Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 9482
Country/Region: South Africa
Year: 2010
Main Partner: University of Washington
Main Partner Program: NA
Organizational Type: University
Funding Agency: HHS/HRSA
Total Funding: $3,432,407

Funding for Treatment: Adult Treatment (HTXS): $737,888


Funding for Health Systems Strengthening (OHSS): $2,118,999

REDACTED I-TECH will develop a management and leadership training program to support key facility level administrators and managers to develop independent, sustainable HIV, AIDS, TB and STI programs that support quality service delivery outcomes, the goal of which will be to improve health service delivery in selected provinces in South Africa by increasing the capacity of health programme managers to effectively and efficiently manage human, fiscal and capital resources.

Objectives include: 1. Improve the capacity of facilities to effectively support the strengthening of health systems in order to improve service delivery in the following programme areas: HIV prevention, care and treatment, Prevention of Mother-to-Child Transmission of HIV and TB management 2. Develop a training initiative that is tailored to the specific needs and realities of health managers 3. Ensure that the training model is sustainable - that it is cost-effective, integrated into existing systems, and designed to be modified as needs change. 4. Improve the capacity of the facility-level managers to effectively manage their programs through a multi-level approach that includes didactic and skill-building workshops, individual and team assignments, mentoring and supportive supervision visits.

Additionally, leadership skills related to HIV and AIDS will be prioritized in providing I-TECH technical assistance to Walter Sisulu University (WSU) for the development of a one year Fellowship program, the

goal of which will be to prepare physicians and nurses to be leaders in HIV-related care and support, education and research. A comprehensive curricula package will be developed and at the completion of the programme, fellows will be qualified as HIV and AIDS experts, as well as provide clinical leadership. TA, in collaboration for Eastern Cape Regional Training Centre (EC RTC), for the HIV/AIDS portion of the WSU Clinical Associate Program will be offered to assure graduates have the necessary care and treatment skills. Additionally, I-TECH will continue to support HPQAs/RTCs to: -Develop 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

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, Limpopo, Free State and others) to continue developing capacity of health care workers, including the training of trainer's model. I-TECH will also host two skills-building workshops for relevant NDOH, HPQA and partner staff. The goals of the workshops are to support and promote excellence, innovation, and collaboration in training program and materials development across SA in support of health workforce capacity development and systems strengthening. Human capacity development activities will include the following.

Skills Development: improve leadership and management skills of physicians in training, administrators and managers at the Province, District and sub-district level; build training program design and evaluation

skills of staff at NDoH and HPQAs related to key components including curriculum development, training materials and reproduction, and performance improvement.

Funding for Care: TB/HIV (HVTB): $575,520

TB/HIV integration, by necessity, is a major focus of the ITECH clinical mentoring program. We estimate that of the patients we see in hospitals over 70% have co-morbid tuberculosis, while in the clinics at least 50%. As has recently been published in Lancet (The Lancet, Volume 373, Issue 9670, Page 1145, 4 April 2009), throughout sub-Saharan Africa, integration of TB-HIV care activities is close to non-existent. This has been our consistent finding in both the Eastern Cape and Mpumalanga provinces. Much of this is structural, with TB care assigned to the PHC level and most ARV clinics still hospital based. Many patients are falling through the cracks as evidenced by high default rates and rising drug resistance. Our major strategic efforts, in addition to providing mentoring around particular cases, are focused on 2 of the 3 "I's" identified by the WHO StopTB Partnership: infection control and isoniazid preventive therapy. In most facilities, there is effectively no TB infection control program. Other activities will build upon previous TB/HIV related courses to accompany mentoring activities at facilities. In response to the growing need to reduce exposure of PLHIV to TB and in line with the PEPFAR State of Program Area priorities for 2009, I-TECH will partners with other global organizations involved in TB and HIV programming to develop a toolkit aimed at helping health care facilities develop and sustain TB infection control practices that a suited to the existing local resources, including the recognition and treatment of MDR TB. The audience for the toolkit includes mid-level program managers at provincial, district and sub-district levels, facility management teams, front line healthcare workers, health management team members, national AIDS control programs, national TB programs and National Departments of Health. Additionally, I-TECH will promote effective infection control practices in all of the trainings developed for health care workers and managers/administrators. Key infection control indicators related to administrative and workplace practices, environmental controls and personal protective equipment will be emphasized throughout trainings and will be integrated into clinical mentoring activities.

I-TECH will facilitate the development of an integrated TB and HIV specialized curriculum based on current national and international guidelines, and grounded in the appropriate body of adult learning theory and experience that can be presented the NDOH. Upon completion of the TB/HIV specialized course in 2009, training in additional provinces will be initiated with this curriculum. For example; efforts will be made through the WSU Fellowship programme to respond to the lack of HIV, AIDS and TB content in pre-service curricula.

Subpartners Total: $0
University of California at San Diego: NA
Boys 2 Men: NA
Empowerment Concepts: NA
Cross Cutting Budget Categories and Known Amounts Total: $0
Construction/Renovation $0