The University of Maryland Partnership for Advanced Clinical Education (PACE) goal is to increase the impact, efficiency, and sustainability of pre-service and in-service HIV training in Kenya. The main objective is to support Kenyas 6 public universities to deliver HIV education which is based on core competencies for HIV service delivery and uses teaching methodologies that maximize adult learning. The PACE strategies link to Kenyas GHI strategies as the program is designed around the Kenya National AIDS Strategic Plan (KNASP) III and working through Ministry of Health (MoH) and local universities by supporting a national training cascade and system for managing in-service HIV training. PACE directly relates to Kenyas Partnership Framework in that HIV service delivery depends on an efficiently trained workforce of highly competent healthcare workers.

PACE will implement a more efficient and sustainable model of HIV training in Kenya by reducing the requirement for costly off-site and hotel-based trainings.

PACE is collaboration between the University of Maryland Baltimore and the University of Nairobi (UON). UON is taking on increasing responsibility for planning and implementing the program and all direct implementation of activities will transition to UON during the grant period.

PACE is developing an M&E framework with output, outcome, and impact indicators that will measure how this new training model improves clinical practice and patient outcomes.

PACE has procured 2 vehicles between FY10 and FY11. An additional vehicle will be required for travel to the 6 public universities and to regional training centers which will pilot the new in-service training model.

The University of Maryland Partnership for Advanced Clinical Education (PACE) in partnership with University of Nairobi (UON) will continue to support pre-service and in-service TB training nationally with focus on three training areas: Pre-service University HIV Education and Training, In-service HIV Training, and Pre-service and In-service HIV Laboratory Education and Training.

PACE is a national program targeting pre-service and in-service health care workers and trainers/mentors. The PACE goals and objectives are being achieved using strategies that link to Kenyas GHI strategies of increased impact through strategic efficiencies, country ownership, strengthening health systems, and rigorous M&E (through implementation of an M&E framework to measure output, outcome, and impact indicators). PACE also directly relates to Pillar 1 of Kenyas Partnership Framework in that HIV service delivery depends on a growing workforce of highly competent healthcare workers and that workforce will be more efficiently trained as a result of PACE.

The PACE program objectives are to support Kenyas 6 public universities to deliver HIV education based on core competencies for HIV service delivery and that uses appropriate adult learning teaching methodologies; partner with the Ministry of Health (MoH) in designing and implementing an integrated competency-based in-service HIV training curriculum that utilizes self-learning and on-site mentorship delivered through a coordinated training network (including TB/HIV); and develop capacity within universities, medical training colleges, and MoH health facilities to provide structured, practical, and high quality in-service training in HIV laboratory services, including TB diagnostic competencies.PACEs contribution to scaling up TB/HIV activities is through the development and implementation of the new integrated in-service HIV curriculum that includes the 5Is of TB/HIV prevention and co-management, including universal testing for HIV in TB services, routine screening for TB in HIV patients, isoniazid preventive therapy, early initiation of ART in TB/HIV co-infected patients, and infection control in the HIV patient care areas. PACE will build capacity of HCWs and facilities for TB/HIV by training and supporting mentorship/training teams at the regional training centers, which will cascade the new curriculum to their own site and peripheral health facilities.

PACE is adequately equipped with Human Resource Capacity to support the development of regional training capacity, comprised of a National Technical Assistance team of Clinical Nurse Trainer, Community Based Treatment Support Nurse Trainer, Medical Laboratory Specialist, CQI Specialist, Pharmacy Specialist, and Strategic Information Specialist. In FY 12 and 13, this team will support 7 regional training centers, in collaboration with MoH and other implementing partners, by assisting in the development of clinical care delivery systems that provide high quality patient care and thus support effective training as well as build the capacity of the regional training teams in these sites.

As part of the sustainability strategy, UON is taking on increasing responsibility for planning and implementing the program and all direct implementation of activities will transition to UON during the grant period. In addition, the program has involved UON faculty as national level master trainers/mentors with an aim to increase exposure to level 3.

The child health training program will build knowledge and capacity of 6500 health workers in community case management of pneumonia, malaria and diarrheal diseases in the highest HIV prevalence areas of Western, Nyanza and Coast Provinces. The training curricula consist of community case management of uncomplicated pneumonia, diarrheal diseases, and malaria in areas with poor access to healthcare, and the ability to refer complicated cases to the facility level. Activities for the health workers include training targeted at increased diagnosis and management of pneumonia, diarrheal diseases, and malaria. These activities will be achieved through implementation and scale-up of the Integrated Management of Childhood illnesses (IMCI) and use of rapid diagnostic tests for HIV, malaria, and other diarrheal diseases. All of these activities are defined as Government of Kenya (GOK) priorities and are stipulated in the national health services strategic plan. The GOK and other partners will continue to support these activities either through the national or county governments in the event that PEPFAR funding is only provided for the initial implementation period.

The Government of Kenya has also developed a community health strategy that relies on community based health workers to reach mothers and their children within their households. Lifesaving interventions and messages will be scaled up to reach children living with HIV/AIDS and therefore enable prevention of opportunistic infections which will result in improvement of quality of life. Proposed activities include the development and deployment of eLearning materials and messages that can be deployed through a variety of different mobile technologies to include smartphones, SMS, DVD, and internet-based. The focus of these will concentrate mainly on promotion of prevention methods, healthy behaviors at household level including exclusive breastfeeding for children below 6 months, appropriate complementary feeding, dietary diversity targeting -9 to 24 months period, use of long-lasting insecticide-treated bed nets (LLINs), hand washing with soap, safe water storage and treatment and community-led total sanitation.

The Partnership for Advanced Clinical Education (PACE) is a partnership between University of Maryland Baltimore (UMB), as a prime partner and University of Nairobi (UON) to support the strengthening of pre-service and in-service HIV education and training in Kenya, since COP 2009. In their first two years of project implementation, PACE has registered various laboratory-related accomplishments, key of which include: revised and developed an integrated in-service base-level laboratory curriculum; a standard pre-service teaching lab to be used by the Kenyan universities or MTCs for skills training; identified 4 mentorship training centers to provide in-service cost-recovery training; trained a total of 264 laboratory personnel: 83 in computer literacy(ICDL), 95 in Laboratory inspection, and 86 on laboratory ART monitoring techniques.

In the FY12 and beyond, PACE will build on previous achievements and lessons learnt to sustain the PACE partnership with more local universities, training institutions and the ministry of health. During this period, this partnership will transition into a mechanism for sustainable exchange of knowledge, skills, best practices between UMB and Kenya. In the long term, this mechanism will provide high-level technical capacity to Kenyan training institutions to ensure greater academic and strategic medical independence. To achieve these broad goals and specific deliverables (below), a budget of $350,000 for the FY 2012 is proposed for the PACE partnership:

Support and sustain regional training centres: PACE will provide TA to the 4 regions developed in the FY 11 to facilitate and cascade training to lower facilities. Through these training centres, standardized lab tools and packages will be used to train 200 laboratory staff in FY 2012 and a similar number in FY 2013

Support to KMTCs to administer cost-recovery in-service training: In FY 12, PACE will continue providing TA to KMTC laboratory mentorship training facilities on cost-recovery and training activities. The TA will be directed to the 3 KMTC facilities established in FY 2011. By the end of FY 2012, 100 laboratory staff will have been trained at these facilities.

The activities proposed for PACE will have strong linkages with the PEPFAR technical area on training and retention of laboratory professionals as it relates to sustaining pre-service training and also providing required technical competencies and skills transfer to staff already in service.

The University of Maryland Partnership for Advanced Clinical Education (PACE) in partnership with University of Nairobi (UON) will continue to support pre-service and in-service training nationally with focus on three training areas: Pre-service University HIV Education and Training, In-service HIV Training, and Pre-service and In-service HIV Laboratory Education and Training.

The overarching goal of PACE is to increase the impact, efficiency, and sustainability of pre-service and in-service HIV training in Kenya. The objectives are to support Kenyas 6 public universities to deliver HIV education which is based on core competencies for HIV service delivery and uses teaching methodologies that maximize adult learning; partner with Ministry of Health (MoH) in designing and implementing an integrated competency-based in-service HIV training curriculum that utilizes self-learning and on-site mentorship delivered through a coordinated training network; and develop capacity within universities, medical training colleges, and MoH health facilities to provide structured and practical high quality in-service training in HIV laboratory services. PACE is a national program targeting pre-service and in-service health care workers and trainers/mentors.

PACE will provide on-site mentorship and systems strengthening through its national Technical Assistance team comprised of a Clinical Nurse Trainer, Community Based Treatment Support Nurse Trainer, Medical Laboratory Specialist, Continuous Quality Improvement Specialist, Pharmacy Specialist, and Strategic Information Specialist. In FY12, this team will support 7 regional training centers, in collaboration with MOH and other implementing partners, by assisting in the development of clinical care delivery systems that provide high quality patient care and thus support effective training as well as build the capacity of the training team in these sites. In addition, the program has involved UON faculty as national level master trainers/mentors with an aim to increase exposure to level 3 and 4 facilities.

The PACE contribution to scaling up HVCT services is through the development and implementation of the new in-service HIV curriculum that includes HTC and through improving capacity at the regional training centers to operationalize the new guidelines. PACE will build capacity of health care workers and facilities to provide HVCT services by training and supporting mentorship/training teams at the regional training centers, which will cascade the new curriculum to their own site and peripheral health facilities.

The University of Maryland Partnership for Advanced Clinical Education (PACE) in partnership with University of Nairobi (UON) will continue to support pre-service and in-service training nationally with focus on three training areas: Pre-service University HIV Education and Training, In-service HIV Training, and Pre-service and In-service HIV Laboratory Education and Training.

The overarching goal of PACE is to increase the impact, efficiency, and sustainability of pre-service and in-service HIV training in Kenya. The objectives are to support Kenyas 6 public universities to deliver HIV education which is based on core competencies for HIV service delivery and uses teaching methodologies that maximize adult learning; partner with Ministry of Health (MoH) in designing and implementing an integrated competency-based in-service HIV training curriculum that utilizes self-learning and on-site mentorship delivered through a coordinated training network; and develop capacity within universities, medical training colleges, and MoH health facilities to provide structured and practical high quality in-service training in HIV laboratory services. PACE is a national program targeting pre-service and in-service health care workers and trainers/mentors.

PACE will provide on-site mentorship and systems strengthening through its national Technical Assistance team comprised of a Clinical Nurse Trainer, Community Based Treatment Support Nurse Trainer, Medical Laboratory Specialist, Continuous Quality Improvement Specialist, Pharmacy Specialist, and Strategic Information Specialist. In FY12, this team will support 7 regional training centers, in collaboration with MOH and other implementing partners, by assisting in the development of clinical care delivery systems that provide high quality patient care and thus support effective training as well as build the capacity of the training team in these sites. In addition, the program has involved UON faculty as national level master trainers/mentors with an aim to increase exposure to level 3 and 4 facilities.

The PACE contribution to scaling up PMTCT services is through the development and implementation of the new in-service HIV curriculum that includes PMTCT and through improving capacity at the regional training centers to operationalize the new guidelines including early entry into care and completion of the PMTCT cascade. Training also includes competencies on early infant diagnosis, PITC, effective ARV regimens for PMTCT, and appropriate use of laboratory diagnosis and monitoring. PACE will build capacity of 200 health care workers and facilities to provide PMTCT services by training and supporting mentorship/training teams at the regional training centers, which will cascade the new curriculum to their own site and peripheral health facilities.

The University of Maryland Partnership for Advanced Clinical Education (PACE) in partnership with University of Nairobi (UON) will continue to support pre-service and in-service training nationally with focus on three training areas: Pre-service University HIV Education and Training, In-service HIV Training, and Pre-service and In-service HIV Laboratory Education and Training.

The overarching goal of PACE is to increase the impact, efficiency, and sustainability of pre-service and in-service HIV training in Kenya. The objectives are to support Kenyas public universities to deliver HIV education which is based on core competencies for service delivery and uses teaching methodologies that maximize adult learning; partner with the Ministry of Health (MoH) in designing and implementing an integrated competency-based in-service HIV training curriculum that utilizes self-learning and on-site mentorship delivered through a coordinated training network; and develop capacity within universities, medical training colleges, and MoH health facilities to provide structured, practical, and high quality in-service training in HIV laboratory services.

Pre-service training to 600 HCWs in FY 12 and 500 in FY 13 will include training university faculty and internship supervisors on innovative teaching methods to enable them to utilize principles of adult learning and better engage their students. Additionally, the pre-service institutions are able to use the competency based in-service integrated HIV training curriculum to support pre-service HIV training. PACE also supports a multi-disciplinary, in terms of student cadres and the training faculty, HIV consolidation workshop for final year health science students at Kenya's public universities to help navigate the transition between training and practice.

For in-service training, PACE will provide on-site mentorship and systems strengthening to 500 HCWs in FY 12 and 400 in FY 13 through its national Technical Assistance team comprised of Clinical Nurse Trainer, Community Based Treatment Support Nurse Trainer, Medical Laboratory Specialist, Continuous Quality Improvement Specialist, Pharmacy Specialist, and Strategic Information Specialist. In FY13 this team will support 7 regional training centers, in collaboration with MOH and other implementing partners, by assisting in the development of clinical care delivery systems that provide high quality patient care and thus support effective training as well as build the capacity of a regional training team in these sites. In addition, the program has involved UON faculty as national level master trainers/mentors with an aim to increase exposure to level 3 and 4 facilities.

PACE tracks and evaluates the programs performance through data collected during the trainings. This tracking specifically accounts for the number of health care workers, faculty, or students who successfully complete the training. PACE is developing an M&E framework that goes beyond the standard training evaluations of recall-based assessments to also measure how this new training model improves clinical practice and patient outcomes. This evaluation will be accomplished through analysis of routinely collected program data and leveraging on formal evaluations funded through other mechanisms such as CQI data collected through NASCOPs HIVQUAL program and the national longitudinal patient-level outcome studies.

The University of Maryland Partnership for Advanced Clinical Education (PACE) in partnership with University of Nairobi (UON) will continue to support pre-service and in-service pediatric training nationally with a focus on three training areas: Pre-service University HIV Education and Training, In-service HIV Training, and Pre-service and In-service HIV Laboratory Education and Training.

The overarching goal of PACE is to increase the impact, efficiency, and sustainability of pre-service and in-service HIV training in Kenya. The objectives are to: support Kenyas 6 public universities to deliver HIV education which is based on core competencies for HIV service delivery and uses teaching methodologies that maximize adult learning; partner with Ministry of Health (MoH) in designing and implementing an integrated competency-based in-service HIV training curriculum that utilizes self-learning and on-site mentorship delivered through a coordinated training network; and develop capacity within universities, medical training colleges, and MoH health facilities to provide structured and practical high quality in-service training in HIV laboratory services. PACE is a national program targeting pre-service and in-service health care workers and trainers/mentors.

PACE will provide on-site mentorship for pediatric and systems strengthening through its National Technical Assistance team comprised of a Clinical Nurse Trainer, Community Based Treatment Support Nurse Trainer, Medical Laboratory Specialist, Continuous Quality Improvement Specialist, Pharmacy Specialist, and Strategic Information Specialist. PACE, in collaboration with MoH and other implementing partners, will provide technical assistance to 500 specialists in FY 12 and 400 in FY 13 by assisting in the development of clinical care delivery systems that provide high quality patient care and thus support effective training as well as building the capacity of the training team in these sites. In addition, the program has involved UON faculty as national level master trainers/mentors with an aim to increase exposure to level 3 and 4 facilities.

PACE will contribute to scaling up of pediatric treatment through the development and implementation of the new in-service HIV curriculum that includes pediatric HIV care and treatment. Training also includes competencies on early infant diagnosis, PITC, appropriate use of laboratory diagnosis and monitoring, and adolescent-specific services. PACE will build capacity of health care workers and facilities to treat children by training and supporting mentorship/training teams at the regional training centers, which will cascade the new curriculum to their own site and peripheral health facilities.