I-TECH supports a variety of activities aimed at improving HIV care and treatment in the Caribbean region, such as on-site clinical mentoring, development of training curricula, and providing clinical support materials to improve care and treatment for HIV/AIDS in the Caribbean region.
Continue reading “Improving HIV Care and Treatment across the Caribbean”
Category: Quality Improvement
Continuous Quality Improvement Collaborative in the Caribbean
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
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
Case Finding and Retention in Care in Mozambique
I-TECH works with the Mozambique Ministry of Health (MISAU) to expand a pilot project to provide an assisted partner services intervention. The project is aimed at encouraging patients newly diagnosed with HIV infection to disclose their status to their partners, and bring them to the clinic for testing. Continue reading “Case Finding and Retention in Care in Mozambique”
Quality Improvement (QI) of HIV Care and Treatment, and Expanded Clinical Mentoring in Mozambique
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.
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 and Program Assistants monitor completeness and accuracy of service delivery documentation from the point of patient encounter to the point of final data capture in Ministry of Health and Social Services electronic databases. M&E Officers promote the use of data by clinicians and facility management for systems improvement and performance enhancement.
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 support expanded to include direct service delivery in the Oshana and Zambezi regions, as well as Karas region from 2017 onward. Since 2016, I-TECH has also supported demand creation with a network of community-based mobilizers and recruiters using a human-centered design approach to actively engage communities and stakeholders to increase the number of men voluntarily electing medical circumcision. The program has performed over 36,000 VMMCs in Namibia.
I-TECH has trained physicians, nurses, and community counselors to ensure that adequate skills and experience are in place to deliver safe, high-quality male circumcision services.
Strengthening the HIV Care Continuum and ART Adherence in Namibia
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.
Quality Improvement in Ukraine
I-TECH applied the Clinical Assessment for Systems Strengthening (ClASS) methodology and tools to assess over 30 regional and local HIV care sites and facilities since 2014.