ITECH works increasingly on projects that twin universities. Partners are assisted to improve the quality and relevance of pre-service education for a range of health care professionals, including graduating physicians, clinical officers, nurses, social workers, psychologists, and lab technicians. ITECH provides competency-based HIV and AIDS curricula for nursing and medical schools, including technical support to schools in several developing countries across the globe to integrate infectious disease-related content into their training. In Angola, ITECH will provide the technical assistance required for health care professions training with an initial emphasis on the most established public universities in Angola, which are Luanda and Huambo.

The Angola MOH programs require additional staff in various technical areas, but a description of the profiles needed and the tasks/scope of practice responding to the needs of the country are not well defined. There is a need to update the pre-service syllabi of health care providers, but the process has taken more than four years when coordinating with the Ministry of Education (MoE). Technical assistance is needed to move this process forward. The secretariat of higher education based out of the MoE regulates all higher education in the country. The MoE conducts these health training, accredits the teaching system and defines the career categories in Angola The MoH manages 18 training institutions for mid-level practitioners, and opened five health schools in different provinces with an emphasis on basic-level training There is presently a plan in place to eliminate basic-level staff through promotion programs that will upgrade them to mid-levels. The MoE hopes to reinforce the technical competencies of the trainees / health professionals.

Senior-level training provided by the Faculty of Medicine at the Universidade Agostinho Neto train nurses, physicians, and lab technologists with an emphasis on physicians and graduates about 80 90 students annually. The Instituto Superior de Enfermeria (ISE) trains nurses. The government recently opened five more medical schools in different provinces under the government's decentralization plan, which includes the training of health providers. The government's plan is to graduate approximately 400 physicians annually within the next 4 to 5 years in different regions. It is hoped that this will contribute to retention of health staff in their home areas and stimulate research and other academic capacities in the region.

Until now, most senior level nurse graduates have been managers. For those who have specialized in teaching, their scopes of work have been clear. However, confusion exists around those conducting clinical work because there is not a clear distinction of roles among the different categories of nurses (basic, mid-level and high level). Most difficulties occur for those graduates who are employed at public health facilities where there is no tradition for placing high-level nurses in facilities as health care providers. In private clinics nurses typically manage the facilities and care for specialized cases.

Regarding the inclusion of HIV content in the nursing curriculum, there is an integrated course on Sexually Transmitted Infections (will become Infectology in future courses), which covers HIV content. Currently, only physicians are authorized to prescribe ARVs, although this is a debate whether this will continue. The Faculty of Medicine and the ISE should work closely together in this area to maximize on efficiency and resources.

For each pre-service initiative, ITECH is positioned to provide the technical assistance required for health care professions training in Angola with an initial emphasis on the most established public universities in Angola situated in the provinces of Luanda and Huambo to revise their pre-service curricula to reflect: 1) the most pressing health needs of the community served, 2) the daily responsibilities of the health care professionals, and 3) the availability of diagnostic tools, drugs, and equipment in the settings in which students will work upon graduation. Due to the pressing need to scale up prevention and ART in Angola, ITECH's pre-service strengthening largely focuses on integrating up-to- date educational content on HIV and AIDS, so all categories of health care workers are better equipped to deliver HIV services.

With FY 2010 and prior year funding, ITECH will assist the MOE with the following activities:

Convening and facilitating stakeholders in strategic planning for pre-service reform;

Assessing the skill and knowledge needs of health care professionals in their local service contexts;

Assessing the capacity of schools to prepare students with necessary skills and knowledge.

Assessing the clinical content and teaching methods of existing curricula;

Rewriting health care curricula to integrate evidence-based content, including learning objectives for curricula and competencies for graduates;

Developing supporting materials, including syllabi, lesson plans, and reference manuals;

Mentoring and building capacity in faculty and other stakeholders in new clinical content, teaching methods, curriculum design, and monitoring and evaluation; and

Evaluating educational outcomes.