Facing Ashitenga Primary School students at the VMMC certificate ceremony are, from left to right: Levi Vries, Education Inspector for Oluno Circuit; Lusia Ndemuweda, I-TECH Demand Creation Coordination Nurse; Ashitenga Principal Edward Asser; Frieda Mupetami, a representative of Okatyali Constituency office; and Life Skills teacher Teopolina Mupetami (in red).
In Namibia, the prevalence of HIV infection among adults aged 15 to 49 is nearly 14%.[1] A key component of national efforts to prevent the spread of HIV is voluntary medical male circumcision, or VMMC, which has proved to reduce the rate of male-to-female transmission by upwards of 60%.
Since 2010, the International Training and Education Center for Health (I-TECH) has supported the VMMC efforts of the Namibian Ministry of Health and Social Services (MOHSS) in the Oshana and Zambezi regions. I-TECH not only supports health care worker training in the provision of VMMC, it is also engaged in critical efforts to create demand for the procedure.
A key element of these efforts is the recognition of schools and school leadership who are supportive of VMMCs. In February, Ashitenga Primary School in Oshana Region was awarded a platinum certificate by I-TECH Namibia for achieving 96% saturation of boys receiving a VMMC. Platinum is the highest honor, with bronze signifying 55-69% saturation, silver awarded for 70-79% saturation, and gold given for 80-89% saturation.
Present at the event was the Oluno Circuit Education Inspector Levi Vries. In his remarks, Mr. Vries encouraged other schools to emulate Ashitenga’s good example. He emphasized the importance of student health to attaining educational goals and urged students to spread the VMMC message to others in their families, villages, and neighborhoods.
As part of the Life Skills curriculum, older boys are instructed on HIV prevention, while the younger boys are taught personal hygiene – messages that are reinforced by I-TECH community mobilizers. Teopolina Mupetami, the Life Skills teacher at Ashitenga, encouraged Life Skills teachers at other schools in the area to support the VMMC program. Ashitenga principal Edward Asser echoed the importance of the school’s recognition; he promised to display the certificate proudly in his office.
Three of the circumcised students were interviewed by the Ministry of Information Communication and Technology, which is charged with spreading the message about “the smart cut” in the government media. The boys responded that “they feel clean and protected from sexual related disease,” said Helena Ferdinand, I-TECH community mobilizer. The students prompted boys at other schools to enroll in the VMMC program and expressed their satisfaction with the service.
“The atmosphere at the handover was joyful and a lot of excitement,” said Ms. Ferdinand. “The principal indicated that they will continue to work hard to get a second platinum certificate.”
Nancy Puttkammer of I-TECH and Rose Boulay of Haiti’s MSPP/PNLS standing next to I-TECH’s poster on MMS of ART at CROI 2018.
Nancy Puttkammer, PhD, MPH, presented a poster at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston on 4-7 March 2018. She was joined by Rose Boulay, a representative from the Haiti Ministry of Health (MSPP) National HIV Program (PNLS). Madame Boulay works on data quality assessment, training for clinical sites, and decision making using data from the iSanté electronic medical record (EMR) system.
The poster, titled “Multi-Month Scripting (MMS) and Retention on HIV Antiretroviral Therapy (ART) in Haiti,” reflected the collaboration between I-TECH and MSPP to analyze national policies using iSanté data from 85 ART clinics. They examined the MSPP-led MMS initiative to prescribe longer intervals of ART for stable patients. The goal of the MMS approach is to improve patient retention on ART by reducing the burden to patients of coming into the clinic monthly to pick up their ART prescription.
“Our analysis showed impressive uptake of MMS across all health facilities, suggesting that longer intervals are welcomed by providers and patients,” explained Dr. Puttkammer. “Patients prescribed ART for two months or more were 18% more likely to be retained, after adjusting for various patient and facility factors, compared to patients on monthly ART regimens. This is a promising result in terms of the goals of the MMS approach.”
Haiti’s national EMR system allows for the MSPP to conduct data analysis to evaluate the success of health interventions across the entire network of clinics and hospitals in a timely manner. “We are very pleased that we have been able use the iSanté data system to measure the progress of our national HIV and AIDS response, and to share our results with an international audience at CROI. It has been a great experience,” stated Madame Boulay.
Logo courtesy of the Consortium of Universities for Global Health (CUGH): https://www.cugh.org/.
Representatives from the International Training and Education Center for Health (I-TECH) are headed to New York for the 9th Annual Consortium of Universities for Global Health (CUGH) Conference. The conference—held on March 16-18, with satellite sessions on March 15—will be co-hosted by Columbia University, Stellenbosch University, and the University of Peradeniya.
Featured speakers include Richard Horton, Editor of The Lancet, and Natalie Kanem, Deputy Executive Director of the United Nations Population Fund.
Building on the theme of “Health Disparities: A Time for Action,” staff and faculty from I-TECH will be presenting on the following topics:
King Holmes, MD, PhD, founding chair of the Department of Global Health and a co-Principal Investigator of I-TECH’s IAETC award, will join a morning plenary session and discussion about global health disparities. The discussion will be moderated by Director of the Fogarty International Center Roger Glass. Dr. Holmes will be joined for the discussion by Rose Leke, Gairdner Foundation Global Health Committee member and Emeritus Professor at Universite de Yaounde, and K. Srinath Reddy, President of the Public Health Foundation of India.
Kate Wilson, PhD, Clinical Assistant Professor, is presenting a poster titled “Evaluation of a New Field Epidemiology Training Program (FETP) Intermediate Course to Strengthen Public Health Preparedness in Tanzania.” The locally adapted course significantly improved trainee knowledge and skills in field epidemiology, and the evaluation also showed evidence of improvement in data quality and performance at trainees’ workplaces and districts.
Lindsay Mumm, MPA, Program Manager, is presenting a poster titled “Creating Relevant Change towards Reaching the UNAIDS 90-90-90 Target with High-Impact Leadership Training – Afya Bora Fellowship in Global Health Leadership.”
In addition to the research being shared at CUGH, I-TECH was represented earlier this month at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston. Nancy Puttkammer, PhD, MPH, presented a poster titled “Multi-Month Scripting (MMS) and Retention on HIV Antiretroviral Therapy (ART) in Haiti.” The retrospective study used data from the iSanté electronic medical record system in Haiti and found promising results that MMS for ART in virally suppressed patients improved retention and engagement in treatment.
About CUGH
The mission of CUGH is to build interdisciplinary collaborations and facilitates the sharing of knowledge to address global health challenges while promoting mutually beneficial, long-term partnerships between universities in resource-rich and resource-poor countries, developing human capital and strengthening institutions’ capabilities to address these challenges. Read more about CUGH: https://www.cugh.org/.
About CROI
Established in 1993, The Conference on Retroviruses and Opportunistic Infections (CROI) was provides a forum for scientists and clinical investigators to present, discuss, and critique their research. The goal of the conference is to provide a forum for researchers to translate their laboratory and clinical findings into tangible progress against the HIV pandemic. Read more about CROI: http://www.croiconference.org/.
I-TECH Haiti’s Dr. Marinho Elisma works with clinician Belhamie Ketleen on the iSanté electronic medical record system.
To mark the 10th year of the iSanté electronic medical record (EMR) system, the International Training and Education for Health (I-TECH) team in Haiti embarked on an analysis of the EMR’s implementation, the results of which were published as a case study last month in Health Policy and Planning.
The study focuses on factors of success, contributing to the industry’s understanding of what it takes to sustain and transition an EMR system in a low- and middle-income country (LMIC) like Haiti. The team found that while functionality and technical factors continue to be relevant as EMR implementations mature, other factors also become significant over time, including governance and leadership, ongoing user capacity, data quality, integration within a larger eHealth framework and financing.
The team assessed factors for success in eight categories: functionality, technical, organizational, training, political, ethical, financial, and sustainability. Seven of these were determined by the work of Fritz et al. in a review of factors contributing to EMR system success in low-resource settings.[1] However, one of the main findings was the eighth category the Haiti team added to the list of factors: sustainability.
Why sustainability is critical
When a system like iSanté is implemented at scale for so many years, the definition of success shifts from design, planning, and rollout to financing, governance, maintenance, and long-term ownership of the system by Haitian stakeholders. Transition planning, including long-term financial sustainability of the system, needs to begin at the start of any implementation.
“iSanté is a part of the legacy of the HIV information system, a model that will be used from generation to generation especially in terms of sustainable HIV/AIDS interventions,” said Nirva Duval, M&E Lead at the National AIDS Control Programme of the Ministry of Public Health and Population (MSPP) in Haiti, a case study author who has been involved in the iSanté implementation since its beginning in 2005. She went on to add, “Use of iSanté data is a major asset and an opportunity to better understand issues and contribute to decision-making at all levels.”
Ultimately, the goal is for iSanté to be fully owned, managed, and maintained in Haiti and wholly integrate into clinical practice. In 2016, I-TECH, the U.S. Centers for Disease Control and Prevention (CDC), and the MSPP undertook an overhaul of iSanté, including moving all servers and the majority of software development to Haiti.
Lessons learned pave the way for integration
The rebuild, known as iSantéPlus, uses an OpenMRS platform, which is supported by a growing global community. The phased national rollout of iSantéPlus is under way and will continue during 2018. I-TECH is also supporting the creation of a new national health information exchange known as “SEDISH” (Système d’Echange d’Information de Santé d’Haïti in French).
SEDISH will ensure a seamless flow of data between the community level to sites to the national level and back, improve clinicians’ ability to see patient history from other sites, and maintain a continuity of care document for patients who move between care sites. SEDISH uses international data standards and a Master Person Index to facilitate harmonization and information sharing between the EMR and other health data systems like lab and supply chain systems, transitioning the Haiti HIS landscape from multiple disparate systems to an interconnected network. Both iSantéPlus and SEDISH will promote collaboration between MSPP and CDC- and USAID-funded partners to improve how health care providers serve individual patients and populations across these systems.
Many of the lessons learned during the implementation of iSanté were applied in the design and execution of iSantéPlus and SEDISH. “iSanté has kept Haiti on the leading edge of HIS implementation in resource-constrained countries,” said Dr. Scott Barnhart, Principal Investigator and Professor in the University of Washington’s Departments of Medicine and Global Health. “The changes under way will have broad global applicability — integrating across direct patient care, lab, pharmacy, as well as supply chain. We have an exciting opportunity to come together and build on our success to respond to the challenges of local ownership, financing, cost-effectiveness, and governance so that these important tools are sustainable.”
Once the team completes and assesses the results of the iSantéPlus and SEDISH pilot, the new systems will be deployed throughout Haiti. It will be critical that the MSPP, CDC, and I-TECH’s partners in Haiti come together to assess the sustainability of iSantéPlus and SEDISH and their impact on the HIS landscape in Haiti.
[1] Fritz F, Tilahun B, Dugas M. 2015. Success criteria for electronic medical record implementations in low-resource settings: a systematic review. Journal of the American Medical Informatics Association 22: 479–88.
Treats served at an end-of-course celebration in Kenya, 2016
Training on leadership and management is a critical component of the University of Washington (UW) International Training and Education Center for Health’s (I-TECH’s) health systems strengthening efforts. To that end, I-TECH has worked closely with the UW Department of Global Health E-Learning Program (eDGH) since 2012 to offer a heavily subscribed online course on leadership and management to health care workers in low- and middle-income countries.
Designed and taught by I-TECH Executive Director and UW Professor of Global Health Ann Downer, Leadership and Management in Health (LMIH) is a 12-week course focusing on the practical leadership and management skills required for working in complex global health environments. Weekly modules include content on team building, accountability, supervision and delegation, conflict management, financial management, use of data for decision-making, and effective communication.
“I want to express my gratitude for giving me the opportunity to do the UW course on Leadership Management in Health. …I find myself going back to these documents again and again to understand and imbibe what is given. I feel that the simple narrative of the course material has made all the difference.”
–2016 course participant from India
Participants from Tunisia, 2015
The course consists of recorded lectures, required readings, a weekly online discussion forum, quizzes, self-reflection assignments, and a final verbal presentation. It is targeted to practicing health care professionals and public health specialists who already have some experience managing people. In most cases, LMIH participants gather in weekly site-specific, in-person discussion groups led by a volunteer facilitator to discuss the material and apply it to their particular linguistic, cultural, social, and political environment.
“We just finished our site discussion this afternoon and the level of contribution and application to our various office settings was wonderful. …I have told my Chief Executive … about the course and he is thinking of asking all Management Staff to do it compulsorily in the next episode.”
–2017 course site facilitator
Due to high enrollment, the course is now offered twice a year, with a completion averaging 84%. Approximately 4,500 individuals are enrolled in the latest offering of the course, representing a nine-fold increase in five years. More than 10,000 health workers in 65 countries have graduated from LMIH since 2012.
Participants from Myanmar, 2017
According to a survey conducted by eDGH, more than half of graduates from the spring 2016 cohort now mentor colleagues on leadership and management-related job tasks. In addition, 67% said they were given new responsibilities or projects as a result of course completion, and 74% reported that they had maintained contact with other students from their sites.
“We consistently hear that how empowering the course is,” said Anya Nartker, E-Learning Project Manager with eDGH. “The course uses a blended model, where participants are required to meet with their local site each week to apply what they are learning in the course, and share problems that they support each other in solving.”
I like the idea of all students teaming together and working together despite their backgrounds and level of education. There were many who were highly educated and some who were moderately [educated], and we all understood and accommodated each other.
–2016 course participant from Kenya
Course graduates have requested a deeper exploration of certain topics introduced in LMIH. As a result, a certificate series of three online courses is being developed that will include LMIH; a new course titled Global Project Management; and a third online course, Fundamentals of Implementation Science.
The Global Project Management online course will be offered as a stand-alone course from July-September 2018, co-taught by Dr. Downer; I-TECH Deputy Director, Chichi Butler; and I-TECH Senior Program Manager, Harnik Gulati. The certificate will be offered in 2018.
E-learning training participants from Ukraine and trainers from eDGH.
In late October, the University of Washington’s Department of Global Health E-Learning (eDGH) facilitated a five-day course on e-learning best practices for a six-member delegation from Ukraine.
The goal of the training was to improve competencies in the development and implementation of online and blended teaching courses in health care. Throughout the five days, experts from eDGH covered the nuts and bolts of e-learning content design, development, rollout, management, assessment, and continuous improvement.
The training participants, led by the International Training and Education Center for Health (I-TECH) Ukraine Program Director Iryna Yuryeva, and Training Developer Tetiana Bairachna, included delegates from the Public Health Center of the Ministry of Health of Ukraine (PHC), Ukrainian Family Medicine Training Center of Bogomolets National Medical University (UCFM), Nursing College of Ternopil State Medical University (TSMU), and Nursing College of Poltava Ukrainian Dental Academy (PUDA).
The host organizations are either currently implementing online learning programs or planning to launch them in the near future: PHC recently introduced a series of distance learning products on HIV care and treatment and UCFM adapted the University of Washington’s Leadership and Management in Health course to the Ukrainian context.
Thanks to the training, “we finally discovered formulas to calculate continuing medical education credits awarded for a distance course completion,” said Volodymyr Vysotskyi of UCFM.
The Nursing College of TSMU offers online degrees such as a Bachelor and Master of Science in Nursing, and will benefit particularly from the course’s focus on evaluation. “Information on e-learning evaluation strategies was of special interest as we are planning to develop new online continuous medical education courses for nurses,” says Svitlana Yastremska of TSMU.
The team of trainers – Alex McGee, eDGH Managing Director; Anya Nartker, eDGH Manager of Online Education; and Elizabeth Scott and Leslie Wall, eDGH Senior eLearning Developers – shared their expertise in planning, development, and implementation of e-learning courses.
In addition, eDGH presented best practices and challenges and advised participants on technicalities of current e-learning courses under development in their organizations. “The approaches to sustainably institutionalize e-learning into the medical education system, both pre- and in-service programs, were the most important part of this training for me,” noted Mykhailo Riabinchuk of PHC.
To ensure continuity of the training, I-TECH and eDGH plan to start a series of follow-up webinars to support training participants as they promote and scale up e-learning in health care in Ukraine. I-TECH Ukraine views developing local capacity in e-learning as a strategic component of programmatic efforts as it extends access and improves efficiency.
“Leveraging the knowledge gained on distance learning, we will be able to take the postgraduate education at our institution to the next level of quality,” said Vadym Bodnar of PUDA.
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.
HIV-positive teens gathered at B2Gold’s Otijikoto Mine Nature Reserve for a weekend of team-building exercises, support, and discussions about the importance of adherence to treatment.
All teens need consistent opportunities to build self-worth, explore their gifts, and feel the support of peers and adults. For teens who are HIV positive, the everyday pressures and fears of adolescence (rejection, bullying, gossip) can be amplified, making these opportunities especially important. In Namibia, adolescents and young people, especially girls and young women, continue to be disproportionately affected by HIV.
In response to these realities, in late August, a three-day Teen Club Retreat was organized by the Katutura Hospital Paediatrics Communicable Disease Clinic (PCDC) team, in collaboration with B2Gold, Champions for Life, and the International Training and Education Center for Health (I-TECH).
Fully funded by B2Gold and hosted at its Otjikoto Mine Nature Reserve, the retreat included 49 teens from the clinic (31 girls and 18 boys), who were joined by clinic doctors, nurses, and counselors as well as facilitators from Champions for Life, a psychosocial-spiritual program for children, adolescents, and young adults with the challenges of being infected or affected by HIV.
Through team exercises, game drives, inspiring films such as “Hacksaw Ridge” and “The Soul Surfer,” lectures, and small group sessions, the retreat aimed to:
strengthen bonds and networks;
create enthusiasm about the future;
develop self-respect;
instill the values of a healthy environment, teamwork, and responsibility; and
keep teens engaged in care.
“I enjoyed the movies, as they motivated me. I realized that I am not the only one facing challenges. When I courageously tackle my challenges, I remain strong even if I may not win them all.” – Teen Club member
I-TECH Namibia’s Sharon Mambo, an HIV Pediatric Expert Nurse, served as a chaperone and as one of the key organizers of the retreat. Mambo led a discussion on the importance of treatment adherence and viral load suppression. In addition, she tasked one of the teens with facilitating a discussion on “transitioning,” the process during which adolescents move from paediatric HIV care to more independent adult care. At Katutura hospital, this means accessing health services at an adult ART clinic.
Addressing the teens’ fears of waiting too long for services and meeting unfamiliar faces, Mambo assured the group that a specific health worker has been assigned to work with them and they would be “fast tracked.”
“It’s a matter of changing consultation rooms when you transition to the adult clinic,” said Mambo. “You will still meet the happy, friendly staff on the other side, so lay your worries aside.”
Teen Club members enjoyed a tour of the B2Gold facility, as well as nature and wildlife walks.
Highlights of the retreat also included a tour of the B2Gold mine and a game drive, where the kids were thrilled to see reserve animals including giraffes, springboks, wildebeests, and zebras at close range. “I got to see some of these animals for the first time,” said one teen. “I never knew that some animals could be as clever as human beings.”
The team from Champions for Life also held a full-day seminar titled “NICHE,” focused on self-image, identifying gifts and abilities, and creating one’s vision for the future. This was done through music, dance drama, group presentations, and poetry.
“I enjoyed the team-building activities because we got to work as a group and had the opportunity to come up with ideas together as a team.” – Teen Club member
“A major success of this trip was the close bond, mutual respect, and trust that developed between the staff and adolescents during the three days,” says Mambo. “The shared experience and willingness of the staff to participate fully in all sessions of the program really lowered some of the barriers and discomfort that normally exist between teens and adults.”
Mambo has also been working with teen leaders from the group to support other facilities in Windhoek to establish their own Teen Clubs.
Patients at Usa River Health Center Tanzania. Photo courtesy of the BID Initiative.
The digital health landscape is rife with disconnected systems that make it challenging to aggregate information and improve the health of populations. After years of disjointed experiences, multiple organizations and governments have found that multi-platform, standardized, and connected information systems are critical to allow health care providers and decision makers access to timely and accurate information.
In this spirit, the International Training and Education Center for Health (I-TECH) joined forces with PATH’s BID Initiative to prevent disease by developing a platform to better trace vaccinations in low-resource settings. As part of its Global Health Security award, I-TECH is localizing the BID Initiative’s Zambia Electronic Immunisation Registry (ZEIR), an app powered by OpenSRP which is an open source mobile health platform, for use in Siaya County, Kenya.
I-TECH reached out to the BID Initiative last summer to hear more about BID’s lessons learned. The two teams began collaborating in earnest last December, leveraging the BID Initiative’s large scope in Zambia and Tanzania with I-TECH’s expertise in working with the OpenMRS platform.
Parallel projects with common goals
Reuben Mwanza (right) of PATH enters vaccination data into a tablet computer during a vaccination service at the Mahatma Gandhi Clinic in Livingstone, Zambia on October 17, 2016. Photo courtesy of the BID Initiative.
In Kenya, I-TECH has been tasked with building an electronic platform to capture immunizations when they happen. The aim of the project—conducted in partnership with the Kenyan Ministry of Health, the CDC Global Health Protection Division, and the CDC Global Immunization Division—is to improve immunization coverage. This is done by tracking and monitoring who is due for which vaccine, starting with population-level coverage within a single county, thus decreasing the chance of outbreaks of vaccine-preventable diseases.
Similarly, the BID Initiative has been working with the Ministry of Health and nurses in Tanzania and Zambia to develop an electronic immunization registry, among other data use tools, to ensure data becomes more accessible and useful to health workers. This, in turn, can help with decision making to prevent vaccine stockouts and enable follow-up with patients who have not returned for needed vaccines. BID’s learnings provided an opportune starting point for I-TECH’s work.
“ZEIR provides all of the workflows we need,” says Craig Appl, I-TECH Senior Technical Advisor for Health Informatics. “It already considers how users will interact with the application. It collects immunization data in a user-friendly manner, allowing health care workers to more accurately administer and record childhood immunizations and to more easily follow-up with children defaulting on their immunization schedule.”
Improvements through open source collaboration
I-TECH and BID have turned to Ona, a social enterprise based in Nairobi, Kenya, committed to fostering change by building information systems infrastructure. BID began working with Ona in January 2017 to adapt the OpenSRP system to Zambia’s national immunization program. This open source development process has been critical to the success of both teams and represents the collective knowledge of a community of developers known as the THRIVE Consortium.
“We simply couldn’t do this if OpenSRP and ZEIR software development was closed source,” says Appl. “The documentation, source code, and community wiki are all open for collaboration. Our team is able to actively track the improvements across the community, receive value where others have built features, and contribute where our projects align. Through open collaboration, we have many more individuals and teams working to improve health outcomes where we work.”
Laurie Werner, BID’s Global Director, agrees, pointing out that each new tool and iteration of the app is more adaptable and affordable than the last. “I-TECH is able to see solutions and propose solutions,” says Werner, “that’s the beauty of open source software.”
Matt Berg, CEO of Ona, views the OpenSRP app created for both projects as a customizable springboard that could potentially accommodate additional modules for antenatal care, malaria data, and maternal and child health.
“From our prior work with BID, we had this great starting point that another country or group could take and adapt and get up and running quickly,” says Berg.
Adaptability equals cost efficiency
Cost is a major driver for any implementation. Until now, it has been more cost efficient to build specific functionality on top of popular generalized information systems and tools, which decreases adaptability. Initial investments in the BID and I-TECH projects have allowed for both flexibility and specificity.
“We tend to focus too much [in the digital health field] on localization, and not on great design,” says Berg. “I think our success in Zambia and Kenya validates the importance of good design…and shows the potential of replicating in places for a fraction of what was originally invested.”
This collaborative environment and focus on adaptable design increases cost efficiency and allows the BID Initiative to fulfill the intention for its solutions to be used in multiple contexts.
“This is the core of the BID Initiative’s theory,” says Werner. “Effective electronic immunization registries have to be adapted to a country’s context and specific needs. Each time you do that, it becomes less and less of a financial investment for future countries.”
This blog post was supported by the Cooperative Agreement Number, U2GH001721, funded by the U.S. Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.
Dr. Michael Martin, Dr. Elliot Marseille, and Dr. Juliana de Fatima da Silva served as keynote speakers.
In early April, the International Training and Education Center for Health (I-TECH) conducted a five-day workshop on “Antiretroviral Drugs for Epidemic Control” for more than 50 chief doctors and deputy chief doctors from Regional AIDS Centers in Ukraine.
Workshop participants learned about evidence-based, international best clinical practices and the cost-effectiveness of strategies for using antiretroviral therapy (ART) to control HIV epidemics. International keynote speakers included:
Dr. Jeremy Penner, International Clinical Advisor in Ukraine to I-TECH/University of Washington (UW);
Dr. Elliot Marseille, Consultant to I-TECH/UW and the Center for Global Surgical Studies at the University of California, San Francisco;
Dr. Michael Martin, U.S. Centers for Disease Control and Prevention (CDC) Senior Technical Advisor for HIV/AIDS care and treatment in Thailand; and
Dr. Juliana de Fatima da Silva, Epidemic Intelligence Service Officer at the CDC.
The pool of facilitators also included nine national experts from the Ministry of Health’s Center of Public Health (CPH).
The workshop aimed to support the development of efficient strategies to achieve the UNAIDS 90-90-90 goals: 90% of HIV-positive people know their status, 90% of those are on treatment, and 90% of those are virally suppressed. To this end, the workshop covered national situational analysis, national clinical recommendations, and service delivery models with the highest potential for adaption in country.
Progress on ART optimization in Ukraine was shared, and participants were able to discuss their experiences and ideas for improving HIV-related services. The presentations and group discussions were particularly timely, given the development of complex new HIV clinical guidelines currently under way in Ukraine – they also provided much needed evidence to support this process.
Similar workshops were requested by the CPH and leaders of the Regional AIDS Centers, and I-TECH plans to meet this request by conducting two workshops in June and September 2017.
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.
Guyana Ministry of Public Health’s Deputy Chief Medical Officer, Dr. Karen Boyle. Photo courtesy of Kaieteur News.
The International Training and Education Center for Health (I-TECH) recently partnered with the Ministry of Public Health in Guyana and the U.S. Centers for Disease Control and Prevention (CDC) to launch a new health information system (HIS) that will protect patients’ privacy, maintain confidentiality, and provide security for sensitive data.
In an article in Guyana’s Kaieteur News, Deputy Chief Medical Officer, Dr. Karen Boyle, described how health officials hope to reduce health service quality inequities between coastal regions and other parts of the country as part of the national 2020 plan, in part by reducing waiting time for medical services and improving patient health literacy. Dr. Boyle stated they expect to “improve access to health information” and allow for “shared responsibility” for health care decision-making by providers and patients.
The health information upgrade is also being supported by PAHO (the Pan-American Health Organization), UNAIDS, and local collaborating partners such as the University of Guyana, e-Government, the National Insurance Scheme, and the Government Technical Institute (GTI).
The workshop aimed to support the development of efficient strategies to achieve the UNAIDS 90-90-90 goals: 90% of HIV-positive people know their status, 90% of those are on treatment, and 90% of those are virally suppressed. To this end, the workshop covered national situational analysis, national clinical recommendations, and service delivery models with the highest potential for adaption in country.