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IDASH Fellowship Meets in Kazakhstan for In-Person, and Virtual, Workshop

IDASH fellows engage in group work during an October workshop in Almaty, Kazakhstan. Photo credit: Jamey Gentry/CDC.

Last month, the International Training and Education Center for Health (I-TECH), in collaboration with the U.S. Centers for Disease Control (CDC) and with support from the World Health Organization (WHO), facilitated the second of three in-person workshops for the Informatics and Data Science for Health (IDASH) fellowship.

Held in Almaty, Kazakhstan, the workshop marked the mid-point of the 12-month fellowship—and a chance for participants to come together to advance their ability to apply public health informatics and data science concepts and approaches.

“This workshop included a lot of hands-on practical exercises, and it was fun to observe how engaged the participants were with these activities and with the learning in general,” said Stacey Lissit, MPH, MS, Senior Technical Advisor for the IDASH program.

Content included all things data (quality, cleaning, analysis, visualization, governance, security, privacy, and confidentiality); interoperability; project management; business process analysis; and systems architecture. Sessions were a mix of didactic lecture, small group activities to practice application of skills and concepts, peer feedback, and guided hands-on learning in R and PowerBI. Over the course of the two weeks, participants collaborated  to develop a data dashboard, a database schema, and a data quality workplan.

The first cohort of the IDASH fellowship, with I-TECH instructors. Photo credit: Jamey Gentry/CDC.

The current fellowship, launched in April 2023, comprises a cohort of four participants each from Georgia, Kazakhstan, Kyrgyzstan, Ukraine, and Uzbekistan—a total of 20 fellows. Each four-person team includes a mix of mid-senior level epidemiologists, informaticians, data scientists, IT, and public health policy personnel.

Fellow Zhanibek Yerubayev, Director of Public Health Emergency Operations at the Kazakhstan Ministry of Health’s National Center of Public Health, says the team mix is an integral part of IDASH’s impact. “[IDASH] connects people from the public health side with people from the IT side,” he says. “These people have a lot of projects to do [together], but they are not always well connected, and they do not always understand each other well.”

“It was exciting to see the relationships and community that are being built through the IDASH Fellowship – both within the country teams where fellows can collaborate closely with colleagues outside of their typical ‘work silos,’ and across countries within the region,” said Lissit. “That peer learning element is such an important part of the fellowship.”

And all efforts were made to ensure multi-directional collaboration. The Ukrainian team did not receive permission to travel to the workshop, so I-TECH made arrangements for them to participate via Zoom. A location was identified in southwest Ukraine where the team could  attend the workshop together remotely, experience fewer daily safety issues related to the war, and avoid the distractions of being in their own workplace. A simultaneous translator for the Ukrainian language was provided on the Zoom call.

While remote participation is not ideal, the Ukraine team was able to attend and hear most of the workshop sessions and engage in the group work in meaningful ways. “A lot of effort went into setting up the technology that enabled this participation,” said Lissit. “At one point the Ukraine team was participating in a peer feedback activity with two country teams in Almaty—there were live cameramen, screen sharing, Zoom translators…and it worked mostly seamlessly!”

Fellow Durbek Aliyev, Deputy CEO at IT-Med LLC, which works under the Uzbekistan Ministry of Health, was especially appreciative of the chance to learn from a wide range experts across the region. “The digitalization of health care cannot be done by only one country itself,” said Aliyev. “The advantage of IDASH over other programs is that it brings [together] specialists from neighbor countries. We are talking to each other….We are learning from each other directly.”

And these relationships will be a lasting benefit of the program, he continued. “IDASH is a place where we can establish very good networking with other countries,” said Aliyev. “Any time I can contact them and learn from their expertise.”

IDASH is a project within the Integrated Next-Generation Surveillance in Global Health: Translation to Action (INSIGHT) program. In addition to acquiring new skills and knowledge in public health informatics and data science, IDASH country teams are developing and will implement a collaborative team project that demonstrates key competencies and is aligned with their country’s needs and priorities.

 

 

 

New I-TECH Publication Shows Effectiveness of Index Testing Program in Ukraine

Index testing is a is a key strategy to identify and support those most at risk of acquiring HIV.1 Within the index testing framework, exposed contacts (i.e., sexual partners, biological children and anyone with whom a needle was shared) of an HIV-positive person (i.e., index client), are elicited and offered HIV testing services.

From 2019 to 2021, the I-TECH team in Ukraine provided increased technical assistance for 39 state healthcare facilities in 11 high HIV-burden regions to advance assisted partner notification/services and index testing.

In a recently published study in BMJ Open, the I-TECH team—along with representatives from the Public Health Center at the Ukrainian Ministry of Health—describe the success of this scaled program in index testing.

“Index case testing is crucial in reaching out to exposed contacts of individuals living with HIV, notifying them, and offering HIV testing,” said Anna Shapoval, I-TECH Ukraine Country Representative. “This approach is particularly important and effective in the context of Ukrainian national HIV response where, despite numerous successes, we still struggle to close HIV testing gap and reach out to people living with HIV earlier rather than later with proper treatment and support.”

I-TECH developed exhaustive standard operating procedures for index testing; thoroughly trained healthcare teams on the index testing algorithm; as well as provided consistent and regular methodological support as part of its index testing program.

The study includes clients enrolled in index testing services in 2020, who had with both recent (<6 months) and previously established (≥6 months) HIV diagnoses. Ukraine’s physician-led model involves a cascade of steps including voluntary informed consent, partner elicitation, selection of partner notification method and follow-up with clients to ensure partners are notified, tested for HIV, and linked to HIV prevention and treatment services, as needed.

“Ukraine’s index testing services were rolled out as a standard part of Ukraine’s HIV service package at the targeted governmental health facilities, and carried out by existing physicians,” said Alyona Ihnatiuk, Strategic Information Lead for I-TECH Ukraine and lead author of the study. “At each supported facility, one or two staff members were designated as focal persons for case management and follow-up. This integrated, physician-led model was streamlined to target index cases with both recent and established HIV diagnosis, to arrive at a high number of new cases of HIV identified.”

There were 976 new cases of HIV identified through the study period, representing a yield of 19.3%, and 1,408 people living with HIV (PLHIV) have been identified throughout the two-year index testing program.

Of 14,525 index clients offered index testing, 51.9% accepted, of whom 98.3% named at least one sexual partner, injection partner, or biological child. Clients named 8,448 unique partners; HIV case finding was highest among clients with recent HIV diagnosis and among people who inject drugs (PWID), and lower among clients with established HIV diagnosis. More than 90% of all partners with new HIV diagnoses were linked to care.

“The BMJ Open study confirms that comprehensive assisted partner notification services and index testing are highly effective in identifying people living with HIV,” says Ms. Shapoval, “as well as tracing previously diagnosed partners and supporting their linkage to care. I-TECH was honored to contribute to the design and implementation of this vital intervention in Ukraine early on and see it gradually rolled out across the country with multiple partners successfully implementing it now.”

  1. Golden M, et al. Partner notification for sexually transmitted infections including HIV infection: an evidence-based assessment. Sexually transmitted diseases. 4th edn. McGraw-Hill; New York, NY: 2007.

THIS PROJECT IS SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) UNDER U91HA06801, THE INTERNATIONAL AIDS EDUCATION AND TRAINING CENTER (IAETC). THE CONTENT OF THIS POST IS THE AUTHOR’S AND SHOULD NOT BE CONSTRUED AS THE OFFICIAL POSITION OR POLICY OF, NOR SHOULD ANY ENDORSEMENTS BE INFERRED BY HRSA, HHS OR THE U.S. GOVERNMENT.

Zim-TTECH’s Innovative Programs Increase Male Circumcision Uptake for HIV Prevention

Voluntary medical male circumcision (VMMC) decreases the risk of female-to-male HIV transmission by about 60%.[1]  I-TECH Network partner the Zimbabwe Technical Assistance, Training, and Education Center for Health (Zim-TTECH) supports innovative VMMC engagement solutions that are tailored to the populations they serve.

Caravans Allow for Mobile Services and Door-to-Door Outreach

VMMC Mobilizers engage with men at a farm compound in Goromonzi District. Photo credit: Zim-TTECH

Makumbe Hospital in Goromonzi District, Zimbabwe, serves a population of more than 100,000 people, including the rapidly expanding population of surrounding townships. Zim-TTECH-led consortium ZAZIC has run the Makumbe Hospital site since October 2018 and supports the VMMC team there.

This population within the hospital’s catchment area primarily comprises informal traders selling necessities such as groceries, garden produce, or second-hand clothes, while others run at-home small businesses that manufacture furniture, iron and steel products, and other wares.

“It’s difficult for economically active young men to leave their businesses and attend to VMMC at a venue away from their premises or market,” said Lewis Masimba, VMMC Program Manager at Zim-TTECH.

In light of this challenge, the team implemented a mobile caravan, which could increase the number of men receiving circumcisions by taking services out of the medical facility and bringing them closer to the concentrated settlements of Domboshava Showground, Mungate, and Mverechena townships and nearby farm compounds.

The caravan has been in use in the district since January 2023, and it has vastly shortening the period between client engagement and service delivery. In most cases, two mobilizers at a time will engage with potential clients within the townships, while another three will conduct intensive door-to-door visits in residential areas.

Mobilization efforts include one-on-one and small group discussions at market stalls, small businesses, and drinking spots, where mobilizers will answer questions and distribute information about VMMC. Sometimes the caravan is supported by a roadshow van and dancers who disseminate VMMC information through edutainment.

“The caravans have so many advantages,” said Mr. Masimba. “Men are able to access the VMMC services near their workplaces, minimizing disruptions to their daily routines. The caravan has also brought convenience and privacy to those who did not feel comfortable being ferried in program vehicles to and from the hospital.”

Fig 1: Outputs three months before receiving the caravan and three months after receiving the caravan

Since the site started utilizing the caravan, the number of men who have received VMMC each month has increased from 159 to 233 (Fig. 1).

On the heels of this success, the ZAZIC teams will continue exploring other combination approaches involving engagement activities such as pool/snooker, soccer, and music roadshows to reach hard-to-convince men in their localities.

Peer-to-Peer Learning Takes Center Stage in Performing Arts Program for Adolescents

Eight secondary schools enrolled in the drama competition. Photo credit: Zim-TTECH

The performing arts have been used since time immemorial as motivators to rally communities toward common goals, to relieve stress, and as an effective teaching tool across diverse cultures and religious settings. They are a particularly effective method for engaging adolescents both in and out of schools. As teens seek independence from their parents, the influence of peers becomes increasingly important, and performing arts are a fantastic way to employ peer-to-peer learning strategies.

Harnessing these strategies, ZAZIC uses drama in several districts to complement efforts already made by VMMC teams and teachers who have previously used sporting events and lectures to communicate with students.

In a particularly successful case, Hurungwe District chose to use a drama competition to communicate VMMC and other health messages to adolescents. The goals of the competition included effective peer-to-peer learning, outreach to a large audience, and the demystification of VMMC.

Roadshows to promote the competition were held at major townships to create awareness of the event and invite members of the public to attend. Eight secondary schools enrolled in the competition, and teams of adolescents led the process of writing and directing short, 30-minute performances incorporating messages in a provided guide.

The guide emphasized use of appropriate language, the need to double-check facts; and encouragement of uptake of VMMC and related services, such as HIV testing and counseling and cervical cancer screening.

More than 1,000 people attended, including students, parents, and staff from all competing schools.

“Matawu Secondary School ultimately won the drama competition, but all of the schools did a wonderful job explaining VMMC and its benefits,” said Mr. Masimba. “Messaging also emphasized abstinence for adolescents, the importance of the HPV vaccine for girls, and details about the VMMC procedure. The level of accuracy of information was extremely high.”

Importantly, two of the performances highlighted communities that reject medical interventions and stressed the need for participation by all.

A total of 182 VMMCs were attained by adolescents aged 15 to 19 years old immediately after the competition. Those who were not ready were booked for the procedure and will be followed up with by school health masters and community mobilizers.

[1] https://www.cdc.gov/mmwr/volumes/72/wr/mm7210a2.htm

 

 

 

I-TECH Says Goodbye to Dr. Pamela Collins, Welcomes New Co-Directors

Dr. Pamela Collins

On May 26, the International Training and Education Center for Health (I-TECH) bids a fond farewell to its Executive Director, Pamela Collins, MD, MPH. Dr. Collins joined I-TECH in July 2020, seeing the center through the height of the COVID-19 pandemic; a new brand; continued localization of I-TECH offices to independent organizations; and a strategic shift toward an increased focus on mental health, digital health, and One Health programming.

She also spearheaded the formation of the I-TECH Humanitarian Fund, a mechanism to support our colleagues’ critical work in Ukraine after the Russian invasion.

“I am privileged to have worked with this talented and compassionate group of colleagues from around the world for the past 3 years,” said Dr. Collins. “As I entered I-TECH, I discovered a network ready manage the demands of health care delivery during the COVID-19 pandemic and one whose capabilities are aligned with contemporary public health priorities—from workforce development, emerging infectious diseases, digital health, to mental health. While I am sad to leave this community, I am extremely excited for I-TECH’s future.”  

While Friday was Dr. Collins’ last day leading I-TECH, she will remain through June as a faculty member in the University of Washington (UW) Departments of Global Health and Psychiatry & Behavioral Sciences. Dr. Collins will then transition to her new role as the Bloomberg Centennial Chair of the Department of Mental Health at Johns Hopkins University’s Bloomberg School of Public Health—the only school of public health in the country with a department dedicated to mental health. 

In her 5 years at the UW, Dr. Collins has also served as the Director of the UW Consortium for Global Mental Health and associate director of the UW Behavioral Research Center for HIV (UW BIRCH). 

Dr. Collins will be succeeded in leadership at I-TECH by Ivonne Ximena “Chichi” Butler, MPH, and Pam Kohler, PhD, MPH, BSN. Ms. Butler and Dr. Kohler will serve as interim co-directors of the center, with Ms. Butler overseeing business and administration and Dr. Kohler leading science and assuming a technical advisor role for faculty and staff. The co-directors will work together to represent and pursue collaborations and partnerships within and outside the UW; engage stakeholders to invest in I-TECH; and liaise with country leadership, principal investigators, and staff on program implementation. 

Dr. Kohler brings experience as co-director of the UW Center for Global Health Nursing and has been a faculty member with I-TECH for 11 years. In that time, she has led a field epidemiology training program in Tanzania and evaluated STD/HIV treatment and prevention programs and policies in Eastern and Southern Africa. Her research is focused on de-stigmatizing adolescent HIV prevention and treatment service delivery.  

“I’m excited about this new leadership structure, which emphasizes and acknowledges both the role of nurses in global health and the profound administrative efforts it takes to lead an organization of this size,” said Dr. Kohler. “I look forward to getting to know our many teams and projects on a deeper level over the coming year.” 

Ms. Butler’s 17 years at I-TECH have seen her in various leadership, program management, and technical roles, supporting multiple countries and a diverse project portfolio from health systems strengthening to prevention and clinical treatment programs. She was most recently Associate Center Director.  

“I will miss Pamela’s insightful, thoughtful, and inclusive leadership,” said Ms. Butler. “She was the right person to lead us through a uniquely challenging time. Moving forward, I am motivated to broaden our reach beyond HIV and AIDS care and delivery and intentionally put individuals and communities at the center of the care they receive. There is much to learn, and the I-TECH network is well-positioned to do this with the expertise and care that our global teams and partners bring.” 

I-TECH Establishes External Advisory Board

In August 2022, the International Training and Education Center for Health (I-TECH) named the first members of an external advisory board (EAB). With decades of combined experience in infectious diseases, non-communicable diseases, mental health, global development, strategy, and public health policy, the members of I-TECH’s EAB will help drive and support I-TECH’s future strategy and direction.

“We are excited to have such an experienced group of public health professionals on our advisory board,” says Dr. Pamela Collins, I-TECH Executive Director. “I anticipate that our Board will grow over time, and we look forward to welcoming the insights and unique perspectives of these members as we move into I-TECH’s next 20 years.”

The EAB’s current members include:

  • Amie Bishop, MSW, MPH, is a Senior Research Advisor for OutRight Action International and has worked for a range of international non-governmental organizations and agencies, including DAI, FHI360, the Fred Hutchinson Cancer Research Center, the Bill and Melinda Gates Foundation, I-TECH, PATH, UNDP, UNICEF, and USAID.
  • Gabrielle Fitzgerald, MA, is the CEO & Founder of the Panorama Group and co-founder of the Pandemic Action Network. With decades of experience in politics, policy, and philanthropy, Gabrielle has become a recognized voice and thought leader on catalytic philanthropy, women’s leadership, and pandemic preparedness and response.
  • Patricio V. Marquez, ScM, is a consultant with World Bank Group and a Senior Associate at Johns Hopkins University Bloomberg School of Public Health. He has over 30 years of experience working in over 80 countries around the world.

For full bios, please see I-TECH’s External Advisory Board page.

Honoring Lives Lost in Buffalo with a Call to Action

The most recent racist mass shooting in Buffalo has left yet another huge hole in the fabric of our country. We honor the memory of the ten people who lost their lives in an act of white supremist terrorism and hope for the healing of not only those wounded but also those who loved the victims, the communities that will suffer for their loss, and the national and global community that bears witness. Please remember to care for yourself during this continually challenging time.

We hold in our hearts the lives, love, and humanity connected with the names that follow—as well as countless people in the Black community who continue to be re-injured by these acts of horrific violence.

The victims:

Roberta A. Drury, 32

Margus D. Morrison, 52

Andre Mackneil, 53

Aaron Salter Jr., 55

Geraldine Talley, 62

Celestine Chaney, 65

Heyward Patterson, 67

Katherine Massey, 72

Pearl Young, 77

Ruth Whitfield, 86

Zaire Goodman, 20, was released from hospital after being shot in the neck; Jennifer Warrington, 50, has also been treated; and Christopher Braden, 55, is in stable condition after being shot in the leg.

According to reports, the gunman was motivated by the so-called “Great Replacement theory,” the racist conspiracy theory that populations with white European backgrounds are being “replaced” by people of non-White, non-European descent. We must do more to combat this type of dangerous rhetoric and ongoing anti-Black violence in our communities. It is up to each of us to redress past and present injustices, find ways to meaningfully engage in work to reduce racism, and collectively contribute to safer communities and workplaces for Black people. Please see the resources below for immediate ways to take action.

Resources:

UW President Ana Mari Cauce’s statement: https://www.washington.edu/president/2022/05/16/we-can-all-play-a-part-in-working-to-end-racist-violence/

Democracy Now! (For independent, up-to-date information and interviews): https://www.democracynow.org/topics/racism

Verified fundraisers for the victims’ families and those affected by the shooting: https://www.gofundme.com/c/act/buffalo-mass-shooting-fundraisers

Feed Buffalo (all donations will be used to serve the communities affected by the shooting): https://www.feedbuffalo.org/

Racist Terrorism in Buffalo: How the Mainstreaming of White Supremacy Puts the Nation at Risk. Thursday, May 19, 1-2 PM PT. In this presentation, anti-racist educator Tim Wise examines how overt racism has increasingly penetrated American political discourse and has contributed to terrorist violence, most recently in Buffalo, Pittsburgh, Charlottesville, El Paso and Charleston. Hosted by SpeakOut: The Institute for Democratic Education and Culture. Register here ($5-250 donation; proceeds go to Black Love Resists in the Rust).

Reading about and watching the coverage of these events can also be extremely painful. Please take care of yourselves. Please find wellness and mental health information at Mental Health America.

In community,

The I-TECH DEI team

I-TECH Remembers Dr. Paul Farmer

Dr. Paul Farmer and Dr. Rachel Chapman during a discussion with UW students reflecting on equity, race, and global health.
Dr. Paul Farmer and Dr. Rachel Chapman during a discussion with UW students on equity, race, and global health. Photo by Maryska Valentine // Courtesy of UW DGH.

The International Training and Education Center for Health (I-TECH) and its partner network were saddened to learn about the unexpected passing of Dr. Paul Farmer. He was not only a leader in the field of global health, but an inspiration to those who knew him and an advocate for social justice. His work shaped the practices of global health and touched countless lives around the world.

As a co-founder of Partners in Health (PIH), a global health and social justice organization dedicated to strengthening health systems and providing access to high-quality healthcare, Dr. Farmer worked to reduce health inequities and provide care to those most in need. He is remembered for his compassion in his humanitarian work and dedication to the PIH mission.

“I am grateful to have known Paul, and like countless others, I benefitted from his kindness, intellect, and zeal,” says Dr. Pamela Collins, I-TECH Executive Director. “This is a devastating loss for the community, but I know that his work will live on as each of us works for compassionate, equitable, and quality health care wherever we may be.”

Dr. Farmer was an inspiration to the global health community. His legacy will continue through the work of PIH and the lives he touched around the world. We thank Dr. Farmer for his life of service and dedication to global health. He will be deeply missed.

To learn more about the impact Dr. Farmer’s work, see these tributes from PIH, NPR, and New York Times.

Kayla Cody-Lushozi Reflects on I-TECH’S Global Health Leadership Development Program

Kayla Cody-Lushozi

By Chelsea Elkins

For the past 10 months, Kayla Cody-Lushozi has served as the inaugural Global Health Program Officer for I-TECH’S Global Health Leadership Development Program. The aim of this program is to support the development of skills in global health program implementation, management, and leadership for recent master’s degree graduates with diverse backgrounds who are transitioning into the public health field.

This program is structured to directly support the programmatic needs of multiple I-TECH projects while providing the Program Officer with mentorship across the I-TECH network and supporting the transition into a non-temporary global health position. In 2019, Cody-Lushozi received her Master’s in Social Work (MSW) from the University of Washington (UW) and has used this background, along with her unique experiences and expertise, to inform her work at I-TECH.

During her time as a Program Officer, Cody-Lushozi has worked with three teams across the I-TECH network, plunging into a few of the many areas of work I-TECH implements and supports. In collaboration with partners from FHI 360 and leaders from the Cambodian Ministry of Health, Cody-Lushozi supported a health informatics program, working to streamline databases and strengthen health systems in Cambodia. Additionally, she explored how to revive Community Advisory Boards for people living with HIV (PLHIV) in Jamaica in a sustainable and community-centered way with I-TECH network partner the Caribbean Training and Education Center for Health (C-TECH). She worked with community partners in Zimbabwe, as well, exploring the support systems in place for case managers supporting young PLHIV. This work was done with I-TECH partner the Zimbabwe Technical Assistance, Training and Education Center for Health (Zim-TTECH).

September marks the end of Cody-Lushozi’s time with I-TECH. Below, she shares some reflections on her time in the Leadership Development Program, as well as what might come next.

What has the experience of being a Program Officer at I-TECH meant to you?

This has been an incredible experience, and it came at a perfect time. Right before I-TECH, I was working at the Washington State Department of Social and Health Services doing direct service social work with economically marginalized clients with mental and physical health needs. While I enjoyed this role and understood its importance, this was not the type of social work practice that I wanted to pursue in the long run.

My passion and interests lie in research, especially community-centered research that allows me to work directly with Black communities in improving access to health justice. I-TECH came along at the right time and allowed me to dive deeper into the world of global health implementation.

The projects I’ve done at I-TECH have been really varied, and I’ve gotten an inside look and experience across different areas. I am constantly learning at I-TECH. I-TECH does a million things, which might have been overwhelming to a new person entering the organization, but I always felt very supported by my teams. They made it clear that I didn’t need to have all the answers.

I also appreciate that this program aims to attract a diversity of experience, background, and perspective. It encourages more than just a singular lens. I’ve been able to share my unique background and experiences as a Black woman social worker in global health. I’m excited to see where this program goes and how it continues to support I-TECH’s evolution.

This has been a beautiful experience for me. Working at I-TECH served as a great affirmation that this is the area of work that I want to continue to grow in.

How has your background in social work shaped how you’ve entered the global health field?

Before getting my MSW I already had an interest in public health, even before I was calling what I was doing public health. I wanted to use the framework and the lens that social work provides within a public health setting. I always gravitate toward work that is community-centered and centers the voices and expertise of those in the margins. These are some of the values that I bring with me into the global health space and that I hold very close to my professional and personal practice.

These values have helped me in this field because public and global health work is not always operating from the pillars of anti-oppressive practice. There’s so much historical and contemporary discourse that needs to be addressed and often isn’t in this field. You can’t be ahistorical if you’re truly trying to get to the root causes of global health inequity and injustice. Many of the issues that we see in global health are connected to issues of global white supremacy, imperialism, and resource extraction. It’s a tension that I hold in this field but something I try to do my part to shed light on.

You have done a lot of meaningful work during your time with I-TECH. What does your life look like when you’re not working?

I’ve gone through a lot of life changes these past 10 months. I’m a newlywed; I got married in June to my now husband Mawande. Being a new wife is really exciting.

A big chunk of my husband’s and my time outside of work is dedicated to our small homemade skincare business, K+M Homemade Skincare, that we officially launched during COVID. We do a lot of farmer’s markets and pop-ups on the weekends. Ask anyone and they can tell you that we love making and talking about our skincare.

In what direction do you see yourself moving after I-TECH?

After I-TECH, I see myself continuing to engage in global and public health spaces that are truly committed to community work and radical racial and social justice transformation. I am not comfortable doing this work in the absence of working directly with community members and local stakeholders. Top-down approaches have colonial and imperialist roots. I believe in doing “with” and not doing “to” and actively partnering with communities for long-term sustainability and quality health care reform.

I will be packing up and moving to South Africa in 2022 and am currently open to a position that will allow me to continue to practice in this exciting field. My interests lie in research, project management, and implementation work related to HIV care and treatment, maternal and child health, and mental health. I am also contemplating pursuing an MPH or a PhD in global health and implementation science sometime in the future. It’s been an incredible past 10 months with I-TECH and I am excited to stay in contact with this global network. I thank everyone who has been part of this journey with me!

The I-TECH network thanks Kayla Cody-Lushozi for her work and wishes her well as she continues to forge her path in global health!

If you are interested in participating in the Global Health Leadership Development Program, more information is available here.

Despite COVID-19 Challenges, I-TECH Supports Progress Toward Cervical Cancer Elimination

The World Health Organization (WHO) Global Strategy to Accelerate the Elimination of Cervical Cancer, launched in November 2020, calls for a world where cervical cancer—which kills more than 300,000 women per year—is eliminated. To achieve this, the strategy proposes ambitious 90-70-90 targets over the next decade.

However, the COVID-19 pandemic has severely hindered critical work on cervical cancer interventions, including reduced clinic flow, training opportunities, and outreach.

Due to agile programs and dedicated staff, several teams within the International Training and Education Center for Health (I-TECH) network, despite the challenges presented by COVID-19, have continued to make strides toward the WHO cervical cancer elimination goal.

Record-breaking cervical cancer screening in Namibia

The I-TECH Namibia program focuses on cervical cancer screening services for women living with HIV (WLHIV). Namibia’s national antiretroviral therapy (ART) program has rapidly adjusted to COVID-19 and the need to decongest public health facilities through multi-month dispensing (MMD) of ART. While this has helped with ART access, it has significantly reduced opportunities for performing facility-based services, since the frequency of health facility visits by women on ART has declined rapidly.

In close collaboration with the Namibia Ministry of Health and Social Services (MoHSS), I-TECH is implementing enhanced facility-based screening campaigns to increase access and rapidly reach more women. For these enhanced screenings, clients within a district are mobilized and given paced appointment times at several facilities in-line with COVID-19 restrictions. Service providers are then assigned to the specific sites where they provide screening services.

From 8-12 February, 805 women were screened through visual inspection with acetic acid (VIA) or Pap smear, 95% of whom were women living with HIV (WLHIV). Of the 137 women screened VIA positive, 98% received treatment. This campaign broke national records by achieving the highest recorded number of women screened in a 5-day campaign, as well as the highest number of women screened in a single day (210).

“As the COVID 19 pandemic rages on, and preventative restrictions limit client screening, the downtime should be used in planning for catch-up screening activities,” says Dr. Laura Muzingwani, I-TECH’s Cervical Cancer Lead Physician in Namibia. “Resource and client mobilization are both key to prepare for any window of opportunity when COVID restrictions are relaxed to enable rapid mass screening.”

Mentoring and training continues in Mozambique via videoconferencing technology

In close collaboration with the Ministry of Health (MOH) and the University of Texas MD Anderson Cancer Center—a Project ECHO® “superhub” for oncology—I-TECH has continued its monthly cervical cancer ECHO sessions in Mozambique, with an additional focus on COVID-19 safety and risk reduction. An average of 40 participants attend each session, and topics have included cervical changes in older women; relevance of normal and abnormal colposcopic findings; and hygiene, disinfection, and asepsis of materials.

“Although the emergence of the COVID-19 pandemic was sudden, it was possible to adapt quickly using remote information and communication technologies,” says Dr. Ernestina David, Program Manager for the I-TECH Cervical Cancer Prevention Program. “The ECHO videoconference sessions made it possible to bring together providers across the country to address uterine cancer and diagnose and treat pre-cancerous lesions, using local cases and looking for ways to approach and treat them.”

In addition, the Mozambique team has continued its regional cervical cancer trainings in a blended format (both virtual and in-person components). I-TECH has implemented three trainings using a model spearheaded by MD Anderson, wherein a two-day LEEP and colposcopy training was adjusted so that trainers could join via Zoom in lieu of traveling to Mozambique.

While some participants join only the Zoom sessions, others are able to watch the sessions from a classroom setting and then work through skills-building demo stations, followed by practice on patients at a provincial hospital.

Access to services increase through health communication in Malawi

Despite the Malawi government indicating cervical cancer screening, care, and treatment as priority services, after the COVID-19 pandemic hit the country, most facilities did not include cervical cancer services on their priority lists. Facilities either completely suspended or heavily reduced screening and treatment. This, coupled with fears among targeted women about contracting COVID-19, marginalized access to services.

To combat these challenges, I-TECH delivered health talks within communities on how women can protect themselves as they access services (social distancing, hand washing, use of face masks, etc.). Those reached were encouraged to pass on information to others.

I-TECH also engaged district health officers and those in charge of affected facilities on the need to continue providing cervical cancer services, in line with MOH COVID-19 prevention guidelines. Presenters emphasized the burden of cervical cancer and how it would worsen should services be interrupted for the entirety of the pandemic. Discussion also touched on including cervical cancer providers on the rotation roster and ensuring that commodities were available.

In Malawi, 391 health facilities are currently providing cervical cancer screening services, and 80% of those health facilities are also providing treatment services. More than a quarter of a million women were screened between January 2020 and June 2021, 57% of whom were WLHIV.

Zimbabwe consortium takes measures to blunt the impact of COVID-19

I-TECH and its network partner the Zimbabwe Training, Technical Assistance and Education Center for Health (Zim-TTECH) implement cervical cancer screening and treatment via the local Zimbabwean consortium ZimPAAC.

By March 2021, ZimPAAC had achieved 53% of the annual target for the number of women on ART screened for cervical cancer. ZimPAAC implemented several measures to mitigate the impact of COVID-19 on continuity of cervical cancer screening services, including:

  • Training of all health care workers on COVID-19 safety and security, transmission, and prevention;
  • Support to ensure infection prevention and control (IPC) and triage at health facilities through training, procurement and distribution of personal protective equipment (PPE), hand washing stations/commodities, face masks for both staff and clients in need; and
  • Procurement and distribution adequate PPE for use by health care workers at facilities.