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I-TECH Ukraine Team Partners with Shelter for Women and Girls

Post categories: Gender/Women & Girls Pamela Collins Ukraine
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Thanks to new generators, the Rehabilitation Shelter had electricity, heat, and Internet connection during massive shelling in Ukraine in fall and winter 2022-2023.

In February 2022, at the advent of the war in Ukraine, the International Training and Education Center for Health (I-TECH) launched the I-TECH Humanitarian Fund to support the work of our team in Ukraine. Many team members remain displaced, away from their homes, and isolated from their families and friends. However, their tireless work continues provide uninterrupted access and services to Ukrainians living with HIV, who are more in need of care and refuge than ever.

Supported by generous donations to the I-TECH Humanitarian Fund, I-TECH Ukraine has been able to advance the work of Eleos-Ukraine, a network of like-minded people and organizations that develop social services through 13 regional offices throughout Ukraine. The common goal of Eleos-Ukraine partners is to feed, clothe, and protect 1 million people in need.

“The compassion and solidarity of our American colleagues and friends with Ukraine and Ukrainians, including those expressed through generous donations to the I-TECH’s Humanitarian Fund just in the first few weeks of the full-scale war, are overwhelmingly moving,” said Anna Shapoval, I-TECH’s Country Representative in Ukraine. “We are eternally grateful.”

To date, the I-TECH Humanitarian Fund has been directed to Eleos’ critical work on behalf of Ukrainian women and girls subjected to sexual violence and other trauma (e.g., incarceration and torture) by the Russian army, notably the development and establishment of the Rehabilitation Shelter in August 2022.

Money from the fund has gone directly to outfitting the shelter with video surveillance, fire alarms, and powerful generators. Thanks to the generators, the shelter had electricity, heat, and internet connection during massive shelling by the Russian Federation in fall and winter 2022-2023.

“We appreciate your cooperation and thank you for helping the citizens of Ukraine during the war,” wrote Eleos-Ukraine Board Chair Serhii Dmytriyev, in a thank you letter to I-TECH Humanitarian Fund donors. “Our joint humanitarian project will help women not just today, at this time of crisis; it will also be important in reducing the consequences of war – which makes it an important contribution to the future of Ukraine!”

Since the shelter opened, more than 150 women from Kyiv, Donetsk, Kherson, Mykolaiv, and Luhansk Oblasts have received help remotely and within the shelter. The duration of a stay in the shelter for one client varies from one to six months and can be extended. The shelter houses 15-20 women and girls as well as their families, with accommodation for up to 30 people.

“Eleos-Ukraine is a truly passionate and efficient organization. They have been at the forefront of response to this war since 2014, the actual start of the Russian invasion,” said Ms. Shapoval. “Eleos put their minds and souls into supporting Ukrainian women and girls, and other civilians, who have suffered from horrifying violence and deprivation daily. They will continue helping people of Ukraine, no matter what – and so, I hope, we as I-TECH will continue supporting groups like Eleos on the ground.”

I-TECH Executive Director Pamela Collins lauded both the Ukraine team’s work with Eleos and those who have contributed generously to the I-TECH Humanitarian Fund. “I am very proud of I-TECH Ukraine’s activities with Eleos to respond to the humanitarian emergency in Ukraine,” said Dr. Collins. “Thanks to our donors, we had the resources to do what I-TECH does well: identify and collaborate with strong partners in the countries where we work to meet urgent needs in a times of crisis.”

 

IDASH Program Launches for Eastern Europe and Central Asia Region

Post categories: Global Health Security Health Information Systems IDASH One Health Surveillance Ukraine
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Participants gather for group discussion during the first IDASH in-person workshop in Tbilisi, Georgia. Photo credit: CDC/EECA

On April 3, the International Training and Education Center for Health (I-TECH) launched the Informatics and Data Science for Health (IDASH) fellowship training program with an in-person workshop in Tbilisi, Georgia. The program launched in partnership with the United States Centers for Disease Control and Prevention’s Eastern Europe and Central Asia (CDC/EECA) Regional Office, the World Health Organization (WHO) Europe, and country governments.

The first IDASH cohort includes 20 fellows from Georgia, Kazakhstan, Kyrgyzstan, Ukraine, and Uzbekistan. Participants include mid- to senior-level technical, analytical, and public health staff working at the national level in public health informatics or data science.

“After several whirlwind months of collaboration and engagement with stakeholders from the five countries, it’s amazing to welcome the first cohort of IDASH to Tbilisi for the first of three in-person workshops,” said Stacey Lissit, MPH, MS, Senior Technical Advisor for the IDASH program.

Fellows will participate in a 12-month in-service training program, in which each country team of four fellows will identify and develop a collaborative project. Fellows will receive sustained mentorship, and regional communities of practice will be established to ensure regional collaboration, share lessons learned and best practices, and establish linkages for future programming needs that span multiple countries.

“IDASH provides the opportunity to link learning to experience, and enables the application of new public health skills, knowledge, and techniques acquired from the training in a real-life context,” said Peter Rabinowitz, MD, MPH, Principal Investigator for the IDASH project. “It also extends benefits beyond the trainees to partner agencies and organizations, helping strengthen public health capacity in the region.”

Proposed fellowship projects include automating data analysis and visualization for diseases, expanding digital immunization registries beyond COVID-19, and developing spatial analysis modules for multi-disease surveillance and response.

“Today, the afternoon of the 4th day, the room is buzzing as the five country teams are hard at work: two engrossed in consultation with our facilitation team of public health informatics and data science experts about their country team projects; the others working on a data science methods exercise, practicing interpretation of descriptive and inferential statistics plots to assess trends in Hepatitis C,” said Ms. Lissit. “The energy and engagement have been high, and we’re looking forward to the next six days and the rest of the year-long fellowship.”

IDASH goals are to enhance capacity to create and use public health information systems that enable the capture, management, analysis, dissemination, and use of reliable, timely information to improve population-level health outcomes, as well as strengthen regional capacity to effectively respond to future global health challenges and pandemics.

“The COVID-19 pandemic made clear the importance of public health data systems that provide real time, accurate data on disease threats to allow for timely intervention and combatting of mis- and disinformation,” said Dr. Rabinowitz. “Programs like IDASH will help ensure there is a workforce prepared to detect, prevent, and respond to future global health threats.”

Story updated: April 11, 2023

I-TECH Updates Its Mission, Vision, and Look

Post categories: Pamela Collins
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To mark two decades of work, the International Training and Education Center for Health (I-TECH) has updated its mission, vision, and branding. This move also reflects I-TECH’s new three-year strategy, with includes the continued growth of I-TECH’s portfolio into technical areas that expand the boundaries of “global public health.”

“While supporting access to health care for communities and individuals continues to be a critical part of our mission, our new mission recognizes that individual and community health is not just about seeking care at a health facility,” says Ivonne Ximena “Chichi” Butler, MPH, Associate Center Director of I-TECH. “It is about recognizing the whole individual, their family and community, their environment, addressing obstacles to health care and wellbeing—these are all part of the broader definition of what it is to be healthy.”

Mission: I-TECH fosters healthier communities around the world through equitable partnerships in research, training and public health practice.

Building on deep experience in health workforce development; training; and prevention, care, and treatment, I-TECH has steadily increased its work in additional fields that enable strong health systems and address emerging threats. These include laboratory and diagnostics, global One Health interventions, and health information systems. I-TECH also supports efforts to address mental health and other issues that affect health and well-being, particularly among adolescent girls and young women.

A key to this holistic approach is meaningful partnership, said Ms. Butler. “Our new mission puts special emphasis on equitable partnerships with the end users as well as ministries of health and local leadership priorities coming first,” she continues. “Needs and gaps are being defined by the communities, and interventions must center those communities to inform locally led development efforts for long-lasting change. That means not just local institutions, but also those seeking care.”

I-TECH’s new color scheme also aligns the organization more closely with the University of Washington. “Our move to a purple-driven colorway is an amplification of our identity as a UW center,” says Anne Fox, I-TECH’s Assistant Director of Communications. “I-TECH has always sought cross-disciplinary partnerships, and that is only increasing as we expand our scope.”

Vision: I-TECH envisions a healthy world in which all people and communities flourish.

With I-TECH’s strategic focus on advancing health equity, efforts to end the HIV epidemic, greater integration of mental health, expanding digital solutions to meet health system needs, and addressing emerging public health threats, a vision that acknowledges influences beyond the health care system is warranted, says Pamela Collins, MD, MPH, Executive Director of I-TECH and Director of the UW Consortium for Global Mental Health.

“As our community reconsidered our vision, we wanted to capture a more holistic vision of health, and ‘flourishing’ conveys this,” says Dr. Collins.  “Flourishing is about not just physical health, but also emotional health and wellbeing—being engaged with life. Importantly, it requires having the right social, physical, and built environment in which to feel good and grow.”

I-TECH and Partners Fête Quality Improvement Teams in Côte d’Ivoire

Post categories: Cote d'Ivoire HIV Care and Treatment PrEP Quality Improvement
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Honorees from well-performing sites in the QISSEC project

In late February, the International Training and Education Center for Health (I-TECH) hosted an awards ceremony for the 10 best-performing health facility-based quality improvement teams focused on improving HIV prevention, care, and treatment services in Côte d’Ivoire. I-TECH currently operates in 80 HIV care and treatment (C&T) health facilities throughout Côte d’Ivoire.

Out of a total of 20 points, and using strict criteria, 10 sites received scores greater than or equal to 18 and were honored at the ceremony. Awards included computer equipment, printers, video projectors, blood pressure monitors, and other vital office equipment.

The ceremony was part of the U.S. Health Resources and Services Administration (HRSA)-funded Quality Improvement Solutions for Sustained Epidemic Control (QISSEC) project, which seeks to improve interventions such as the  provision of pre-exposure prophylaxis (PrEP), decreasing treatment interruption, and improving viral load testing coverage and suppression.

“This ceremony was a way to applaud the enthusiasm from the teams, demonstrate an understanding of the methodology, and share the projects that have so far been implemented,” said Dr. Nathalie Krou Danho, QISSEC Project Director.

PEPFAR Coordinator Bibola Ngalamulume

In addition to Dr. Danho, ceremony attendees included the National AIDS Control Program (PNLS) Director, PEPFAR Coordinator Bibola Ngalamulume, HRSA representatives, QISSEC Principal Investigator Ellen MacLachlan, CDC and USAID Country Directors, and representatives from the regions, districts, and sites.

“It is important that we put an accent on service quality,” said Ms. Ngalamulume. “The CQI project that is being implemented by I-TECH is an initiative that is extremely important because not only does it ensure that we improve access to care for all the HIV population–those who are infected and affected–but also it gives us the opportunity to create some kind of a mentorship network between health facilities that are performing well and facilities that need support. [This ceremony] is going to drive even more innovation moving forward.”

Within the QISSEC project, I-TECH has been working closely with the Ministry of Health and Public Hygiene (MSHP) and implementing partners to strengthen provider and community counselor capacity in quality improvement to ensure HIV epidemic control.

I-TECH’s methodology is to build a culture of quality improvement from central, to regional, to site levels. Importantly, I-TECH supports sites to work with the community to center their needs, and patient needs, in providing quality care.

One of the sites honored, an urban health center in Libreville, had set a goal to increase individuals on PrEP from 23 in December 2021 to 78 in June 2022. Their root cause analysis revealed that training in PrEP was insufficient. After orienting prescribers and clinical advisors to PrEP, and organizing community awareness sessions where eligible individuals were identified, the site surpassed their goal by 200%, initiating 230 individuals on PrEP by June 2022. The site continued to increase that pace, reaching 353 by August of that year.

“It’s been a lot for the teams to do this work on top of their day-to-day jobs: to form a quality improvement team, brainstorm, and think of ideas on how to implement the changes,” said Dr. MacLachlan, “but they have taken great care in this work. The quality of HIV care in Côte d’Ivoire will be better for it.”

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.

I-TECH Presents at ICBD 2023 Conference

Post categories: Malawi Surveillance
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Representatives from I-TECH Malawi attend ICBD 2023 in Santiago, Chile from 1-4 March 2023 to present findings from the Malawi Birth Defects Surveillance Program. L-R: Luke Chiwala, Simkonda Yamikani Malanga, George Bello. Photo Credit: I-TECH Malawi

Representatives from I-TECH Malawi attended and presented findings from the Malawi Birth Defects Surveillance Program at the 2023 International Conference on Birth Defects and Disabilities in the Developing World (ICBD 2023). ICBD 2023, hosted by the March of Dimes, took place in Santiago, Chile, from 1-4 March 2023.

The conference brought together maternal and child health practitioners and researchers from around the world who presented their latest research, tools, and approaches in surveillance, diagnosis, and care for babies born with birth defects. This year’s theme was “Accelerating Action for Birth Defects and Disabilities: Surveillance, Prevention, Diagnosis, Management and Family-Centered Care.”

The following presentations were given during the conference:

  • “Prevalence of Adverse Birth Outcomes and External Birth Defects Among Women Living with HIV in Malawi”
    Authors: Bello G, Smith-Sreen J, Williamson D, Taulo F, Kabaghe A, Kerry Thomson K, Kagoli M, Chipeta S, Namakhoma I, Nyirenda R, Babaye Y, Auld A, Kim E, Matatiyo B, Zenengeya E, Muula AS, Nyasulu I, Gomes MF, Chiwala L, Kamzati M, Mkungudza J, Valencia D, Moore C, O’Malley G, Wadonda-Kabondo AN
  • “Correct Diagnosis of Birth Defects by Health Facility Staff in Four Facilities in Malawi”
    Authors: Malanga SY, Luke Chiwala L, Kamzati M, Valencia D, Mkungudza J, Bello G, Williamson D, Moore C, Thomson K, Ireen Namakhoma I, Gondwe E, Banda F, Sangaya N, Chirwa M, Kagoli M, Chipeta S, Nyirenda R, Zenengeya E, Babaye Y, O’Malley G, Wadonda-Kabondo N, Kabaghe AN
  • “Use of Electronic Data Collection and Web-Based Portal to Ensure the Completeness, Timeliness, and Accuracy of Final External Birth Defects Diagnosis in Malawi”
    Authors: Chiwala L, Kamzati M, Valencia D, Mkungudza J, Bello G, Williamson D, Moore C, Thomson K, Namakhoma I, Gondwe E, Banda F, Sangaya N, Chirwa M, Kagoli M, Chipeta S, Nyirenda R, Zenengeya E, Babaye Y, O’Malley G, Wadonda-Kabondo N, Kabaghe AN

To learn more about ICBD 2023 conference, please visit the ICBD 2023 website and review the ICBD 2023 Agenda.

*Bolded names indicates presenting author.

I-TECH Stands with LGBTQ+ Individuals in Uganda

Post categories: Uganda
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On March 21, the Ugandan parliament passed a hardline bill criminalizing LGBTQ+ identity, giving the government wide latitude to prosecute gay Ugandans, punishable by life imprisonment. This represents a clear violation of human rights and dignity for Ugandans who identify as LGBTQ+, putting them at further risk of violence and discrimination in a country where same-sex relations were already illegal.

Global condemnation of the new legislation has been swift, within and outside of Uganda. Richard Lusimbo, a Ugandan LGBTQ+ activist, told NPR, “The LGBTQI community has basically been told, you can’t raise your head, you can’t be seen, you can’t be heard.”  The UN’s High Commissioner for Human Rights is urging Ugandan President Yoweri Museveni not to sign the bill.  “The bill would have negative repercussions on society as a whole and violates the nation’s constitution. The passing of this discriminatory bill – probably among the worst of its kind in the world – is a deeply troubling development.”

Such violations of human rights, regardless of where they occur, are antithetical to I-TECH’s values and our vision of health and flourishing for all. We strongly object to these actions by the Ugandan government and stand against the criminalization of and discrimination against LGBTQ+ individuals and communities in Uganda.

I-TECH Data Presented at CROI 2023

Post categories: Gabrielle O'Malley HIV and STI Prevention Malawi Surveillance
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Data from the International Training and Education Center for Health (I-TECH) program in Malawi were presented during the 2023 Conference on Retroviruses and Opportunistic Infections (CROI). The annual conference took place in Seattle, WA, from 19-22 February 2023, and brought together researchers, academics, and experts to discuss and present on their scientific achievements and new research.

During the “Insights into Prevention and Treatment of HIV in Women and Children” oral abstract session that was held on 20 February 2023, representatives from I-TECH Malawi presented on recent HIV infection surveillance data in breastfeeding women in Malawi:

The Centers for Disease Control and Prevention also presented a poster during the poster session that used data from the I-TECH Malawi HIV Recency Surveillance project:

To learn more about CROI, download conference resources, or to peruse the 2023 CROI program, please visit the CROI 2023 website.

Note: Bold name indicates presenting author.

 

I-TECH Supported Reference Center Serves as Critical Lifeline for People with Advanced HIV Disease

Post categories: HIV Care and Treatment HIV Co-Infection Mozambique Pamela Collins Tuberculosis
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The Alto Maé Reference Center (CRAM). Photo courtesy of I-TECH Mozambique.

Four decades into the HIV epidemic, more than 50,000 people per year in Mozambique continue to die from HIV-related conditions.

The Alto Maé Reference Center (CRAM) provides a specialized package of care and treatment services for patients with advanced HIV disease from the urban health network of Maputo, Mozambique. Since January 1, 2021, the International Training and Education Center for Health (I-TECH) has served as the Ministry of Health’s primary partner for managing CRAM, a role handed over by Médecins Sans Frontières (MSF), which established the clinic in 2010.

Since I-TECH started its activities at CRAM, the center has had 1,599 active patients in follow-up care.

“More than 80% of patients admitted to CRAM for specialized care are referred by other health centers,” explains Dr. Florindo Mudender, Country Director for I-TECH Mozambique. “Critically ill patients are treated at CRAM until they are stable, then sent back to their facilities of origin to continue treatment. In addition to acute care, CRAM also provides individualized supportive services to patients who often present with dire psychological, social, and economic conditions.”

These supportive services proved crucial to Aisha,* a 43-year-old mother of five who had difficulty accepting her HIV status, believing that her church’s pastor had cured her disease through prayer.

Referred to CRAM five years ago with a diagnosis of Kaposi’s sarcoma, Aisha was prescribed second-line antiretroviral therapy (ART). However, after losing her job due to COVID-19, Aisha was subject to food insecurity, discrimination, social stigma, and physical, psychological, and financial abuse by her partner.

After routinely presenting a high viral load and suffering severe weight loss, Aisha’s care team at CRAM assumed she had not been taking her medication – possibly because of her religious beliefs and a lack of food. She was severely depressed, to the point of attempting suicide.

Worried about her condition, the team at CRAM enrolled Aisha in wraparound services, including behavioral psychotherapy, education in self-care and self-esteem, treatment adherence support, positive prevention, couple’s therapy and socio-family integration, group therapy with other patients with depression, and antidepressant medication.

After several months, Aisha’s last viral load test showed a result of “undetectable,” and her depressive symptoms abated. Thanks in part to the support from CRAM, Aisha is now adhering to her ART, has regained her self-esteem, is working again, and eats regular meals. Her partner tested HIV-negative and has learned to support her so that she feels valued and loved. Aisha attends psychotherapeutic sessions quarterly at the CRAM to monitor her psychological and social well-being.

“[My husband] helps me a lot, so I don’t forget to take my pills, and I am very happy about that and with the improvement I made with my health,” says Aisha. “Before, we were hungry, and now, I am back to work. With the little I earn I can help with the household expenses.”

CRAM is considered a center of excellence and the main training site for AHD for Mozambique Ministry of Health clinicians and PEPFAR-funded implementing partners.

“I-TECH is currently refining a referral and counter-referral system between CRAM and Maputo City’s health centers, to ensure patient care continues after discharge,” says Dr. Mudender “The system will include a free mobile line to assist clinicians with advice from senior specialists.”

*Name has been changed to protect privacy.

 

I-TECH and Zim-TTECH Publish Paper on Transitioned Programs

Post categories: Best Practices Health Systems Strengthening Integrating Research and Practice Scott Barnhart Stefan Wiktor Transition & Sustainability Zimbabwe
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Faculty and staff from the International Training and Education Center for Health (I-TECH) and its network partner the Zimbabwe Training, Technical Assistance and Education Center for Health (Zim-TTECH) have published a new paper in the journal PLOS One.

Working toward sustainability: Transitioning HIV programs from a USA-based organization to a local partner in Zimbabwe catalogs the challenges and lessons learned as I-TECH laid the groundwork to transition the voluntary medical male circumcision (VMMC) and HIV care and treatment programming in Zimbabwe to the newly established Zim-TTECH, a fully independent local organization.

“I-TECH prides itself on working collaboratively with our international partners. We held the principle from day one that the most successful programs happen when the locus of control sits in-country,” said Marrianne Holec, Senior Program Manager at I-TECH. “We had the foundation in place with our local staff, what was missing was the organizational structure to allow the team in-country to truly lead the project. With the formation of Zim-TTECH, I’m happy to say we are there.”

Among USG funders, it’s recognized that future models for sustainable healthcare rely on local country ownership and leadership.[1] But making the transition from US-based ownership to country ownership isn’t a one-time event, added Holec, “It’s a process that takes time. We wanted to document our process so that other international organizations who are looking to pursue decolonizing global health programming can learn from our experience.”

Through 16 key informant interviews, the team gathered views on transition planning, implementation, and technical support, ethics, and success. Five themes emerged from the data collected:

  • Develop a vision and empower leadership for change by delegating clear roles and supporting local ownership;
  • Plan and strategize for transition in a manner that accounts for historical context;
  • Communicate with and inform stakeholders to understand transition perceptions, understand barriers to transition, and enable open communications related to risks and benefits;
  • Engage and mobilize staff by constructing necessary infrastructure and providing technical assistance as needed; and
  • Define short-term and long-term success.

“Sustainability of successful donor funded public health programs is critical if we want to maintain the important gains that have been made over the years,” says Dr. Batsi Makunike, Executive Director of Zim-TTECH. “Strong local organizations with good governance, management, and technical capacities are an important cornerstone of sustainability.

“The process of transitioning from an international to a local organization is daunting,” she continues. “We hope that this study is helpful to other organizations in their efforts to transition.”

[1] Goosby E, Von Zinkernagel D, Holmes C, Haroz D, Walsh T. Raising the Bar: PEPFAR and New Paradigms for Global Health. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2012;60.

I-TECH Establishes External Advisory Board

Post categories: Uncategorized
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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.