ITECHs primary focus is on providing TA in the areas of in-service and pre-service curriculum design, strategic planning for health worker education, task shifting, faculty development, and clinical mentoring. Their activities align with the PF goal of strengthening the Mozambican health system including HRH and social welfare in key areas to support HIV prevention, care and treatment. They will also support GBV programming by incorporating information on GBV directly into the pre-service curriculums - ensuring that all new graduates have been educated on the topic. The geographic coverage is national with emphasis on select pre-service institutions for faculty development activities. ITECH is working to streamline their costs as they have participated in the expenditure analysis exercise and strive to reduce investment costs as they move into their recurrent cost implementation phase. Most of their curricula development activities are ending which will also reduce their costs. ITECH is committed to transfer skills to their staff and has developed a timeline for mentoring their Mozambican staff to move into positions that are currently held by an expatriate. A further demonstration of their cost savings is through a reduction of over 2 mill from their last year's budget. ITECH has a robust M&E plan in place. They record and report on PEPFAR indicators robustly, and conduct periodic outcome evaluations to measure changes in student performance under new curriculums, following faculty training, and after in-service trainings. They are also conducting a PHE to formally assess the skills and knowledge of recent graduates from the ITech developed medical technician curriculum as compared to graduates from the old curriculum. ITECH does not plan to purchase vehicles.

I-Tech supports Ministry of Health (MOH) priorities outlined in the Human Resources National Development Plan (2008-2015).In 2012 will continue to support the following activities:I-Tech wil significally scale up Faculty Development efforts and conduct Distance Trainings in 15 Pre-service Training Institutes (IdFs) including 4 of the largest health training institutions (Maputo, Beira, Quelimane, Nampula).This includes the development, piloting and implementation of a new teacher training course for new HTIs teachers as well as roll-out to existing faculty in a modular form outside of work hours; the establishment of a new training data base linked to the central level to better track students; the on-going capacity building of the existing faculty and administration thorugh the establishment of pedagogic nucleos; day to day technical support to the faculty; purchasing training materials and support for the teachers as they implement the new TM pre-service course. I-Tech will Conduct baseline assessments for measuring the impact of 6 months training programs and adapt the existing pedagocgic trainig materials to 6 months, certificate-level for faculty. Also provide management and leardership training, clinical upadates, and pedagogic training via distance lerning and on-site follow-up and mentoring.Clinical mentoring, QA/QI, warmlineI-tech will expand its Continuing Medical Education program for clinition and mentors to all provinces . I-TECH will provide HIV/AIDS training to newly graduateted medical doctors before their placement in the field. I-TECH will provide training on the Pediatrics ART to mentors, then will assist mentors to conduct training to TMs. The training will be followed by one-week intensive support to mentors and TMs. I-TECH will maintain a mentor consultation line so that mentors can phone if/when they have difficult mentoring or clinical case while visiting TMs. I-Tech will also ensure the integration of positive prevention in all I-Tect and Misau pre& in-service training.Clinical officer curriculum revisionThis activity will continue by a combined effort of the implementing partner works closely with the MOHs Training Department as they develop national products (i.e. curricula) and systems (i.e. clinical mentoring). M & E plans are a required component of each I-TECH activity and include process (i.e., draft curriculum piloted), output (i.e., numbers trained), and outcome indicators (i.e., measureable improvement in quality of HIV care provided by Clinical Officers). Prior to any training program, each curriculum undergoes a rigorous evaluation that consists of an external clinical review (by a pre-tested Portuguese-speaking clinical expert) followed by a review of language and cultural appropriateness, and finally a pilot training using the draft curriculum. Gender-based violence (GBV) materials are being incorporated directly into the new curriculum with the use of extra GBV funds alloted for this purpose.Continuing education. Jhpiego will partner with ITech and the MoH Human Resources Directorate to create a national plan for continuing education for mid- and basic-level nurses, MCH nurses, and tecnicos de medinca. Partner will also work on promotional courses for Agentes de Medicina (basic level) to become Tecnicos de Medicina (mid-level)

ITECH priority in FY2012 is to support the MoH to address the gaps in trainings for MNCH service providers as a result of adoption of recent policy developments whereby task shifting was authorized for MCH nurses start prescribing ART in MCH services. Main interventions will be focused in central level coordination for training MCH nurses, using curriculum that MISAU developed with other partners support.In FY2012 ITECH will implement the following Key activities:1) Coordinate with central level MISAU for organization of training of trainers (TOT) in ART provision by MCH nurses;2) In collaboration with MISAU, conduct TOT in ART provision for MCH nurses.ITECHs role will focus on the in-service training component of ART task shifting for MNCH service providers.

With the PEPFAR funds for FY12, ITECH will develop the following activities as part of quality improvement of HIV care and treatment and related conditions in Mozambique:1. Develop, pilot, and maintain a national telemedicine and continuing medical education for HIV care and treatment and related conditions program for clinicians:Develop and operate a low-cost national telemedicine service for clinicians, used for virtual mentoring, clinical case discussions, new protocols dissemination, etc; work towards developing a decentralized model at the provincial level.Maintain a telemedicine website where case discussions and teaching sessions are archived for public useExpand I-TECHs Continuing Medical Education program for clinicians and clinical mentors in all provinces using both on-site and distance learning technologies; archive sessions on the telemedicine website and address common issues or questions in trainingsContinue with assistance on dissemination of clinical protocols/guidelines of the different clinical programs (STI syndromic management per the request of CDC and DNAM).

2. Provide technical assistance to DNAM for developing and implementing the new national strategy for Quality Improvement and Humanization that covers HIV and non- HIV health conditions:Continue to provide TA to DNAM and the DPSs supporting the implementation of Quality Standards of HIV care and treatment by the clinical teams in the Health UnitsContinue to train and mentor Provincial Health Management Committees and focal points at the provincial level in management, implementation, and supervision of the prioritized quality improvement goals (virtually and on-site)Continue to provide HIV/AIDS training for recently graduated medical doctors before their placement in the fieldAs per DNAMs request, provide TA to adaptation of HIV/AIDS ART content and technically support the training of Agentes and Nurses in their new ART task-shifting roles; provide follow up through an integrated quality improvement approach;Continue to provide assistance on the implementation of clinical protocols/guidelines of the different clinical programs (STI syndromic management per the request of CDC and DNAM).Continue to support the implementation of the classification of clinical staff (quantity and skills) per health unit

3. HTXS funds will complement task shifting for MCH nurses to start prescribing ART in MCH services as described in the MTCT budget code narrative. Main interventions will be focused in central level coordination for training MCH nurses, using curriculum that MISAU developed with other partners support.In FY2012 ITECH will implement the following Key activities:1) Coordinate with central level MISAU for organization of training of trainers (TOT) in ART provision by MCH nurses;2) In collaboration with MISAU, conduct TOT in ART provision for MCH nurses.

ITECHs role will focus on the in-service training component of ART task shifting for MNCH service providers.