Increased use of technology to deliver healthcare using distance learning, telemedicine and other platforms has particularly come to the forefront due to the COVID-19 pandemic. AIHA has been involved in telehealth under a few different projects, please see below for more information.
Advancing Human Resources for Health in Philippines through eLearning
As in many other countries, the Philippine health system faces challenges in the development and distribution of health workers. Ten percent of the country’s human resources for health (HRH) serve geographically isolated and disadvantaged rural areas, leaving some islands and barangays without adequately prepared medical professionals. HRH shortages limit the quality and availability of care, resulting in disparities in health outcomes.
USAID’s HRH2030 program began partnering with the Philippines Department of Health in 2018 to strengthen the deployment, training, and management of the health workforce to improve access to and quality of tuberculosis, family planning, and maternal and child health services in the Philippines. Key objectives were to:
- Improve the skill mix, competency, and distribution of the health workforce at the primary level
- Strengthen human resources for health leadership, governance, and performance management
- Advance the use of data for human resources for health decision-making at central and regional levels
In keeping with these objectives, AIHA developed The Health Academy available via e-Learning portal for the Department of Health in the Philippines.. USAID considers the portal we developed and training we provided as one of best practices for utilization of e-Learning on a national level for user-friendly continuous professional education courses to strengthen the knowledge and skills of the country’s health workforce, specifically physicians, nurses, midwives, and medical technologists. Targeted learning focus areas were tuberculosis, family planning, and maternal and child health.
AIHA designed the platform and materials to be a publicly available resource for more than 100,000 people. The DOH e-Learning Academy is delivered on the Moodle open-source platform. Content for one-hour content modules continue to be prepared by local experts. This ensures all training is of high quality, evidence-based and consistent with local procedures. AIHA tested and disseminated these modules in mobile smart phones, laptops, tablets, or desktop devices. The modules are accessible for instruction completely off-line by downloading with Wi-Fi onto any device. The offline version can be delivered in small groups of trainees in face-to-face training or can be completed by an individual.
To learn more about this project, including project accomplishments, please read:
Zambian Defense Forces Learning Resource Center Initiative
Building on an existing relationship between the Zambian Defense Force and the US Department of Defense, this AIHA initiative is working to improve Zambia’s HIV treatment and care for military personnel and their families by improving access to evidence-based medical resources through information and communication technologies and telemedicine.
AIHA has been collaborating with Zambian Defense Forces (ZDF) military medical personnel since 2005 with support from the US Department of Defense. We’ve been providing direct assistance since 2007 on a broad range of technical areas, including pre- and in-service training at the Defense School of Health Sciences in HIV care and treatment, injection safety, infection control, emergency medicine, and telemedicine, as well as targeted initiatives to improve rates of retention in care for PLHIV.
ZDF oversees more than 50 clinical health sites, many situated in rural areas far from referral hospitals where specialized care can be accessed, so it is well-positioned to take the lead on telemedicine and other technology-driven health initiatives.
In underserved rural areas, telemedicine can greatly improve access to care, reduce morbidity and mortality rates, and improve quality of life for both the military and local civilian populations that ZDF clinics serve.
In 2014, AIHA and ZDF began collaborating with the Georgia-based Global Partnership for Telehealth on a groundbreak- ing locally-driven, locally-owned telemedicine program designed to improve access to quality care by linking clinics or care providers to central referral hospitals. Launched in September 2015, the ZDF telemedicine program links experts at Maina Soko Military Hospital in Lusaka with health staff at five sites across the country to improve the quality of diagnostics and treatment services at these military clinics.
Tracking Patients Lost to Follow-up and Reengaging Them in Care
In 2016, AIHA began working with ZDF’s HIV/AIDS Secretariat to implement another technology-driven project under PEPFAR’s Accelerated Childhood Treatment (ACT) Initiative. This intervention focuses on reducing loss to follow-up among children living with HIV and their mothers.
AIHA contracted US-based software company Zerion to assist with a needs assessment and create a mobile application to track patients. In September 2016, AIHA piloted the app — which enables health workers to input a patient’s national SmartCare identification number, address, demographic information, date of follow-up appointment, and name of the communi- ty health workers (CHW) assigned to the case — at ZDF sites in Kabwe, Lusaka, and Ndola.
CHWs receive an alert prior to a patient’s next appointment, so they can follow up with him or her as a reminder. The app also allows facility health workers to input the names and information of patients who are lost to follow-up (LTFU), so CHWs can redouble efforts to either bring them back into care or provide an explanation for why they are no longer on treatment.
Currently there is little data on loss to follow-up in Zambia. This mobile platform may help change that, while at the same time facilitating more effective monitoring, evaluation, and reporting. At present, health workers are manually linking patients tracked through the app to SmartCare, but in the coming months, AIHA and ZDF will work toward automated integration into the national SmartCare system.
Bolstering In-service Training Capacity
Over the course of our partnership with ZDF, AIHA has been working closely with the Defense School of Health Sciences and Zambia’s Ministry of Health on the development of training packages for a number of clinical disciplines, including developing a National Curriculum for Emergency Services, which is already being used. Similarly, AIHA supported the school’s efforts to draft curricula for injection safety and infection prevention, which are currently being implemented by faculty.
Strengthening Knowledge Management to Support Improved Health Outcomes
AIHA’s earliest collaboration with ZDF focused on establishing Knowledge Management Centers (KMCs) at clinical sites to empower healthcare personnel through access to a wealth of up-to-date clinical research, texts, case studies, protocols, and other evidenced-based resources that can guide their practice and improve quality of HIV-related care and treatment outcomes.
AIHA supported effective use and scale up of the 21 KMCs we established at ZDF sites by providing targeted training on evidence-based medicine, emergency medicine, proper research protocols, online resources, and other relevant topics both through workshops and distance learning courses.
In alignment with PEPFAR 3.0 goals and objectives, AIHA transitioned many KMCs into Monitoring and Evaluation Hubs to better support data-driven interventions and outcomes. This strategic shift is helping ensure effective use of resources for data management to enhance quality im- provement in HIV service delivery at the facility level. AIHA is providing focused training in data analysis, interpretation, and use to meet the daily needs of ZDF end-users, which addresses a serious gap in capacity to interpret and act on data to drive program surveillance and quality assurance processes. Other KMCs are being transitioned to adolescent- focused centers to support adherence and healthy lifestyles based on community needs.
To read the final closeout report of AIHA’s Twinning Center Program, click here.