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I-TECH

Category: Human Resources for Health

Lydia Chwastiak

Lydia Chwastiak MD, MPH is a psychiatrist and internal medicine physician and Professor in the Department of Psychiatry and Behavioral Sciences and Adjunct Professor in Global Health in the University of Washington. Her research for the past 21 years has focused on improving the care and outcomes of people with chronic medical conditions and serious mental disorders. She has been a principal investigator (PI) or co-investigator on eight NIH-funded clinical trials of integrated care in both medical and community mental health settings, including MPI on the multi-center INDEPENDENT Study (R01 MH100390) which demonstrated the effectiveness of collaborative care for the treatment of depression among patients with poorly controlled type 2 diabetes in 4 diabetes centers in India.

At I-TECH, Dr. Chwastiak is also the PI on a large global HRSA-funded grant to support capacity building for sustainable HIV services in Jamaica, Trinidad and Tobago, India, Mozambique, and Ukraine (U91HA06801). The goal of Capacity Building Program is to improve health outcomes for people living with HIV (PLHIV) along the HIV care continuum by building sustainable health systems. The program seeks to improve the efficiency and client-centeredness of HIV care systems by strengthening the operational and adaptive capacities of health institutions and the health workforce; expand the use of evidence-based methodologies and best practice approaches to improve health outcomes for PLHIV; increase the functionality and coverage of innovative technology platforms to improve HIV service delivery, public health communication, and data use for decision making; and strengthen equitable collaborations between country governments, implementing partners and communities to achieve and sustain epidemic control.

In addition to her work with I-TECH, Dr. Chwastiak is Associate Director of the UW Behavioral Research Center in HIV (BIRCH), an NIMH-funded developmental AIDS Research Center and directs the Center’s Integrated Care Research Core. She also is the PI and co-director of the SAMHSA-funded Northwest Mental Health Technology Transfer Center (Northwest-MHTTC), which provides training and technical assistance to support the behavioral health workforce of HHS Region 10 (AK, ID, OR and WA) to disseminate and implement evidence-based practices for mental disorders.

Nurses Complete Infectious Disease Specialization with CHARESS Support

Post categories: Haiti HIV Care and Treatment HIV Co-Infection Human Resources for Health Nancy Puttkammer Nursing/HCW Cadres
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This story was first reported in Vant Bèf Info.

With the support of the Haitian Center for Health System Strengthening (CHARESS), I-TECH’s primary partner in Haiti, 17 clinical nurses recently completed specialty training in infectious diseases.

The initiative, conducted in partnership with the U.S. Centers for Disease Control and Prevention (CDC) and the Faculty of Medicine and Pharmacy (FMP) of the Université d’État d’Haïti, aims to contribute to the strengthening of human resources in health, increasing the number of qualified clinicians in Haiti. The year-long training comprises theoretical and practical components; this cohort’s practica took place at seven different university hospitals and other health institutions around the country.

“Haiti faces a serious problem of shortage of human resources in health, due in part to the ‘brain drain’ abroad,” says Dr. Jean Guy Honoré, Executive Director of CHARESS. “In some health facilities located in remote parts of the country, there are no physicians, and patients are seen by nurses who sometimes have limited knowledge of the management of infectious pathologies. This training aims to improve the skills of these nurses.”

This aptly fits the vision of CHARESS, which is “to be the reference center, in terms of training, research and technical assistance, allowing populations to receive quality care, with humanity,” says Dr. Honoré. Two other cohorts of nurses have already started this specialized training.

Dr. Bernard Pierre, Dean of the FMP, expressed a wish to strengthen the collaboration between the FMP and CHARESS to extend similar specialized training to doctors — in particular, general practitioners.

I-TECH and its partners have been working in Haiti since 2006, delivering training, clinical mentoring, health information systems, and other health systems strengthening interventions.

I-TECH Helps to Improve Health Regulatory Systems and Training Programs in Cambodia

Post categories: Ann Downer Cambodia Health Policy Health Systems Strengthening HIV Care and Treatment Human Resources for Health Jeff Lane Leadership & Management Uncategorized
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Pictured are mannequins used at two regional training centers for nurses, midwives, and dental nurses in Kampong Cham and Battambang, Cambodia. I-TECH has supported the procurement of new mannequins to replace those that are old or broken, as well as new teaching tools that will expand the centers’ ability to conduct simulation training. Photo credit: Ann Downer/I-TECH.

The International Training and Education Center for Health (I-TECH) is working on a project led by FHI360, and funded by the U.S. Agency for International Development (USAID), to empower health care managers and national and provincial stakeholders to improve service quality, safety, and utilization, as well as strengthen overall health systems in Cambodia.

The project’s four objectives include:

  1. Improving policies, guidelines and standards for streamlined quality assurance.
  2. Increasing the efficiency and effectiveness of service delivery.
  3. Strengthening regulatory framework, implementation, and enforcement.
  4. Supporting pre-service public health training.

Given I-TECH’s deep experience in health workforce development, supporting the environments that enable strong health systems, and working with stakeholders at all levels, the team was a natural fit for Objectives 3 and 4.

In service of this critical work, I-TECH is supporting implementation of regulations among private and public health workers, as well as helping to lay the foundation for a sustainable accreditation program for public and private health facilities. I-TECH’s team also works with national stakeholders to develop the capacity of pre-service training institutions to deliver high-quality programs aligned with current evidence and national health priorities.

“We are excited to work with our partners to strengthen these critical components of quality health services in Cambodia,” said Jeff Lane, Principal Investigator and Assistant Professor in the Department of Global Health.

“By leveraging I-TECH’s broad experience in health policy, regulation, and workforce development,” he continued, “we can help Cambodia build an accreditation program to recognize high-performing hospitals, strengthen health professional councils to regulate health practitioners, and build sustainable pre-service training institutions that deliver competency-based education to train Cambodia’s health care workers of tomorrow.”

Laboratory Quality Stepwise Program in Cambodia

Post categories: Cambodia Clinical Mentoring Health Systems Strengthening Human Resources for Health Implementation Science Laboratory Systems Leadership & Management Lucy Perrone Quality Improvement
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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 laboratories improved their operations in the areas of: biosafety, organization, personnel, equipment maintenance, purchasing and inventory, testing accuracy, process management, documentation and communication.

The project recruited and trained four laboratory technician to be mentors, training staff from 12 referral hospital laboratories in quality management systems (QMS), and reinforcing skills acquisition through in-person mentoring. Participating laboratories reported a 36% increase in quality management, 29% improvement in data management, and 25% improvement in specimen collection and handling. The laboratories established the foundational practices of a QMS, and the LQSI program has improved the recognition of the laboratory within the hospitals.

Improving Laboratory Quality in Cambodia

Post categories: Cambodia Clinical Mentoring Health Systems Strengthening Human Resources for Health Laboratory Systems Leadership & Management Lucy Perrone Quality Improvement
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The I-TECH Cambodia Lab team. L to R: Sophanna Song, Cat Koehn , Siew Kim Ong, and Sophat Sek

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), and with funding provided by the Department of Defense and DTRA, I-TECH strengthens the Cambodian laboratory system through:

  • Implementation of an intensive mentoring program at 12 national and provincial public health laboratories;
  • Leadership and management capacity building of MoH laboratory leaders;
  • Mentoring and capacity building the National Animal Health and Production Research Institute (in collaboration with Washington State University);
  • Job specific training delivered in service and through educational programs such as the Quality Assurance Certificate Course (in collaboration with the University of British Columbia);
  • Support for laboratory workforce development through on-site technical assistance and training;
  • Support for national laboratory system policy development.

Advanced Disease and Patient Care/Cryptococcal Antigen Screening and Treatment in Tanzania

Post categories: Clinical Mentoring Differentiated Care Health Systems Strengthening HIV Care and Treatment HIV Co-Infection Human Resources for Health Tanzania
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High-quality, effective, and evidence-based service delivery for HIV care and prevention requires a broad continuum of integrated and linked services to ensure consistent and high-quality client management over time. With the World Health Organization’s (WHO) recommendation to “Treat All,” eligibility for antiretroviral therapy (ART) among People Living with HIV (PLHIV) is eliminated, and all populations and age groups are linked in one universal policy. This recommendation change erases the distinction between all groups. However, a substantial number of PLHIV still present late to care and have advanced disease, and require interventions that prioritize clinical packages to reduce mortality and morbidity and eventually enable them to become clinically stable [1].

Continue reading “Advanced Disease and Patient Care/Cryptococcal Antigen Screening and Treatment in Tanzania”

Nursing Efficiency and Task-Sharing in Tanzania

Post categories: Differentiated Care Health Policy Health Systems Strengthening Human Resources for Health Nursing/HCW Cadres Pamela Kohler Quality Improvement Tanzania
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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].

Continue reading “Nursing Efficiency and Task-Sharing in Tanzania”

Building the Capacity of the Health Workforce in India

Post categories: Ann Downer eLearning/Distance Learning Human Resources for Health India Leadership & Management
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I-TECH India PL has worked with stakeholders to develop national training curricula for health care staff on delivering HIV care and treatment services. In addition, it has:

  • Planned and implemented training programs for various cadres of clinical and program staff;
  • Participated in medical officer training programs at the national level;
  • Designed and conducted five regional continuing medical education (CME) courses in North, South, West and Northeastern regions on “Invigorating HIV Care” for ART center medical officers;
  • Designed and conducted four workshops in two weeks reaching 164 ART counselors for improving care support and treatment services provided to key population clients accessing ART centre services in Maharashtra;
  • Conducted National Distance Learning Seminars (webinars)—an average of 25 sessions per year on clinical- and program-related topics for the past five years reaching over 50% of ART Centers in India, with average participation of 1000 per session. These sessions are recorded and are available on YouTube channel “I-TECH India.”
  • Conducted Regional Distance Learning Seminars (webinars)—an average of 60 sessions per year through 15 HIV/AIDS Centres of Excellence in more than six languages during the last five years reaching over 50 % of ART Centers in India, with average participation of 50 per session; and
  • Coordinated certificate courses from UW on Leadership and Management in Health, Principles of STD (Sexually Transmitted Diseases) and HIV Research, Introduction to Epidemiology for Global Health, Clinical Management of HIV, and Fundamentals of Implementation Science for over 500 individuals during the past five years.

Caryl Feldacker

Caryl Feldacker, PhD, MPH, has over 20 years of international experience focused on ensuring quality public health programming and rigorous program monitoring and evaluation (M&E), including more than ten years conducting HIV-related implementation science research in sub-Saharan Africa. Dr. Feldacker is the co-principal investigator (PI) on the International Training and Education Center for Health (I-TECH) Integrated Voluntary Medical Male Circumcision (VMMC) program in Zimbabwe. Her current research focuses on digital health solutions to improve the quality of patient care while reducing provider workload and program costs. She is PI for four National Institutes for Health (NIH) studies using interactive, two-way texting (2wT) between patients and providers to improve patient retention in care, provide post-operative telehealth, and improve data quality in Malawi, Zimbabwe, and South Africa. For each initiative, she partners closely with ministries of health and local partners with the aim of helping strengthen monitoring and evaluation (M&E) and research capacity for sustained improvement. Her digital health interventions employ the open-source Community Health Toolkit in collaboration with Medic.

Her broad implementation and research experience includes exploring trends in adverse events in VMMC programs; closing HIV service delivery gaps; strengthening routine data quality for accurate and timely reporting; task-shifting of healthcare workers; understanding patterns in loss-to-follow-up within routine HIV program settings; strengthening integration of family planning into HIV-related care; and expanding electronic medical record systems to provide integrated patient care.

Her current collaborations include partnerships with Lighthouse Trust (Lilongwe, Malawi); Aurum Institute and The Centre for HIV-AIDS Prevention Studies – CHAPS (South Africa); and Zimbabwe Technical Assistance, Training and Education Centre for Health – Zim-TTECH (Harare, Zimbabwe).

Dr. Feldacker is an Associate Professor in the Department of Global Health in the School of Public Health at the University of Washington (UW). In addition to her work with I-TECH, Dr. Feldacker is affiliated with the UW Global Center for Integrated Health of Women, Adolescents, and Children (GlobalWACh) where she aims to translate 2wT-based advantages for the postpartum care context.

Program Highlights

Expanding Two-Way Texting for Voluntary Medical Male Circumcision Clients in South Africa

I-TECH, in close partnership with voluntary medical male circumcision (VMMC) implementing partner, the Aurum Institute and technology partner, Medic, is ...
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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 ...
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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 ...
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Increasing VMMC Delivery and Safety in Zimbabwe

Employing modern medical male circumcision within traditional settings may increase patient safety and further male circumcision scale up efforts in ...
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Achieving Targets through Performance-Based Financing in Zimbabwe

ZAZIC employs an innovative performance-based financing (PBF) system to speed progress towards ambitious voluntary medical male circumcision (VMMC) targets. The ...
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