A key focus for I-TECH in Ukraine is strengthening the capacity of local partners to develop and deliver high-quality clinical trainings and expand the supply of skilled health care workers.
Category: Countries
Ukraine
To support I-TECH Ukraine during this crisis, donate to the I-TECH Humanitarian Fund.
I-TECH began working in Ukraine in 2011 at the invitation of the U.S. Centers for Disease Control and Prevention and the Ukrainian Ministry of Health. I-TECH currently supports the Government of Ukraine in implementing reforms in health services management, human resources for health, and other key areas to improve service provision for people living with HIV and achieve the UNAIDS 95-95-95 Fast Track targets.1
Ukraine is experiencing one of the fastest-growing HIV epidemics in the world, with twelve central and eastern large industrial regions of Ukraine being most affected.2 There is an estimated 260,000 people living with HIV (PLHIV) in Ukraine, 120,000 of which are women.3 Injection drug use was the main pathway for the spread of the disease from 1995 to 2008; sexual transmission, also among men who have sex with men, has been a growing primary mode of transmission.2
Ukraine has made significant progress in achieving the UNAIDS 90-90-90 targets over the past two years. As of early 2020, 68% of estimated PLHIV in Ukraine were aware of their HIV status; 80% of PLHIV, who tested positive and registered with the healthcare system, received antiretroviral therapy (ART); and 94% of PLHIV who received ART had undetectable viral loads.2
Considerable challenges remain with timely HIV testing/diagnostics in early stages, especially among hard-to-reach populations. The number of officially registered HIV cases in Ukraine also dropped in 2015-2016 as a result of the armed conflict in eastern Ukraine and due to loss to follow-up of people living with HIV in the affected regions of Donetsk and the Crimea.2
Sources
- The Cabinet of Ministers of Ukraine (CMU) (2019). The National Strategy on HIV/AIDS, Tuberculosis and Viral Hepatitis Response for the Period until 2030.
- The Ministry of Health of Ukraine (MoH) (2020). HIV in Ukraine, Information Bulletin #51, 2020.
- UNAIDS (2020). Country Factsheets: Ukraine 2020.
Program Highlights
Workforce Development in Haiti
It is critical that health care providers receive the necessary training to empower them to improve patient outcomes CHARESS supports both pre-service and in-service training efforts in Haiti. In particular, CHARESS is a key partner of MSPP in maintaining its national clinical guidelines. Continue reading “Workforce Development in Haiti”
Scott Barnhart
Scott Barnhart, MD, MPH, has an extensive background as Professor of Global Health and former Director of Global Health Programs for I-TECH at the University of Washington. He has had responsibility for leading nine country offices, projects in 14 countries, and more than 500 staff. This experience and training has included extensive clinical work, research and program management in pulmonary and environmental and occupational medicine, and more than eight years as Medical Director of a safety net/Level 1 Trauma Center hospital.
Ensuring health systems can quickly detect and respond to emerging health threats is a critical challenge in both domestic and global health. Dr. Barnhart’s major implementation projects include scale-up of voluntary medical male circumcision (VMMC) in Zimbabwe and Malawi, OpenMRS, and laboratory information systems. Dr. Barnhart deploys his expertise in multiple African countries and Haiti to strengthen health systems and health care.
A goal of Dr. Barnhart’s work is to promote country-led, country owned sustainable development. Consistent with the principles of the Paris Declaration, the goal is to transition the bulk of development work and the associated leadership, ownership, technical direction and control of funding into the countries where development occurs. This approach ensures that the entire continuum of skills necessary for development (technical expertise, administration (human resources, operations, and management and accountability for funds) is transitioned to local partners. A key indicator is to have 75% or more of a grant’s funding expended in-country on local programs and local citizens and to support the local economies in these highly resourced constrained countries. Dr. Barnhart has worked closely to advance this model through projects in Haiti with a goal to shift the majority of a project to a local organization and in Zimbabwe where the VMMC program is largely run through local partners.
Program Highlights
Health Information Systems in Haiti
Electronic medical record (EMR) systems have the capacity to improve clinical decision making and quality of care at site level but can also be leveraged to make data-driven, population-level public health decisions. At the request of the MSPP Continue reading “Health Information Systems in Haiti”
Continuous Quality Improvement in Haiti
In partnership with CDC, CHARESS helps the Haitian MSPP to implement the national care improvement program, HealthQual, by training providers on quality improvement concepts and using data from the EMR, iSanté, for clinical decision making and improved care. Continue reading “Continuous Quality Improvement in Haiti”
Clinical Mentoring in Haiti
I-TECH introduced its clinical mentoring program in Haiti in 2006. A team of physicians, nurses, and psychologists provide technical assistance to 20 sites in the MSPP care and services network to help strengthen HIV- and AIDS-related services. During site visits, CHARESS mentors conduct clinical rounds Continue reading “Clinical Mentoring in Haiti”
Haiti
In partnership with the Ministère de la Santé Publique et de la Population (MSPP) and the local nongovernmental organization (NGO) Centre Haïtien pour le Renforcement du Système de Santé (CHARESS), I-TECH implements programs to improve HIV services via a trained health workforce and robust health information systems (HIS) in Haiti. In June 2018, I-TECH successfully transitioned the country office in Haiti to the fully independent NGO, CHARESS, after years of strategic planning. Since the conversion to CHARESS, all of I-TECH’s activities are executed through the NGO.
Through CHARESS, I-TECH provides technical assistance to ensure that both national-level entities and health care sites are able to effectively use the integrated systems iSanté, the electronic medical record system, OpenELIS, the laboratory information system, and TrainSMART, the training participant management database. These allow for better decision making by providers, differentiated care for patients, and improved clinical performance through continuous quality improvement.
At the national level, the MSPP and the donor, the U.S. Centers for Disease Control and Prevention (CDC) through the President’s Emergency Plan for AIDS Relief (PEPFAR), are able to conduct national-level public health analysis using data from the systems. These analyses are used to modify policies and target assistance for better care and treatment of patients.
Currently, I-TECH focuses on three of the six World Health Organization health systems building blocks: health service delivery, health workforce, and HIS. Previously, I-TECH also supported the other three building blocks of leadership and governance, access to essential medicines, and health systems financing through the Centers of Excellence project that ended in September 2016.
Program Highlights
I-TECH Ukraine Conducts ARVs for Epidemic Control Workshop
In early April, the International Training and Education Center for Health (I-TECH) conducted a five-day workshop on “Antiretroviral Drugs for Epidemic Control” for more than 50 chief doctors and deputy chief doctors from Regional AIDS Centers in Ukraine.
Workshop participants learned about evidence-based, international best clinical practices and the cost-effectiveness of strategies for using antiretroviral therapy (ART) to control HIV epidemics. International keynote speakers included:
- Dr. Jeremy Penner, International Clinical Advisor in Ukraine to I-TECH/University of Washington (UW);
- Dr. Elliot Marseille, Consultant to I-TECH/UW and the Center for Global Surgical Studies at the University of California, San Francisco;
- Dr. Michael Martin, U.S. Centers for Disease Control and Prevention (CDC) Senior Technical Advisor for HIV/AIDS care and treatment in Thailand; and
- Dr. Juliana de Fatima da Silva, Epidemic Intelligence Service Officer at the CDC.
The pool of facilitators also included nine national experts from the Ministry of Health’s Center of Public Health (CPH).
The workshop aimed to support the development of efficient strategies to achieve the UNAIDS 90-90-90 goals: 90% of HIV-positive people know their status, 90% of those are on treatment, and 90% of those are virally suppressed. To this end, the workshop covered national situational analysis, national clinical recommendations, and service delivery models with the highest potential for adaption in country.
Progress on ART optimization in Ukraine was shared, and participants were able to discuss their experiences and ideas for improving HIV-related services. The presentations and group discussions were particularly timely, given the development of complex new HIV clinical guidelines currently under way in Ukraine – they also provided much needed evidence to support this process.
Similar workshops were requested by the CPH and leaders of the Regional AIDS Centers, and I-TECH plans to meet this request by conducting two workshops in June and September 2017.
THIS PROJECT IS SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) UNDER U91HA06801, THE INTERNATIONAL AIDS EDUCATION AND TRAINING CENTER (IAETC). THE CONTENT OF THIS POST IS THE AUTHOR’S AND SHOULD NOT BE CONSTRUED AS THE OFFICIAL POSITION OR POLICY OF, NOR SHOULD ANY ENDORSEMENTS BE INFERRED BY HRSA, HHS OR THE U.S. GOVERNMENT.
Guyana Revamps Its Health Information System with I-TECH Support
The International Training and Education Center for Health (I-TECH) recently partnered with the Ministry of Public Health in Guyana and the U.S. Centers for Disease Control and Prevention (CDC) to launch a new health information system (HIS) that will protect patients’ privacy, maintain confidentiality, and provide security for sensitive data.
In an article in Guyana’s Kaieteur News, Deputy Chief Medical Officer, Dr. Karen Boyle, described how health officials hope to reduce health service quality inequities between coastal regions and other parts of the country as part of the national 2020 plan, in part by reducing waiting time for medical services and improving patient health literacy. Dr. Boyle stated they expect to “improve access to health information” and allow for “shared responsibility” for health care decision-making by providers and patients.
The health information upgrade is also being supported by PAHO (the Pan-American Health Organization), UNAIDS, and local collaborating partners such as the University of Guyana, e-Government, the National Insurance Scheme, and the Government Technical Institute (GTI).