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I-TECH

Category: Human Resources for Health

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.

Continue reading “Improving HIV Care for Key Populations in the Caribbean”

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

HIV Recency Surveillance in Malawi
The International Training and Education Center for Health (I-TECH), in collaboration with the Malawian Ministry of Health (MOH) and the Centers for Disease Control and Prevention, began implementing recent HIV infection surveillance in April 2019. The project aims to establish a surveillance system among persons newly diagnosed with HIV infection ...
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National COVID-19 Emergency Response in Malawi
In collaboration with the Malawi Ministry of Health (MOH) and Centers for the Disease Control and Prevention (CDC), I-TECH has supported the national COVID-19 response in Malawi since March 2020. Technical assistance has focused on laboratory capacity, supporting quality COVID-19 surveillance and data management, and implementing a COVID-19 population-based survey ...
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Pre-Exposure Prophylaxis for HIV Prevention in Namibia
I-TECH began supporting the implementation of pre-exposure prophylaxis (PrEP) as part of Namibia’s combination HIV prevention strategy in 2017 ...
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Site-level Data Improvement and Use in Namibia
I-TECH continues to focus efforts on the improvement of data quality and use of data to improve clinical decision making. I-TECH works at the site level to build awareness and buy-in for data quality and use among site-level management and health care workers. On-site I-TECH Monitoring and Evaluation (M&E) Officers ...
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Pamela Kohler

Pamela Kohler, PhD, MPH, BSN, co-directs I-TECH and holds a joint appointment in Child, Family, and Population Health Nursing, and the Department of Global Health. At I-TECH, Dr. Kohler led the Tanzania Intermediate Field Epidemiology Training Program (FETP) and currently leads the evaluation and continuous quality improvement activities of the Afya Hatua Project under Tanzania Health Promotion Support. She has led multiple evaluations of programs and policies throughout Eastern and Southern Africa, including HIV differentiated care, cervical cancer screening and treatment, and cryptococcol meningitis services.

Dr. Kohler’s research involves development and testing of health services interventions to improve engagement in HIV care. She led two trials using standardized patient actors to destigmatize HIV prevention and treatment services for adolescents in Kenya and currently leads a stepped care intervention, assigning intensity of services to those with highest need, in Western Kenya. Dr. Kohler completed her nursing training at Johns Hopkins University, and worked clinically in HIV care and Emergency Departments. She holds a PhD in Nursing and an MPH in Health Services from the University of Washington.

Publications

McConnico C, Jed SL, Marumo E, Mazibuko S, Mema GM, DeKadt J, Holmes K, Kohler PK. Systems Mapping of Sexually Transmitted Infection Services at Three Clinical Sentinel Surveillance Sites in South Africa: Opportunities for Integrated Care. J Assoc Nurses AIDS Care. 2017 Jan-Feb. pii: S1055-3290(16)30121-2. doi: 10.1016/j.jana.2016.09.004.

Kohler PK, Marumo E, Jed SL, Mema G, Galagan S, Tapia K, Pillay E, DeKadt J, Naidoo E, Dombrowski JC, Holmes KK. A national evaluation using standardised patient actors to assess STI services in public sector clinical sentinel surveillance facilities in South Africa. Sex Transm Infect. 2017 Jan 27. pii: sextrans-2016-052930. doi: 10.1136/sextrans-2016-052930.

Kohler PK, Tippett Barr BA, Kangʼombe A, Hofstee C, Kilembe F, Galagan S, Chilongozi D, Namate D, Machaya M, Kabwere K, Mwale M, Msunguma W, Reed J, Chimbwandira F. Safety, Feasibility, and Acceptability of the PrePex Device for Adult Male Circumcision in Malawi. J Acquir Immune Defic Syndr. 2016 Jun 1;72 Suppl 1:S49-55. doi: 10.1097/QAI.0000000000000774.

Kohler PK, Namate D, Barnhart S, Chimbwandira F, Tippet-Barr BA, Perdue T, Chilongozi DA, Tenthani L, Phiri O, Msungama W, Holmes KK, Krieger JN. Classification and rates of adverse events in a Malawi male circumcision program: impact of quality improvement training. BMC Health Serv Res. 2016 Feb 17;16(1):61. doi: 10.1186/s12913-016-1305-x.

Program Highlights

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Peter Rabinowitz

Peter Rabinowitz, MD, MPH, directs the Center for One Health Research and has multiple faculty appointments including Professor, Global Health, at UW. The “One Health” center explores linkages between human, animal, and environmental health. Dr. Rabinowitz has expertise in zoonotic infectious disease; diseases of animal workers; microbiome sharing between humans and animals; emerging infectious disease; antimicrobial resistance animal sentinels of environmental health hazards; and noise and hearing loss.

Dr. Rabinowitz also directs the Canary Database, an online resource for evidence about animals as sentinels of environmental health threats from both toxic and infectious hazards. He was a visiting scientist at the Global Influenza Program of the WHO, and also in the Animal Health Division of the U.N. Food and Agriculture Organization (FAO). He completed a Family Medicine residency through the University of California San Francisco, and completed fellowships in General Preventive Medicine and Occupational and Environmental Medicine at the Yale School of Medicine.

Program Highlights

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Field Epidemiology Training Program in Malawi

Post categories: Gabrielle O'Malley Human Resources for Health Malawi Surveillance
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The Frontline Field Epidemiology Training Program (Frontline FETP) enhances the capacity of HIV and AIDS surveillance and strengthens health systems. The program contributes to a sustainable response to HIV by training health professionals in basic field epidemiology that can support responsiveness to HIV surveillance needs.  Continue reading “Field Epidemiology Training Program in Malawi”

Human Resources for Health in Mozambique

Post categories: Ann Downer Clinical Mentoring HIV and STI Prevention Human Resources for Health Mozambique
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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 is now standardized so that students at all health training institutes (HTIs) are taught using the same material and methods. Continue reading “Human Resources for Health in Mozambique”

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.