Namibian Primary School Receives Platinum Certificate for VMMC Saturation

Posted on April 18, 2018May 2, 2018

Facing Ashitenga Primary School students at the VMMC certificate ceremony are, from left to right: Levi Vries, Education Inspector for Oluno Circuit; Lusia Ndemuweda, I-TECH Demand Creation Coordination Nurse; Ashitenga Principal Edward Asser; Frieda Mupetami, a representative of Okatyali Constituency office; and Life Skills teacher Teopolina Mupetami (in red).

In Namibia, the prevalence of HIV infection among adults aged 15 to 49 is nearly 14%.[1] A key component of national efforts to prevent the spread of HIV is voluntary medical male circumcision, or VMMC, which has proved to reduce the rate of male-to-female transmission by upwards of 60%.

Since 2010, the International Training and Education Center for Health (I-TECH) has supported the VMMC efforts of the Namibian Ministry of Health and Social Services (MOHSS) in the Oshana and Zambezi regions. I-TECH not only supports health care worker training in the provision of VMMC, it is also engaged in critical efforts to create demand for the procedure.

A key element of these efforts is the recognition of schools and school leadership who are supportive of VMMCs. In February, Ashitenga Primary School in Oshana Region was awarded a platinum certificate by I-TECH Namibia for achieving 96% saturation of boys receiving a VMMC. Platinum is the highest honor, with bronze signifying 55-69% saturation, silver awarded for 70-79% saturation, and gold given for 80-89% saturation.

Present at the event was the Oluno Circuit Education Inspector Levi Vries. In his remarks, Mr. Vries encouraged other schools to emulate Ashitenga’s good example. He emphasized the importance of student health to attaining educational goals and urged students to spread the VMMC message to others in their families, villages, and neighborhoods.

As part of the Life Skills curriculum, older boys are instructed on HIV prevention, while the younger boys are taught personal hygiene – messages that are reinforced by I-TECH community mobilizers. Teopolina Mupetami, the Life Skills teacher at Ashitenga, encouraged Life Skills teachers at other schools in the area to support the VMMC program. Ashitenga principal Edward Asser echoed the importance of the school’s recognition; he promised to display the certificate proudly in his office.

Three of the circumcised students were interviewed by the Ministry of Information Communication and Technology, which is charged with spreading the message about “the smart cut” in the government media. The boys responded that “they feel clean and protected from sexual related disease,” said Helena Ferdinand, I-TECH community mobilizer. The students prompted boys at other schools to enroll in the VMMC program and expressed their satisfaction with the service.

“The atmosphere at the handover was joyful and a lot of excitement,” said Ms. Ferdinand. “The principal indicated that they will continue to work hard to get a second platinum certificate.”

[1] UNAIDS; http://www.unaids.org/en/regionscountries/countries/namibia

Case Finding and Retention in Care in Mozambique

Clinical Mentoring Demand Creation HIV and STI Prevention Male Circumcision Matthew Golden Monitoring & Evaluation Mozambique Quality Improvement Scott Barnhart

Posted on July 25, 2017July 8, 2019

I-TECH works with the Mozambique Ministry of Health (MISAU) to expand a pilot project to provide an assisted partner services intervention. The project is aimed at encouraging patients newly diagnosed with HIV infection to disclose their status to their partners, and bring them to the clinic for testing. Continue reading “Case Finding and Retention in Care in Mozambique”

VMMC for HIV Prevention in Namibia

Demand Creation Gabrielle O'Malley HIV and STI Prevention Male Circumcision Namibia Quality Improvement Scott Barnhart

Posted on July 24, 2017July 24, 2019

I-TECH assists the Ministry of Health and Social Services with the expansion and provision of voluntary medical male circumcision (VMMC) as an HIV prevention option. This support started in 2008 with the development of national guidelines and training materials, followed by national trainings of health care workers. In 2015, this support expanded to include direct service delivery in the Oshana and Zambezi regions, as well as Karas region from 2017 onward. Since 2016, I-TECH has also supported demand creation with a network of community-based mobilizers and recruiters using a human-centered design approach to actively engage communities and stakeholders to increase the number of men voluntarily electing medical circumcision. The program has performed over 36,000 VMMCs in Namibia.

I-TECH has trained physicians, nurses, and community counselors to ensure that adequate skills and experience are in place to deliver safe, high-quality male circumcision services.

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

Achieving Targets through Performance-Based Financing in Zimbabwe

ZAZIC employs an innovative performance-based financing (PBF) system to speed progress towards ambitious voluntary medical male circumcision (VMMC) targets. The PBF schedule, which started at $25 USD and now varies from $6.50-$14 USD depending on the location and the circumcision team, is continually refined to set the program up for ...
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Case Finding and Retention in Care in Mozambique

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 ...
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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 ...
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VMMC Community Mobilizers Now More Mobile in Malawi

Demand Creation Health Systems Strengthening Malawi Male Circumcision

Posted on September 15, 2014July 25, 2017

Community Mobilizer Adyasi Bamusi (left) receives advice on bicycle care from Lilongwe District Environmental Health Officer Mavuto Thomas.

A group of eight Voluntary Medical Male Circumcision (VMMC) Community Mobilizers can breathe a sigh of relief after receiving bicycles to ease mobility in their clusters. The beneficiaries were selected based on the remote areas and long distances they cover.

Desiree Mhango, I-TECH Malawi’s Deputy Country Director, presented the bicycles. During the ceremony, Lilongwe District Environmental Health Officer Mavuto Thomas, thanked I-TECH for the donation of the 10 bicycles, saying they will be a huge help to mobilizers as they disseminate information on the importance of male circumcision.

Mr. Thomas further advised the eight beneficiaries to take good care of the bicycles in order to sustain their usefulness well into the future.

One of the beneficiaries, Adyasi Bamusi, said the bicycles will not only solve mobility problems in rural communities, but also will be used to ferry clients to circumcision centers.

I-TECH’s VMMC program, administered in partnership with the Lilongwe District Health Office, is funded by the Health Resources and Services Administration (HRSA) in collaboration with the U.S. Centers for Disease Control and Prevention’s Division of Global HIV and AIDS (CDC-DGHA), under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

The donation is part of a pilot study examining the impact of bicycles on the effectiveness of community mobilizers in rural areas.

Launch of HIV Programs in Zimbabwe Hits the Right Note

Clinical Mentoring Demand Creation eLearning/Distance Learning Health Systems Strengthening HIV and STI Prevention Male Circumcision Monitoring & Evaluation Scott Barnhart Zimbabwe

Posted on February 20, 2014July 25, 2017

To the brass beats of the Prince Edward School Jazz Band, on Feb. 6, a crowd of approximately 150 government officials, health professionals, and members of the press celebrated the launch of three programs in Zimbabwe, two of which are implemented by I-TECH Zimbabwe and partners. These vital programs aim to build local capacity and provide comprehensive services to prevent and combat HIV/AIDS in the country.

Speaking at the festivities were David Bruce Wharton, U.S. Ambassador to the Republic of Zimbabwe; Dr. Owen Mugurungi, director of the AIDS and TB Unit at the Ministry of Health and Child Care (MOHCC); Dr. King Holmes, Chair of the Department of Global Health at the University of Washington; Dr. Ann Downer, Executive Director of the International Training and Education Center for Health (I-TECH); and Dr. Batsirai Makunike-Chikwinya, Country Director of I-TECH Zimbabwe.

“Preventing the spread of HIV/AIDS is important to all of us, as is providing the best level of care to those living with this disease,” said Amb. Wharton. “Today we celebrate the launch of programs that will help us reach these goals together – programs that were designed together, by dedicated teams of collaborating partners from Zimbabwe and from the United States.”

In this spirit of collaboration, the programs, totaling $65 million over five years, support the Zimbabwe MOHCC with grant funding by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), technical support from the Centers for Disease Control and Prevention, and implementation by local and U.S.-based partners. These partners include I-TECH; Zimbabwe Association of Church-Related Hospitals; Zimbabwe Community Health Intervention Research Project; Compre Health Services; The Newlands Clinic and Newlands Clinic Training Centre; Pangaea Global AIDS Foundation, Zimbabwe; and the University of Zimbabwe-University of California, San Francisco Collaborative Research Programme.

The Training and Mentoring Program seeks to develop and deliver in-service training on antiretroviral therapy, including the medical management of HIV/AIDS, women’s reproductive health, tuberculosis (TB), and TB/HIV co-infection to 8,000 health care workers across the country over five years. A mentorship component will also provide health care workers with access to ongoing learning and feedback on clinical issues. Health workers will receive refresher trainings via distance learning technologies, and the effectiveness of the program will be measured through a training database.

Also celebrated – and accompanied by a ribbon-cutting and presentation of 17 new vehicles – was the launch of the Voluntary Medical Male Circumcision Program. The program, building on work that started last spring, seeks to deliver services to 412,000 men in Zimbabwe between the ages of 15 and 49 years over the next five years. Medical male circumcision has proved very effective in preventing the spread of HIV. Randomized controlled trials in Uganda, Kenya, and South Africa have shown that this intervention reduces the risk of female-to-male sexual transmission of HIV by approximately 60%.

“Together, these two programs will improve the effectiveness and quality of prevention, treatment, and care services for those affected by HIV/AIDS – and create better health systems for all Zimbabweans,” said Dr. Holmes.

Malawi Bishop Promotes Male Circumcision

Demand Creation HIV and STI Prevention Malawi Male Circumcision

Posted on July 23, 2013July 25, 2017

Right Reverend Bishop Emmanuel Fanuel Magangani of the Anglican Diocese of Northern Malawi is the first prominent church leader to announce that he was recently circumcised as part of the country’s efforts to promote Voluntary Medical Male Circumcision (VMMC).

Malawi’s Nkhoma Hospital Launches Voluntary Medical Male Circumcision Program

Demand Creation Malawi Male Circumcision

Posted on May 24, 2013July 25, 2017

Report by Pius Mtike

Lilongwe District’s Nkhoma Hospital has started offering Voluntary Medical Male Circumcision (VMMC) services.

VMMC services began with great enthusiasm: 37 procedures were performed in less than two weeks, according to Dr. Roderick Banda, Medical Officer at Nkhoma Hospital.

“We are encouraged by this overwhelming response,” Banda said.

Malawi comedians The project has taken a novel approach to recruiting participants by staging a two-week awareness campaign that incorporates comedy, music, and film. The group has engaged the services of popular local comedians Chindime and Samalani and the Health Education Band of the Ministry of Health. VMMC promotional film documentaries will also be shown.

Local leaders are also getting in on the act. Encouraging his subjects following a VMMC promotional documentary, Group Village Headman (GVH) Chimwaye underscored the need to seriously consider VMMC, a one-time intervention scientifically proven to reduce the transmission of HIV by 60 percent.

“Now we have no reason to complain about long distance to town (VMMC Center in old town in Lilongwe),” he said. “VMMC services are within our own vicinity.”

The initiative is in partnership with Lilongwe District Office and Health Education Unit of the Ministry of Health (HEU), and the International Technology and Education Centers for Health (I-TECH) Malawi as part of a PEPFAR subgrant. It is intended to encourage more eligible men to access locally available VMMC services.