ...
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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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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

Ensuring High-Quality Service Provision in Zimbabwe
Describing Adverse Events within VMMC Programs at Scale I-TECH works diligently to review and revise procedures to identify, manage, and report adverse events (AEs). I-TECH’s previous publications on AEs reveal efforts to maintain high quality programming and emphasize patient safety alongside achievement of targets. An evaluation published in the Journal ...
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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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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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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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HIV Co-infection

Program Highlights

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HIV and STI Prevention

Program Highlights

HIS Leadership and Governance in Kenya
As a key member of the Kenya electronic medical record (EMR) system technical working group, I-TECH works to implement and standardize the EMR systems used in the management of national HIV and AIDS care and treatment data. Similar efforts have focused on ensuring that different electronic systems can communicate with ...
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HIV Pre-Exposure Prophylaxis (PrEP) in Ukraine
The Government of Ukraine prioritized pre-exposure prophylaxis (PrEP) as part of combination prevention for HIV in 2019.1 Since 2020, I-TECH has focused its programmatic efforts in Ukraine on improving PrEP services uptake and strengthening PrEP delivery at selected stat healthcare facilities ...
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HIV Testing Services in Botswana
I-TECH Botswana conducts facility-based HIV testing at selected PEPFAR supported scale-up sites in seven PEPFAR districts. Testing is carried out by Health Care Assistants and includes expanded provider initiated testing, counseling, and partner notification. In addition, I-TECH Botswana conducts regular continuous quality improvement (CQI) visits at I-TECH-supported facilities and provides ...
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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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HIV Care and Treatment

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

Driving Collaboration with Local Implementation Partners in Zimbabwe
I-TECH builds local ownership and sustainability through collaborations throughout Zimbabwe. Under the CDC and PEPFAR awards, I-TECH has formed and leads two consortia – ZAZIC and ZimPAAC ...
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eLearning Programs in the Caribbean
I-TECH has partnered with universities and ministries of health (MoH) in the region to develop accessible in-service training opportunities for HIV providers using distance and blended learning ...
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Expanding HIV Care and Treatment in Zimbabwe
The ZimPAAC consortium collaborates with the Ministry of Health and Child Care (MoHCC) in Zimbabwe to meet the following primary HIV epidemic control objectives:

  • Diagnose 95% of all persons living with HIV through integrated testing
  • Ensure 95% of individuals diagnosed with HIV are initiated on antiretroviral therapy (ART), retained ...
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Health Information Systems in Botswana
I-TECH has worked with the Ministry of Health and Wellness (MOHW), Centers for Disease Control and Prevention (CDC), and other implementing partners to develop and implement robust national health information systems (HIS) that enable greater efficiency and accountability and strategic use of information. These HIS include: ...
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Differentiated Care

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

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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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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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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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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