Category Archives: Human Resources for Health

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

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

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

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

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].

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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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Building the Capacity of the Health Workforce in India

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.

Health Worker Capacity Development in South Africa

I-TECH will support Human Resource and Primary Healthcare Directorate-led training and capacity development initiatives through training and mentoring activities based on gaps identified from assessment of health care worker competencies, with emphasis placed on the Professional Nurse.

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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. Continue reading »