Category: Technical Areas
Monitoring & Evaluation
I-TECH’s monitoring and evaluation staff work to ensure the efficacy of health care training sessions and programs by applying their expertise in cost analysis, data collection, and measurement to rigorous evaluations of these interventions.
In addition to routine monitoring and evaluation (M&E) and continuous quality improvement (CQI), I-TECH designs and implements operations research (the application of research methodology to inform and improve program design and management) and special studies for both I-TECH country programs and our partners. These activities enable us to answer strategic questions concerning the selection and effectiveness of program interventions. The team analyzes and designs evidence-based solutions to increase relevance, access, and scope of HIV services.
Monitoring ongoing projects and programs allows for midstream corrections; key findings are communicated to managers and leaders to improve programmatic decision making. Results are disseminated through publication, when appropriate.
Additionally, I-TECH has significant capacity in the rapidly expanding field of health informatics for resource-limited clinical settings. I-TECH develops tools and systems—such as the Training System Monitoring and Reporting Tool (TrainSMART)—and provides technical assistance for electronic medical records, training management, and remote clinical diagnostic systems.
Program Highlights
Implementation Science
I-TECH specializes in developing appropriate research designs and methods for application in resource-limited settings, to get answers to research questions in real time. A university-based program, I-TECH draws from experts in qualitative and quantitative methods in a wide range of theoretical and practical disciplines, including health economics, anthropology, health sciences, medicine, and education.
Program Highlights
Nursing/HCW Cadres
World Health Organization guidelines for placing all HIV positive individuals on antiretroviral treatment has intensified the demand for a competent and accessible global health work force that can accommodate 90-90-90 UNAIDS targets for testing, treating, and virally suppressing HIV patients. There is an urgent need to concentrate on effective, differentiated, and cost-efficient service delivery models that embrace high quality patient-centered HIV care as countries adopt and roll out Test and Start. Achieving 90-90-90 will require substantial shifts in how HIV services are staffed and delivered; different solutions, including task sharing, are still needed to reach targets. Over the past decade, a variety of non-physician cadres, such as nurse-midwives, clinical officers, and medical assistants, have contributed to growing evidence of task sharing’s positive contributions to HIV health outcomes in resource-limited settings.
Program Highlights
Human Resources for Health
The effective diagnosis, care, and treatment of infectious diseases require a skilled and motivated health care workforce, and sustainable systems to educate and train those workers. I-TECH uses a systemic approach to build the skills and knowledge of, and foster attitude changes in, health care staff and those who train and educate them.
The following model outlines I-TECH’s human resources for health-based approach to achieving comprehensive patient-centered care. Each component of the model, including a strong enabling environment, supports an optimized health workforce as the foundation of an effective service delivery system.
Program Highlights
e-Learning/Distance Learning
I-TECH’s distance learning and e-learning projects provide opportunities for health care professionals in resource-limited settings to gain knowledge and skills while minimizing their need to leave the workplace.
I-TECH distance learning projects typically have four goals:
- Increase the capacity of health care workers in resource-limited settings to deliver high quality care and treatment while allowing them to remain in their workplaces to provide services at their sites.
- Build the capacity of ministries of health and governmental institutions to use learning technologies and design blended learning, e-learning, and distance learning programs for health care workforce development.
- In collaboration with the UW Department of Global Health’s E-Learning Program (eDGH), provide technical assistance in effectively using e-learning, blended learning, and distance learning for health care workforce development.
Examples of I-TECH’s e-learning products are available in eDGH’s E-Learning Library.
Program Highlights
Clinical Mentoring
Clinical mentoring is a critical component of I-TECH’s comprehensive approach to training, as it provides a bridge between didactic training and independent clinical practice. Clinical mentoring enables health care workers (HCW) to practice new skills in clinical settings with the support and guidance of a more specialized and experienced clinician. Intensive, practical training is especially important in HIV care and treatment given the diversity of illnesses associated with AIDS and the complexities of antiretroviral therapy (ART).
Typically, the clinical mentor is an experienced clinician-trainer who provides onsite training and consultation on complex cases; supports and enhances high level problem solving, diagnostic, and decision-making skills; leads case discussions; and addresses issues of quality assurance and continuing education. These mentoring activities take place in the context of an ongoing, two-way relationship between the mentor and the clinicians working at the site.
The I-TECH approach to mentoring includes five key components:
- Relationship building. The establishment of a trusting, receptive relationship between the mentor and mentee(s) that evolves and grows over the course of mentorship is the foundation of effective mentoring practice.
- Identifying areas for improvement. Observation and assessment of existing systems, practices, and policies leads to the identification of areas for improvement. I-TECH has developed a number of tools for use during the assessment phase. Information obtained during an assessment helps to inform the establishment of goals and objectives for the mentorship.
- Responsive coaching and modeling of best practices. Mentors must demonstrate proper techniques and model good clinical practice. Targeted activities with mentees may include demonstrating appropriate examination techniques, modeling proper infection control measures, and setting examples for establishing good rapport with patients.
- Advocating for environments conducive to quality patient care and provider development. This component relates to technical assistance in support of systems-level changes at a site. Mentors work with colleagues to enhance the development of clinical site infrastructure, systems, and approaches that can support the delivery of comprehensive HIV care.
- Data collection and reporting. Mentors support the utilization and integration of patient data into clinical practice by encouraging staff to adopt documentation practices that promote effective chronic disease management. Mentors can help demonstrate the utility of data collection and reporting to mentees during mentorship.
The ultimate goal of I-TECH’s clinical mentoring programs is to build the skills of local clinicians to become clinical mentors themselves. Ideally, as the pool of expert HIV/ART clinicians in each country expands, a network of local HIV clinical mentors will emerge to support and train other HIV clinicians with less experience.
Program Highlights
Laboratory Systems
Medical laboratories are a critical component of quality health care and provide essential data for patient care and treatment, disease prevention and control, and public health policy development. I-TECH recognizes laboratory strengthening as a core component of its work. I-TECH’s Laboratory Systems Strengthening (LSS) team’s mission is to improve laboratory operations for optimal patient care and treatment, disease surveillance and response, biosecurity, and policy development. The LSS team fosters the development of sustainable laboratory systems and laboratory capacity in multiple countries throughout the world and comprises staff at the University of Washington (UW) in Seattle, as well as locally based staff. The team leverages partnerships within UW and with external collaborators globally, and engages directly with Ministries of Health and funders to accomplish mutual objectives.
In addition to the highlights below, I-TECH also has had laboratory programs in Cambodia, Côte d’Ivoire, Lao PDR, the Middle East and North Africa, and Zambia.
Program Highlights
Health Policy & Regulatory Strengthening
The International Training and Education Center for Health (I-TECH) has broad expertise in strengthening health care regulatory systems in low- and middle-income countries. I-TECH’s approach to regulatory strengthening emphasizes the importance of sustainability and country ownership, by working with ministries of health, health professional councils, and health professional associations to:
- Conduct sound situational analyses and needs assessments;
- Develop standard operating procedures to efficiently operationalize and scale key regulatory activities;
- Develop regulatory information management systems;
- Develop standards to establish consistent expectations for high quality health services; and
- Develop continuing professional development frameworks and guidelines.
Program Highlights
Global Health Security
The COVID-19 pandemic has highlighted the critical importance of strong national disease surveillance systems that can detect disease threats in a timely fashion and provide actionable information for public health action. I-TECH focuses on preventing the likelihood of disease outbreaks, improving the efficiency and accuracy of the detection of communicable diseases, strengthening surveillance capacity for rapid and effective responses, and enhancing infection prevention and control practices to prevent the emergence and spread of pathogens and antimicrobial resistant bacteria.
In response to the COVID-19 pandemic, I-TECH provided technical assistance on the prevention and control of COVID-19 that ranges from training healthcare workers and facilities in infection prevention and control best practices to supporting the development of national policies and standard operating procedures. Throughout the COVID-19 pandemic, I-TECH has worked with Ministries of Health and other local stakeholders to ensure that laboratories, health facilities, clinics, and providers are being trained in and implementing procedures to prevent and control the spread of COVID-19.