A new article on cost-effectiveness analysis of global training programs has been published in a leading journal on health workforce issues.
The article, “Cost-Effectiveness Analyses of Training: A Manager’s Guide,” was written by two I-TECH faculty: Gabrielle O’Malley, who is I-TECH’s Director of Operations Research and Quality Improvement, and Marcia Weaver, a Research Associate Professor based at I-TECH. Elliot Marseille of Health Strategies International in San Francisco also contributed to the article that appears in the journal Human Resources for Health.
The evidence on the cost and cost-effectiveness of global training programs is sparse. O’Malley and Weaver wrote this manager’s guide for professionals who want to recognize and encourage high quality cost-effectiveness analysis.
Weaver credits O’Malley with coming up with the idea for the article and spearheading it through several drafts over several years. In her role at I-TECH, O’Malley participates in meetings with policymakers and sees how compelling evidence on cost-effectiveness can be as well as the potential for cost data to be misinterpreted or misused.
“The objectives of the article are to promote professional standards for cost analyses and cost-effectiveness and show it’s feasible to provide evidence within the scope and budget of a training program evaluation,” Weaver said.
I-TECH clinical mentors work to strengthen the provision of care for people living with HIV and AIDS, tuberculosis (TB), and sexually transmitted infections (STI) by assessing and making recommendations for improvements to service-delivery systems.
The International Training and Education Center for Health (I-TECH) is pleased to announce the release of the second edition of I-TECH’s manual Essential Supervisory Skills, which you can download here (PDF, 2.7 MB).
A resource for managers, this “supervisor’s toolbox” is a 65-page manual developed from years of research and discussions with supervisors in a variety of industries from several countries. This easy-to-use guide gives managers a step-by-step plan to develop their supervisory skills while helping their employees reach their potential. Seven chapters include background and instructions on accountability, evaluation, effective hiring and how to address performance issues.
“The purpose of the Supervisor’s Toolbox is to provide a convenient resource supervisors can turn to when dealing with the myriad of issues that come their way,” said Richard Wilkinson, I-TECH Human Resources Director.
Decisions supervisors make often have a direct impact on employees’ lives—and global health. Wilkinson points out that investing in training for supervisors translates to more effective, efficient, and happier employees.
“There’s an old saying that employees join organizations and leave bosses,” he said. “Supervisors directly affect the difference employees can make in contributing to the success of their teams and I-TECH. My hope is these tools will help supervisors communicate clearly and manage confidently.”
Every biennium, the South African National Department of Health hosts a National Regional Training Center (RTC) Conference that brings together RTC managers, their line management, as well as key policy makers from the National and Provincial Departments of Health.This year I-TECH South Africa was honored to serve as a co-host.
This was the third national conference, and this year the theme was A Decade of Strengthening the Health Care System: Developing Human Resources for Health through the Regional Training Centers.
The popular conference registered 137 delegates out of the expected 120. Public health experts delivered compelling talks, whose topics ranged from leadership and management to innovative ways of delivering training.
I-TECH South Africa presented a talk on The Findings of the Situational Analysis in Nine Regional Training Centres of South Africa, as well as a report on Regional Training Center Models, which was authored by Dr Nathan Linsk, a professor at the Jane Addams College of Social Work at the University of Illinois at Chicago, who drew on his 25 years experience with the US AIDS Education and Training Centers network. Both of these reports contributed significantly to the subsequent three days of discussion about the future of Regional Training Centers in South Africa.
During the conference, delegates were divided into five commission that looked at:
Future role (Coordination of all in-service training; Institutional Base, Location, Funding model)
Resources for RTCs (Human, IT, Internet connectivity, Equipment, Infrastructure etc.)
Training and Education Approach (Mentoring, distance learning and Resource Library)
Coordination, Accreditation and linkages with academic institutions (levels of accreditation, certification etc.)
Planning, M & E, Reporting (Training needs analysis, integrated planning, M & E systems)
RTC managers took the worksheets from the 5 Commissions and developed an action plan, which was presented by the National Department of Health in a plenary session. As part of the next steps, I-TECH South Africa and NDOH will write a Conference report that will contain the action plan and a monitoring and evaluation plan as attachments. The NDOH will present the action plan to the National Health Council, made up of the National and Provincial Ministers of Health, for high level decisions and support toward the implementation of the proposed model.
I-TECH Zimbabwe’s male circumcision program was inaugurated this month by our local partner, the Zimbabwe Association of Church-Related Hospitals (ZACH), with completion of 16 surgeries at the Tshelanyemba Mission Hospital in Gwanda District in the Southern Province.
“Today is a milestone for our male circumcision program in Zimbabwe,” said Esther Machakaire, CDC-Zimbabwe Biomedical HIV Prevention Advisor who is providing technical assistance to I-TECH and ZACH to implement male circumcision services. “We expect the numbers to keep growing. I am confident that together we will make the I-TECH/ZACH/CDC male circumcision program a huge success!”
Male circumcision performed by well-trained medical professionals is an evidenced-based public health intervention to reduce the risk of men acquiring HIV/AIDs through female-to-male transmission. Scale up of male circumcision services is an important part of the combination prevention strategy developed by the Zimbabwe Ministry of Health and Child Welfare (MOHCW) to decrease HIV incidence among adults.
The I-TECH/ZACH male circumcision program is supported by CDC and MOHCW, and has plans to rapidly scale up services at 10 sites in 10 of Zimbabwe’s 62 districts, with the goal of conducting 16,000 surgeries by September 2013. It follows the model of similar safe male circumcision programs that have been implemented by I-TECH in Botswana and Malawi. The program includes assessment of site readiness to implement services, training of medical professionals in safe circumcision, procurement of medical supplies and equipment, close monitoring of quality control and quality assurance, and community outreach for demand creation.
A new regional referral health and research laboratory in Afar regional state, in Semera was inaugurated on February 9, 2013. The regional laboratory was renovated and established by I-TECH through partnership with the Ethiopian Health and Nutrition Research Institute (EHNRI) and collaboration with the Afar Regional Health Bureau and funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Centers for Disease Control and Prevention (CDC).
The new regional health facility, which is well equipped with advanced laboratory diagnostic technologies, was handed over to the Regional State with eventful program that brought together high level officials from the Federal Ministry of Health, the Afar regional state, the EHNRI, Afar regional health bureau and I-TECH Ethiopia leadership team.
The Afar regional Health Bureau Head, and the EHNRI regional laboratory capacity building directorate, Director addressed the impacts of partnership/collaboration to the improvement of the health system in the country in general and in the Afar region in particular and also applauded the I-TECH-Ethiopia’s significant contribution in strengthening the laboratory system in the Afar region.
The health facilities in the Afar region were small in number and were not well developed to provide standard and quality laboratory diagnosis services for the highly prevalent and deadliest diseases, but this is now changing following the intensified national health system strengthening programs in the country.
Dr. Nega G/yesus, the acting country Director of I-TECH Ethiopia acknowledged the long years of collaboration and partnership efforts put up by partners and the regional health bureau for all the successes achieved and appreciated the unwavering support of the United States Government in the health sector development in Ethiopia.
This new regional referral health laboratory will be a center to systematically build capacities of laboratories in the region to improve, assure and maintain quality laboratory diagnostic services. Moreover, it strengthens the regional referral system that would significantly improve the diagnostic capacities of laboratories for such as, HIV/AIDS, Malaria, TB, STIs and other opportunistic and tropical diseases, playing an integral role in Ethiopia’s public health emergency response system.
Dr. Wubshet Mamo, I-TECH Ethiopia’s Laboratory Program Director said, “The goal of the PEPFAR laboratory program is to support countries implement laboratory services in a sustainable manner to provide quality diagnostic tests, strengthen integrated laboratory systems and support and/or establish country or regional laboratory institutions. Establishing this modern laboratory, which is the 1st in the Afar regional state and the 9th regional referral health laboratory in the country will play a substantial role in changing the region’s laboratory diagnostic service quality, ensuring accurate and reliable laboratory test results that every patient deserves to get.”
He further explained that the role of this regional laboratory primarily will be assuring the quality of laboratory services through conducting external quality assessment, providing referral testing services and strengthening the referral system, supporting in skill building of laboratory professionals, conducting disease surveillance and taking appropriate measures in case of emerging infections in the region. This laboratory will also be a hub for evidence-based interventions (operational health research). More importantly, supporting laboratories in the region to improve their laboratory quality system towards the WHO-AFRO step-wise laboratory accreditation will be another key role of this regional laboratory facility, said Dr Mamo.
The establishment of this Regional Referral Health Laboratory will have significant impact in building the capacities of the hospitals and health centers in the Afar region to provide standardized and quality laboratory services to the people in the region.
If there is one reason that shines the glowing happiness of the local leaders over the scorching sun during the event; it is the anticipated reduction in referrals to distant cities for a better laboratory diagnosis.
The weather has been rainy, and the midwinter days are short, but for two software developers from Côte D’Ivoire, four mid-winter weeks in Seattle offer a rare chance to develop skills under the close mentorship of University of Washington I-TECH experts.
“There is no opportunity in Côte D’Ivoire to build software development skills like this,” said Dr Constant Kone on a recent afternoon as the grey Seattle rain pelted against the window of his borrowed office at I-TECH. His colleague Mr Kamalan Fourier, typing intently on his laptop across the table they share, nodded in agreement.
For several years, I-TECH has coordinated the implementation of the OpenELIS software in national public health laboratories in Côte D’Ivoire, an effort that is led by a highly skilled UW-based health informatics team. The open source laboratory informatics software was customized by the I-TECH team to match the workflow and local needs in Côte D’Ivoire.
But after the initial push to develop and install the software, there was a need for ongoing support, bug fixes, and additional features. “We get continual requests to add new features,” says Jen Antilla, a training specialist on the Seattle team, “for example to respond to new lab processes or build new reports that users need. And like any software, there will always be bugs to fix. We want to build the capacity to respond to those requests locally, in the labs where OpenELIS is running.”
Like all I-TECH programs, the Côte D’Ivoire deployment of Open ELIS is on a trajectory towards local ownership and sustainability, but that path is made more complicated by the lack of skilled software developers in Côte D’Ivoire. I-TECH began recruiting for local software developers in April 2012, and recognizing that most applicants would require additional training, the team started designing a custom training course to build the Open ELIS development skills of the new hires in Côte D’Ivoire.
As the first trainees, Dr Kone and Mr Fourier are in Seattle for four weeks, which is the intensive first phase of a planned nine month training program that will continue remotely after they return home.
Central to the training is a problem-based curriculum developed by Antilla and her colleagues, which moves the learners through a typical software development cycle: gathering requirements, designing the solution, developing it into the Open ELIS codebase, and testing it before implementation.
“It gives them the opportunity to learn about the different facets of Open ELIS as well as the tools and process needed to build a new feature,” says Antilla. “And to do so under the direct guidance of a mentor who’s spending lots of face-to-face time with them. When they return to Côte D’Ivoire they will continue with similar exercises a few hours each week, under a remote mentorship of our team, for the next 8 months.”
In the next few months Open ELIS will be fully implemented at a new site in Côte D’Ivoire, the lab at the Institut Pasteur. For the first time there will be local developers on-site with the skills to solve problems locally for their colleagues, with ever-decreasing support from Seattle.
And the I-TECH team in Seattle looks forward to having skilled colleagues at the point of deployment, sharing of the load.
“There’s nothing quite like having the opportunity to build a personal relationship over 4 weeks together in Seattle,” said Paul Schwartz, the senior software engineer on the Seattle team. “I look forward to working shoulder to shoulder with them after they return. Even when those shoulders are half a world away in West Africa!”