PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
It was determined that Activities 1-6 are now covered under Health Systems Strengthening. With FY 2009
funds, these activities will continue as described in the FY 2008 COP with expansion to new geographic
areas as sites are graduated. In FY 2009 there will be an emphasis on developing graduating sites as
mentors to new sites for sustainability.
Activity 7: Pharmacovigilance
Funds will be used to support pharmacovigilance capacity building. Health care workers will be trained on
filling out the South African government forms for pharmacovigilance. Routine meetings will also be held
with health care workers to highlight issues of data quality and interpretation of the data from the routine
reporting for pharmacovigilance. The objective of this activity it to ultimately improve the quality of care that
patients receive in public sector facilities.
---------------------------------
SUMMARY:
I-TECH carries out activities to support the expansion of HIV and AIDS, tuberculosis (TB) and sexually
transmitted infection (STI) care and treatment in the Eastern Cape (EC) through on-the-job clinical
training/mentoring activities. The primary emphasis area for these activities is human capacity development;
minor emphasis areas are strategic information and local organization capacity building. The primary target
populations are doctors (public and private), pharmacists (public), and nurses (public)
BACKGROUND:
I-TECH has been working in the EC since 2003 to develop the capacity of clinicians in the care and
treatment of HIV and AIDS, TB and STI. The activities described here were first funded by PEPFAR
between FY 2004 and FY 2007. The EC Department of Health (ECDOH) specifically requested I-TECH to
conduct on-the-job training and mentoring to augment didactic trainings conducted by the Eastern Cape
Regional Training Centre (ECRTC) and other professional training organizations in the EC, as well as the
placement of I-TECH mentors in the EC for longer periods of time (i.e., six to twelve months) to allow
ongoing mentoring. Treatment/ARV Services activities were and will continue to be largely implemented by
I-TECH's subcontractor, the University of California at San Diego (UCSD) Owen Clinic. I-TECH central
office (Seattle) and South Africa country staff have and will continue to provide oversight and logistical
support related to this activity.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Human Capacity Building and Program Sustainability: In-country Intensive Mentoring of the
ECRTC Clinical Team
This activity continues the work begun in FY 2004 to mentor the EC RTC clinical teams in-country. FY 2008
PEPFAR funds will continue to support I-TECH's intensive mentoring model of the ECRTC's medical teams
on a limited basis as the ECRTC medical teams' clinical care and mentoring capacities have improved. It is
expected that up to three new RTC clinical team medical officers will be mentored by experienced ECRTC
clinical team members and by year-round I-TECH UCSD mentors (see Activity 3). Specific activities for
which FY 2008 PEPFAR funds will be used are itemized in Activity 2; Activity1 will occur simultaneously
with Activity 2.
ACTIVITY 2: Human Capacity Building: Educational support of EC clinicians via in-country clinical
training/mentoring and monitoring
In FY 2008 I-TECH and UCSD mentor teams will be placed in the EC year-round to mentor the two full-time
I-TECH clinical mentors (see Activity 6 below), the I-TECH mentoring coordinator (see Activity 4), and
health care workers (HCW) in EC clinics (includes clinics targeted and not targeted by the ECRTC in their
FY 2008 plan). The I-TECH and UCSD mentor teams will include one to two clinical mentors: up to six
infectious disease or HIV fellows spending a minimum of two months during each rotation, and up to six
expert UCSD HIV faculty physicians, pharmacists or nurse practitioners spending a minimum of a month
during each rotation. FY 2008 funds will support UCSD Owen Clinic administrative staff time, and the
salaries, travel, lodging and expenses for the Owen Clinic mentor teams. I-TECH UCSD mentors and the
Owen Clinic Director will visit the Mpumalanga regions to provide clinical mentoring (see Palliative Care;
HIV/TB). Depending on the results of I-TECH's Limpopo Needs Assessment, clinical mentoring may be
provided in this province (see Other Policy/Systems Strengthening). Up to six mentors are allocated for
these two activities.
ACTIVITY 3: Sustainability: Mentorship Coordinator
This activity began in FY 2007 whereby PEPFAR funds were used to hire a local mentorship coordinator in
the EC to plan and coordinate the in-country logistics and support for the UCSD clinical mentors, and
provide clinical mentoring to Eastern Cape HCW. In FY 2008, funds will be used to pay the coordinator's
salary and in-country travel expenses, as well as one trip to the UCSD Owen Clinic for intensive mentoring.
ACTIVITY 4: Human Capacity Building and Sustainability: Precepting senior level EC clinicians at the Owen
Clinic
This activity began in FY 2004 whereby PEPFAR funds were used to support the air travel, lodging and per
diem of committed EC clinicians to travel to the Owen Clinic for a two-week intensive training on systems of
care and clinical management. The intent of this activity is to develop EC clinician leadership to champion
HIV treatment issues through the further development of clinical skills, and increased knowledge of systems
of care and quality improvement methodologies. FY 2008 funds will support the air travel, lodging and per
Activity Narrative: diem to intensively train 2 ECRTC health care workers, the mentoring coordinator (see Activity 3), and the
two full-time I-TECH South Africa doctors for two weeks each at the Owen Clinic on systems of care and
clinical management issues (see Activity 6).
ACTIVITY 5: Human Capacity Building: Distance-based ongoing clinical consultation
This activity was first funded by PEPFAR in FY 2005. During UCSD/ECRTC trainings, EC clinicians are
encouraged to contact the RTC team for clinical consultation as needed, who then forward the query and
response to the UCSD Owen Clinical mentors for additional guidance before delivering their consultative
advice. Achievements toward FY 2007 goals include the provision of 48 distance consultations to Eastern
Cape HCW in the first months of FY 2007. In FY 2008, PEPFAR funds will support UCSD consultants' time
(a portion of salaries) related to the time spent fielding consultations; estimated at five consults per week.
Activity 6: Human Capacity Building and Sustainability: Developing the treatment and mentoring capacity
of two in-country clinical mentors
I-TECH's FY 2008 activities will be expanded to hire and mentor two doctors as full-time I-TECH mentors in
the EC. Funds will be used to pay the doctors' salaries for twelve months and in-country travel expenses, as
well as one trip each to the UCSD Owen Clinic for intensive mentoring.
ACTIVITY 7:
By training a large cadre of healthcare workers to provide ARV services, I-TECH will contribute to the
PEPFAR goal of providing treatment to 2 million people by increasing access to quality HIV/AIDS/TB/STI
care and treatment.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13868
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13868 3334.08 HHS/Health University of 6637 2808.08 I-TECH $2,455,000
Resources Washington
Services
Administration
7491 3334.07 HHS/Health University of 4439 2808.07 University of $800,000
Resources Washington Washington/I-
Services TECH
3334 3334.06 HHS/Health University of 2808 2808.06 $350,000
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $600,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.09:
The International Training and Education Center on HIV (I-TECH) will expand COP 2008 activities in the
following ways affecting TB/HIV training and mentoring, and the integration of TB and HIV curricula
activities in the Mpumalanga and Limpopo Departments of Health (DOH) and their Health Professions
Quality Assurance (HPQA) Centres.
I-TECH will implement and evaluate two one-and-a-half day TB/HIV and clinical treatment update training
courses, consisting of 80 participants in total, for Mpumalanga and Limpopo DOH, HPQA Centres. The
target audience will consist of HPQA Centre trainers, provincial DOH district trainers, and project managers
(i.e., doctors and nurses from Mpumalanga and Limpopo antiretroviral treatment (ART) clinics). Content of
the courses will include guidelines for palliative care, screening for TB in people living with HIV (PLHIV),
implementation of isoniazid preventative therapy, HIV counseling for TB suspects, diagnosis and
management of TB in PLHIV including HIV-resistance drug interactions, and HIV in pediatric care. Such
updates were conducted in the Eastern Cape, and described in COP 2008. Newly employed Eastern Cape
HPQA Centre trainers, Department of health district trainers and project managers may attend the trainings
in Limpopo or Mpumalanga provided sufficient space and funding.
An integrated training model for the Mpumalanga DOH's HPQA includes (1) development of a basic HIV &
AIDS, STI and TB (HAST) in-service training curriculum; (2) modification of a specialized TB/HIV training
curriculum based on current South African National Department of Health treatment guidelines; (3)
identification of selection criteria for enrollment into the TB/HIV specialized course; (4) development of
course certificates; and (5) evaluation tools. To build the Mpumalanga DOH human capacity, I-TECH
curriculum specialists will work with a dedicated Mpumalanga DOH team to facilitate the TB/HIV curriculum
integration process, develop or revise curricula, prepare TB/HIV materials for clinical review and pilot
testing, and provide technical assistance on evaluation processes, tools and certificates. The integrated
plan and developed or revised curricula will be shared with the National Department of Health, the Limpopo
and Eastern Cape HPQA Centres, and finally, will be promoted to the other six provincial HPQA Centres. I-
TECH is working with the Mpumalanga DOH to build momentum, vision, and commitment to development
of in-house capacity for production of quality curriculum materials.
In FY 2009, I-TECH will provide technical assistance on TB/HIV curriculum integration to the six remaining
provinces. FY 2009 funds will be used do support salaries for the Limpopo, Mpumalanga and Eastern Cape
DOH HPQA Centres, to hire one medical officer per site.
I-TECH will develop, implement, and evaluate two three-day interactive mentoring-of-mentors' workshops
conducted for the Eastern Cape, Limpopo, and Mpumalanga DOH HPQA Centre mentors (i.e., doctors,
nurses, pharmacists). The course aims to develop effective mentoring (on-the-job) skills and to improve the
mentor's TB/HIV clinical decision-making skills. The first two days will be dedicated to strengthening
mentoring skills using a newly published I-TECH clinical mentoring curriculum adapted for South Africa. The
third day will focus on updated TB/HIV clinical content, using case study presentations and discussions
intended to improve service delivery (e.g., intensified case-finding, the scale up of isoniazid preventive
therapy, TB infection control guidelines, and screening questions), and decrease the burden of HIV in
patients with TB disease (e.g., referral of all TB patients identified as HIV-infected for care and treatment,
provider-initiated counseling and testing, detection and proper management of multi- and extensively drug-
resistant TB (MDR/XDR TB) in HIV-infected patients). Mentors from the remaining provincial HPQA Centres
and provinces may attend given sufficient space and funding.
A two-person I-TECH/University of California, San Diego (UCSD) mentoring team (including one infectious
disease clinician and one nurse practitioner) will conduct three one-month mentoring-of-mentor visits to
Mpumalanga. The team will accompany the Mpumalanga DOH Training Advisor, medical doctor and other
HPQA clinical team mentors (i.e., medical officers, nurses, pharmacists) to three clinics (one week per clinic
each month for three months) to provide on-site TB/HIV care and treatment mentoring. The UCSD team will
mentor up to two doctors and two nurses per site (12 total) and consult total of 50 patients with TB and HIV
per week. Clinic shadowing will be augmented by bedside rounds, case study discussions, and distance
learning supported by HIV physician experts. This highly interactive training/mentoring model is consistent
with I-TECH's best practices for changing knowledge into practice, and allows health care workers to obtain
the specialized knowledge and TB/HIV clinical decision-making skills specific to their actual job
responsibilities (e.g., the early detection of HIV in TB patients (including pregnant women and children) and
vice versa, the management of TB in the HIV-infected patient, the management of MDR/XDR TB in HIV-
infected patients). TB infection control will be assessed at each clinic and recommendations reported to
clinic administrators
If the Limpopo DOH HPQA Centre hires doctors, nurses, and pharmacist mentors, I-TECH will support a
two-person mentoring team from UCSD to conduct two one-month mentoring-of-mentor visits. They will
accompany Limpopo DOH HPQA mentors to three ART clinics (one week per clinic each month for two
months) to provide on-site mentoring to the HPQA Centre mentors. The team will mentor two doctors and
two nurses per site (12 total) on TB/HIV care and treatment and consult 50 patients per week. The same
interactive methods used in Mpumalanga will be employed.
Expected outcomes or impact of these intensive mentoring visits include improved clinical practice and
service delivery, improved mentoring skills, and capacity building of DH HPQA Centres on development and
implementation of clinical mentoring programs.
Eastern Cape I-TECH/UCSD mentoring activities will continue as described in the COP 2008 model, but in
June 2009, it will transition to concentrated support of pre-service programs, curriculum, and faculty
development at the Walter Sisulu University (WSU), School of Medicine. By the end of FY 2009, it is
expected that the Eastern Cape HPQA Centre clinical team members will be working toward or will have
received post-graduate diplomas in HIV and AIDS from WSU, and through this program and I-TECH/UCSD
mentoring since 2004 will have the TB/HIV care and treatment knowledge, skills and experience to mentor
Activity Narrative: other health-care providers. This approach is consistent with I-TECH's goal of clinical mentoring programs,
which is to build the skills of local clinicians to become clinical mentors themselves. The HIV/AIDS
fellowship program in concert with a well established HPQA clinical mentoring team and model supports an
increased number of health-care workers providing quality TB and HIV services in the Eastern Cape.
In FY 2009, I-TECH will identify and establish agreements with effective South African ART clinics expert in
providing quality TB/HIV care and treatment to provide preceptorship experiences to HPQA health-care
providers and staff, reflective of I-TECH's commitment to build capacity of pre-service and in-service clinical
education opportunities within South Africa.
The above-mentioned activities also apply to the Health Systems Strengthening program area.
------------------------
The International Training and Education Center on HIV (I-TECH) FY 2008 COP activities will be expanded
to include technical assistance (TA) activities to enhance the Mpumalanga Department of Health (DOH)
RTC's organizational and human capacity to train Mpumalanga health care workers (HCW with the primary
target audience being doctors and nurses) on the care and treatment of concomitant HIV and TB and
thereby increase access to quality concomitant TB/HIV care and treatment in the province. Funds will be
used to support the technical (e.g., the development/modification of TB/HIV curricula in accordance with
national guidelines; curricula accreditation) and human capacity development of the Mpumalanga DOH
RTC (MRTC) to train Mpumalanga HCW on HIV/AIDS, tuberculosis (TB) and sexually transmitted infections
(STIs) care and treatment. The primary emphasis area for these activities is local organization capacity
building to affect the care and treatment of patients with HIV and TB. Human capacity development and
strategic information are secondary emphasis areas. The primary target organization is a host country
provincial government organization and its medical teams comprised of doctors and nurses.
I-TECH has been supported by PEPFAR for the past five years to work in the Eastern Cape province, with
the invitation and support of the South Africa (SA) National DOH and EC DOH, to develop the
organizational and human capacity of the EC RTC to train/mentor clinicians in the care and treatment of
HIV, AIDS, TB and STI. Organizational TA to the EC RTC included strategic planning, infrastructure
development, human resource development and management, small grant or proposal development, the
development of memoranda of understanding, financial management, marketing, health management
information systems, and disseminating best practices to improve program efficiency and effectiveness.
These activities will be extended to Mpumalanga province in FY 2008 and implemented by the primary
partner. Human capacity development of the EC RTC included the longitudinal mentoring of its clinical
teams by experienced I-TECH HIV specialists and infectious disease clinicians on the care and treatment of
HIV/AIDS/TB/STI and the art of effectively mentoring others. These clinical human capacity development
activities will be extended to the MRTC in FY 2008 and will be implemented by I-TECH's sub-contractor, the
University of California at San Diego (UCSD) Owen Clinic.
ACTIVITY 1: Human Capacity Building, In-country Mentoring of the Mpumalanga Regional Training Centre
(MRTC) Clinical Team
This activity expands I-TECH's in-country mentoring program to Mpumalanga. FY 2008 funds will be used
to mentor MRTC clinical staff to develop their mentoring skills as well as their clinical skills in the treatment
of concomitant TB/HIV patients, complex case management, rapidly emerging treatment complications, and
evidence-based clinical decision-making. Six I-TECH UCSD mentors will individually accompany MRTC
medical team members as they travel to sites in the province to provide onsite mentoring to Mpumalanga
clinicians while seeing together up to 50 patients per week. Mentoring will also include technical assistance
centered on systems strengthening provided to MRTC RTC sites/feeder clinics. FY 2008 PEPFAR funds will
support UCSD Owen Clinic administrative staff time, and the salaries, travel, lodging and expenses for six
infectious disease or HIV specialists to travel to Mpumalanga during FY 2007 for one month stays.
ACTIVITY 2: Program Sustainability: In-country Mentoring of the Mpumalanga Regional Training Centre
(MRTC) Clinical Team to Develop and Update Curricula
FY 2007 PEPFAR funds supported a needs assessment of the Mpumalanga HCW TB/HIV training needs.
In 2008, the results will be utilized to assist the MRTC to develop/modify and accredit its TB and HIV
training courses for health care providers, and develop training plans. In addition, I-TECH will respond to
other training needs of the MRTC HCW based on the results of the needs assessment, such as TB/HIV/STI
curricula revision and update. Training will be provided through a high-level training specialist who will
mentor MRTC staff to update curricula according to provincial and national guidelines. This transfer of skills
activity will include developing and strengthening monitoring and evaluation of training programs in this
region. FY 2008 funds will be used to support the salary, travel and lodging cost of a training technical
expert. Contingent upon the availability of FY 2008 funds and depending on the training needs of MRTC
HCW, additional training will be provided through sponsorship at national or international training summits,
study tours, or other preceptorships.
ACTIVITY 3: Human Capacity Building: Distance-based ongoing clinical consultation
This activity was first funded for the Eastern Cape RTC by PEPFAR in FY 2005. During UCSD/RTC
trainings, EC clinicians are encouraged to contact the RTC team for clinical consultation as needed, who
then forward the query and response to the UCSD Owen Clinical mentors for additional guidance before
Activity Narrative: delivering their consultative advice. In FY 2008, PEPFAR funds will be used to expand this activity to the
Mpumalanga RTC HCW. Funds will support UCSD consultants' time (a portion of salaries) related to the
time spent fielding consultations; estimated at five consults per week.
These activities contribute to the overall PEPFAR 2-7-10 goals and to program sustainability by improving
the organizational and human capacity of the MRTC to effectively treat affected patients and mentor other
HCW on the care and treatment of concomitant TB/HIV care and treatment, thereby increasing both access
to and the quality of TB/HIV care and treatment.
Continuing Activity: 13867
13867 12464.08 HHS/Health University of 6637 2808.08 I-TECH $679,000
12464 12464.07 HHS/Health University of 4439 2808.07 University of $350,000
Health-related Wraparound Programs
* TB
Estimated amount of funding that is planned for Human Capacity Development $482,288
Table 3.3.12:
This activity has been extensively expanded in FY 2009 to provide a foundation for building sustainable in-
country training and mentoring services. Activities include providing technical assistance (TA) to the
National Department of Health (NDOH) to plan, manage and implement its national Health Promotion and
Quality Assurance (HPQA) Centre initiative; strengthening leadership and management at provincial HPQA
Centres; developing the human capacity of HPQA clinical/mentoring teams and healthcare professionals
(HCPs) to provide quality prevention, care and treatment to persons infected with HIV, AIDS, STIs and/or
TB (HAST); and developing integrated pre- and in-service HAST educational/training programs at Walter
Sisulu University (WSU).
- Recruitment of additional in-country I-TECH staff including a clinical advisor, a monitoring and evaluation
(M&E) specialist, a fiscal lead and an instructional design specialist: Preference will be given to South
African applicants. The clinical advisor will oversee all clinical matters and programming related to
development of pre- and in-service programs and HPQA capacity building through clinical mentoring
programs and other clinical training support modalities. This position will assume some of the
responsibilities and leadership provided currently under the I-TECH University of California San Diego
(UCSD) subcontract. The M&E specialist will work with individual HPQAs to identify their 2008-2011 goals
and objectives for increasing their institutional capacity and to set/monitor benchmarks/milestones. This
approach, with involvement from the NDOH and provincial DOH, will assure achievements are maintained
and that threats to maintenance are foreseen and addressed. This position is also responsible for mentoring
HPQA M&E staff on evaluation methods and working with them to implement and review newly introduced
forms allowing for more regular and robust capturing of clinical mentoring outcomes/impact and technical
assistance events. The fiscal lead position is a requirement of I-TECH headquarters. The instructional
design specialist will work with and mentor HPQA Centres to build their curriculum/instructional design
capacity. It is anticipated the in-country instructional design specialist will need substantial mentoring by the
Seattle Training Development Team (TDT) team to meet I-TECH's standards. Over 12 months, Seattle TDT
will work with this individual, ultimately transferring curriculum and instructional design responsibilities to the
Pretoria Office. The I-TECH in-country mentor will be transferred to the Eastern Cape (EC) HPQA, thereby
expanding the HPQA's clinical mentoring capacity and expertise. Also the EC technical advisor to the
Pretoria office will become the training program manager to allow for expansion of I-TECH activities to all
provinces.
- Expansion of intensive I-TECH SA health system strengthening TA to the Limpopo DOH and Mpumalanga
DOH HPQA Centres: In addition to providing a wide array of on-going TA for the development of HPQA
Centres, TA will also centre on 1) the accreditation of curricula and training credentialing; 2) development of
instructional design/curriculum/training programs; 3) the development and maintenance of on-line resource
libraries; 4) the development of clinical practice sites for hands-on learning; 5) distance learning strategies;
6) building of M&E expertise and capacity at the HPQA level; 7) training of HPQA staff on TrainSMART (I-
TECH open source training database) and data quality issues, as requested; and 8) development of training
standards per individual HPQA Centres and initiative at the NDOH for monitoring and assessing
performance against these standards. I-TECH will provide in-country TA to assist in the capacity building for
the support and local development of these components. It is estimated that this will take several months
spread throughout the duration of the year.
- TA will be provided to the WSU School of Medicine to build the following components: 1) a faculty
development program for developing HIV expertise among the faculty and attending physicians at the
teaching hospitals; 2) the creation of an HIV fellowship program; and 3) the development of a formal
inpatient HIV consultation service at Nelson Mandela Academic Hospital and Umtata General Hospital,
staffed by HIV fellows and faculty participating in the faculty development program. This set of activities
represents a major undertaking and will be supported by UCSD physician faculty, the I-TECH clinical
advisor position, and I-TECH headquarters TDT. I-TECH has a strong track record in developing,
implementing and evaluating pre-service course materials and faculty development programs
(Mozambique, Haiti), and fellowship offerings (India). It will use the lessons learned, in-house expertise,
advice and consultation from the Stellenbosch Africa Center for HIV/AIDS Management, and existing
products to support rapid scale up of this initiative.
- Support certificate and diploma courses in HIV/AIDS at WSU for practicing HCPs at the facility level: The
in-service course will be largely practically conducted in students' place of work allowing the obtainment of
specialized knowledge and skills specific to actual job responsibilities while they are performing their care
and treatment duties. These activities support the establishment of an integrated HIV/AIDS
training/education strategy and provide the structure for a career path. Such activities may help address
worker shortages and provide HIV/AIDS clinical leadership in areas where none exist.
- Customization of existing I-TECH nurse training materials for South Africa to strengthen clinical skills,
clinical acumen, and the expansion of their role at the facility level (e.g. expansion of prescribing rights):
This work is to be done at the request of WSU and/or EC HPQA.
- The development of an advanced diploma in HIV/AIDS for nurses will help prepare nurses for increased
responsibilities in the care and treatment of persons with HIV, AIDS and TB. I-TECH will its HIV/AIDS Nurse
Specialist course (which has didactic, preceptorship, and on-site clinical mentoring components) as a
primary reference, based on the success of the program in Ethiopia and current adaptation by Zambia
partners.
- TA to the University of Pretoria to develop, implement and evaluate a HAST module into the new Clinical
Associate program and TA to the WSU program upon request: The Clinical Associate program serves to
broaden the range of health care workers who can address various health issues and assures the HAST
knowledge and skills of pre-service HCP. I-TECH will draw upon its pre-service materials recently
developed for Mozambique, as well as other existing in-house curricula and clinical materials. This work
assumes close and positive collaboration with the named universities and other SA universities providing
similar programming, and an academic-based curriculum review and approval process.
- Ongoing TA to the NDOH to strengthen its capacity to plan, manage, implement and evaluate its HPQA
Centre initiative. It supports the development of local leadership and ownership, and assures program
sustainability.
- Implementation and evaluation of two one-and-a-half day clinical treatment updates (80 participants total)
for Mpumalanga and Limpopo DOH HPQA Centre trainers, provincial DOH district trainers, and project
Activity Narrative: managers (i.e., doctors and nurses from Mpumalanga and Limpopo antiretroviral clinics). See page 22
under Comments on Past Performance. EC HPQA Centre trainers, DOH district trainers and project
managers who did not attend these updates when offered in the EC in FY 2008 may attend one of the
trainings in Limpopo or Mpumalanga provided sufficient space and funding.
- Provide TA on the modification of a basic HAST course and four specialized in-service training curricula
(i.e., counseling skills, mother and child HIV care and treatment, STI care and treatment, TB/HIV). These
curricula will be promoted to the other eight DOH HPQA Centres. A training of trainers workshop and
orientation of Mpumalanga HPQA and DOH staff to these materials will be developed and conducted. The I-
TECH South Africa M&E specialist, I-TECH curriculum integration specialist, and I-TECH HQ Quality
Improvement Team will assess if the curriculum integration project is successful in reducing the number of
training days HCW are away from the clinics, as well as greater training delivery efficiency (i.e., improved
materials, better participant selection criteria). This evaluation component is necessary if NDOH or other
HPQAs consider either replicating or adopting similar processes, training program designs, or curriculum
products.
Three laptops, 3 printers, 2 LCDs, 25 tables, and 50 chairs will be purchased for Limpopo HPQA and
satellite sites. A partial contribution toward the renovation of a training center may be made as well.
-----------------------
I-TECH activities are currently carried out to support sustainability of HIV, AIDS, TB and STI care and
treatment programming in the Eastern Cape (EC) province through four components: 1) establishing I-
TECH field offices in South Africa (SA); 2) providing organizational development and human capacity
building technical assistance (TA) up to three Regional Training Centers (RTC); 3) supporting the EC
Department of Health (ECDOH) HIV and AIDS program; These activities are continued in FY 2008. The
primary emphasis area for these activities is local organization capacity building. Strategic information and
human capacity development are secondary emphasis areas. The primary target population is a non-
governmental organization.
I-TECH has been working in the EC since 2003 to develop the capacity of the RTC to train/mentor clinicians
in the care and treatment of HIV, AIDS, TB and STI. The majority of activities described here (exceptions
include expansion activities) were first funded between FY 2003 and FY 2007. I-TECH established an office
in the EC beginning January 2007, is collaborating with other EC PEPFAR partners, and has/will conduct
field assessments of TA needs with 16 EC PEPFAR partners to identify programmatic TA activities which
could be supported by I-TECH. I-TECH is working in SA at the invitation of the ECDOH, and its activities are
supported by the NDOH HIV/AIDS Directorate. All activities described under this program area with the
exception of TA related to the development of clinical care information systems will be implemented by the
primary partner. TA related to clinical care information systems will be implemented by the primary partner
and its subcontractor, UCSD Owen Clinic.
ACTIVITY 1: Technical assistance to NDOH Human Resource Department (HRD) to develop Regional
Training Centres (RTC) nationally
I-TECH as part of its HCD program will assist the National Department of Health HRD responsible for the
establishment and monitoring of RTC in each province to develop policies and guidelines to strengthen
provincial RTCs and improve the quality of HIV/AIDS/STI/TB (HAST) training programs. I-TECH will also
work with the national department to develop tools to monitor the quality of services rendered by these
RTCs, identify provincial RTCs in need of technical support and develop a plan of action to assist those
identified.
ACTIVITY 2: TA to Mpumalanga RTC
I-TECH will assist the Mpumalanga and Limpopo RTC in:
-Developing policies and guidelines and a governance structure for the RTC.
-Develop capacity of RTC staff in developing assessment tools to assess training needs of health care
providers in the province
-Develop the capacity of RTC staff in developing yearly HAST training plans for the province and conducting
quarterly reviews of training and develop skills of RTC and district training staff to monitor quality of training
programs
-Develop skills of RTC staff in curriculum development and integration of new national and international
guidelines into existing curricula and seeking accreditation with SAQA
-Develop capacity of RTC staff to track, monitor and assess HAST training done by other NGO within the
province
-Develop capacity of RTC and other district trainers to monitor quality of training and assessment of skills
transfer.
-Develop facilitation skills of district trainers in Mpumalanga, Eastern Cape and Limpopo provinces
-Development and production of HAST training manuals for accredited training
-Purchase of teaching aids such as data projectors, lap tops, demonstration models and other visual aids to
be used by the RTC to train health care workers
ACTIVITY 3: Development of training and facilitation skills of trainers
I-TECH will develop capacity of district and RTC trainers to ensure a pool of qualified trainers are available
in each of these provinces (Mpumalanga, Eastern Cape and Limpopo) to continue developing capacity of
health care workers. These training programs will utilize a variety of training techniques to ensure transfer of
skills. These trainings will also include the techniques on assessing training programs. For this activity I-
TECH will utilize the services of a local service provider accredited to conduct such trainings.
Activity Narrative: ACTIVITY 4: Prevention with Positives
I-Tech will develop capacity of trainers at the Regional Training Centre in 3 provinces (Mpumalanga,
Eastern Cape and Limpopo Provinces) to integrate Prevention with Positive for PLHIV into the HIV and
AIDS training curriculum and content material for both health care professionals and lay health care
workers. This integrated curriculum will ensure that HIV and AIDS training programs are updated with
messages and programs on Prevention with Positives.
ACTIVITY 5: Training
I-TECH will also train the trainers of all three RTCs on prevention with positives, develop their skills to
impart these trainings to others and mentor them on conducting the actual training. I-TECH will also assist
the RTCs in developing and disseminating quick reference guides on Prevention with Positives to be used
by health care providers and lay health care workers in all settings (i.e. facility, community and home based
settings). These quick reference guides will serve as prompt tools for health care providers and lay health
care workers.
Continuing Activity: 13869
13869 3335.08 HHS/Health University of 6637 2808.08 I-TECH $1,370,000
7492 3335.07 HHS/Health University of 4439 2808.07 University of $600,000
3335 3335.06 HHS/Health University of 2808 2808.06 $350,000
Estimated amount of funding that is planned for Human Capacity Development $1,709,932
Table 3.3.18:
