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I-TECH

Category: HIV Care and Treatment

Improving HIV Care for Key Populations in the Caribbean

Post categories: Caribbean Differentiated Care Gender/Women & Girls HIV Care and Treatment Human Resources for Health Key Populations
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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 HIV prevalence was estimated between 25.2%2 – 52.9%3 and among female sex workers, HIV prevalence is estimated at 2%.1 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 in communities most heavily burdened by HIV infection.

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Continuous Quality Improvement Collaborative in the Caribbean

Post categories: Best Practices Caribbean Clinical Mentoring Differentiated Care eLearning/Distance Learning HIV Care and Treatment Key Populations Lydia Chwastiak Quality Improvement Transition & Sustainability
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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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Gabrielle O’Malley

Gabrielle O’Malley, MA, PHD, is I-TECH’S Director of Implementation Science. Dr. O’Malley has worked as an applied research and evaluation professional for over 25 years. Her experience includes a wide variety of international and domestic programs including child survival, private agricultural enterprise, medical education, community technology, reproductive health, HIV prevention (PrEP), and care and treatment as well as applied research for private industry. Her research interests include innovative practices for program evaluation and improvement, formative research, qualitative methods, and the relationship of gender and health.

Dr. O’Malley received her PhD from UW, an MA from Johns Hopkins University and a BA from Smith College.

Program Highlights

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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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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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 (QI) of HIV Care and Treatment, and Expanded Clinical Mentoring in Mozambique

Post categories: Ann Downer Clinical Mentoring eLearning/Distance Learning HIV Care and Treatment Monitoring & Evaluation Mozambique Quality Improvement
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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 and distance learning have been used to reach health workers in more rural settings.

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Training through Distance Learning in Namibia using the Project ECHO Model

Post categories: Clinical Mentoring eLearning/Distance Learning Gabrielle O'Malley HIV Care and Treatment Human Resources for Health Namibia
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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 Project ECHO model, a tele-health platform started at the University of New Mexico, whereby clinicians in remote areas connect with rotating subject matter experts and clinicians a robust virtual community of practice to build health care worker capacity, support peer-to-peer cross-facility learning and reduce feelings of professional isolation.

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Strengthening National Health Systems through Task Shifting and Training in Namibia

Post categories: Ann Downer HIV Care and Treatment Human Resources for Health Integrating Research and Practice Namibia
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Working with the Ministry of Health and Social Services (MoHSS) to roll out treatment in the country, I-TECH supported the training of physicians to provide antiretroviral therapy (ART) soon after the first national ART guidelines were published in 2003. I-TECH subsequently began supporting the training of nurses in both ART (2006) and Integrated Management of Adolescent and Adult Illness (IMAI, 2007) to increase health system capacity to expand delivery of ART services.

In 2010, I-TECH implemented a task shifting demonstration project to determine whether nurse-initiated management of antiretroviral treatment (NIMART) is a feasible alternative to doctor-led models. I-TECH subsequently supported an evaluation of this project which confirmed its feasibility for use in certain countries. In Namibia, NIMART was adopted by the MoHSS for use nationwide in 2013. I-TECH continues to hold NIMART trainings: five were held in 2016, with 125 health care workers trained.

Support for Pediatric HIV Care and Treatment in Namibia

Post categories: Gabrielle O'Malley HIV Care and Treatment Human Resources for Health Integrating Research and Practice Key Populations Namibia
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I-TECH works to strengthen the quality of pediatric HIV care and treatment in Namibia through the development of a “model” pediatric HIV clinic and supporting decentralization of quality pediatric care to other facilities. In collaboration with the Ministry of Health and Social Services, I-TECH developed an innovative, structured, culturally-relevant intervention to help guide health care workers and caregivers of HIV-positive children through the process of disclosing a child’s HIV-positive status to the child.

An evaluation of the disclosure program showed that it increased health care worker and caregiver confidence and communication in pediatric disclosure, as well as demonstrating improved viral suppression, adherence, and HIV knowledge among pediatric patients. I-TECH clinicians have also worked at the site level to support the development, implementation, and monitoring of strategies to improve adolescent HIV services and transition of adolescents from pediatric to adult care.

Strengthening the HIV Care Continuum and ART Adherence in Namibia

Post categories: Gabrielle O'Malley Health Information Systems HIV Care and Treatment Namibia Quality Improvement
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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 to the clinic.

In collaboration with the MoHSS, I-TECH is implementing “Treatment for All” guidelines (December 2016), an HIV care and treatment approach that initiates patients on lifelong antiretroviral therapy as soon as they test HIV-positive. I-TECH has developed an interactive education and counseling intervention, ARVs and Healthy Me, for health care workers to support HIV-positive patients in attaining good adherence and engagement in care.

To improve the quality of data for use in clinical decision-making, I-TECH actively participates in national technical working groups and advisory committees, and conducts rigorous monitoring and evaluation (M&E) to build awareness and buy-in for data quality and date use among site-level managers and health care workers.