In Malawi, International Training & Education Center for Health (I-TECH) utilizes Community Mobilizers (CMs), who use interpersonal communication to create demand among males needing Voluntary Medical Male Circumcision services. In order to ease the mobility of CMs within their locales, I-TECH recently donated 10 bicycles to the program. The District Environmental Health Officer for Lilongwe, Mr. Mavuto Thomas, thanked I-TECH for the donation, saying this will greatly assist the CMs in their communities with mobility and information dissemination on the importance of male circumcision. Read more.
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UW Researchers Contribute to Special Supplement on the Medical Education Partnership Initiative or MEPI
UW researchers contributed to a special supplement in the August issue of Academic Medicine, the journal of the Association of American Medical Colleges, about the work of the Medical Education Partnership Initiative (MEPI), a U.S.-funded program to strengthen health systems in Sub-Saharan Africa.
Sub-Saharan Africa suffers 25 percent of the global burden of disease but has only three percent of the world’s health care workers. This continental problem is not news to Africans but recent reports from the World Health Organization and others have brought this challenge to global attention. In 2010, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) launched MEPI in an effort to help address this crisis in regard to medicine. MEPI is funding 13 medical schools in 12 African countries to help increase the quality, quantity and retention of medical school graduates. The UW is partnering with the University of Nairobi.
This supplement speaks to special circumstances of medical education in Africa and addresses many crosscutting topical, global themes in medical education. It includes 33 articles with 225 authors from all the 13 MEPI-sponsored medical schools and many partner schools in Africa and the United States.
The article,“Expanding Clinical Medical Training Opportunities at the University of Nairobi: Adapting a Regional Medical Education Model from the WWAMI Program at the University of Washington,” was written by Mara J. Child, James N. Kiarie, Suzanne M. Allen, Ruth Nduati, Judith N. Wasserheit, Minnie W. Kibore, Grace John-Stewart, Francis J. Njiri, Gabrielle O’Malley, Raphael Kinuthia,Tom E. Norris, and Carey Farquhar.
Lancet: Donors and Ministries of Health Pushed to Sign a NGO Code of Conduct; Health Alliance International Leads Effort
Seattle, WA - Aug. 23, 2014 – One of the best ways to help a country is to do no harm while helping, argue a consortium of public health researchers, physicians, activists and funders in a comment published in the Aug. 23 edition of The Lancet.
The consortium, led by Health Alliance International, a UW-related nongovernmental organization, are pushing for donors and ministries of health to make signing the NGO Code of Conduct for Health Systems Strengthening, a condition for receiving funding or working in their countries.
The Code of Conduct, started by Health Alliance International, focuses on strengthening health systems within a country and sets ethical principles for groups to follow, including:
- Engaging in hiring practices that ensure long-term health system sustainability.
- Enacting employee compensation practices that strengthen the public sector.
- Pledging to create and maintain human resources training and support systems.
- Minimizing the NGO management burden for ministries of health.
- Supporting ministries of health as they engage with communities.
- Advocating for policies which promote and support the public sector.
“When the Code was first released in 2008, our focus was to get other NGOs on board and committed to a set of best practices to support public-sector health systems,” said James Pfeiffer, the executive director of Health Alliance International. “But over time we’ve realized that if we really want to make sure that NGOs aren’t harming public-sector health systems, we have to get donors on board.”
The consortium includes representatives from Health Alliance International, the University of Washington, Health GAP, the Doris Duke Charitable Foundation, the University of Colorado-Denver, and Jawaharlal Nehru University in New Dehli.
“The end of AIDS cannot be achieved through a patchwork of uncoordinated NGO projects, private providers, and underfunded public health systems,” the article concludes. “Conscientious donors, using the NGO Code of Conduct, can help strengthen local services and build the public national health systems capable of producing an AIDS-free generation.”
Since 2008, 59 NGOs have signed the Code of Conduct, including Partners in Health, Oxfam, Health GAP, ActionAid, African Medical and Research Foundation (AMREF), and Physicians for Human Rights.
The article can be accessed on The Lancet’s website.
For a related podcast of James Pfeiffer speaking to Humanosphere, go here.
The Washington Global Health Alliance has compiled a list of the many efforts going on in the state around containing the Ebola outbreak. For more information, go to the WGHA website.
I-TECH Research Idenitfies Four Principal Social Barriers to HIV Prevention and Care in South Africa
Congratulations to International Training & Education Center for Health (I-TECH) for a new article, published in PLOSONE: “Informing Comprehensive HIV Prevention: A Situational Analysis of the HIV Prevention and Care Context, North West Province South Africa,” authored by Sheri A. Lippman, Sarah Treves-Kagan, Jennifer M. Gilvydis, Evasen Naidoo, Gertrude Khumalo-Sakutukwa, Lynae Darbes, Elsie Raphela, Lebogang Ntswane, and Scott Barnhart.
The team conducted more than 200 individual and group interviews and gleaned four principal social barriers to HIV prevention and care: HIV fatalism, traditional gender norms, HIV-related stigma, and challenges with communication around HIV. Understanding these social and structural barriers to care helped shape I-TECH South Africa’s comprehensive HIV prevention program.
In addition, the situational analysis method used was an effective way to collect ample data to inform programming in a short period of time, build community support for the program, and establish excellent relationships with governmental stakeholders. Click here for the full article.
I-TECH Partners for First Randomized Trial of Educational Outreach and Continuous Quality Improvement (CQI) in Africa
International Training & Education Center for Health (I-TECH) recently partnered on the first randomized trial of educational outreach and continuous quality improvement (CQI) in Africa. The evidence in a new IDCAP Overview article published in PLOS ONE — “Improving Facility Performance in Infectious Disease Care in Uganda: a Mixed Design Study with Pre/Post and Cluster Randomized TrialComponents” — by Dr. Marcia Weaver et al. supports work that I-TECH is already doing in three ways:
- The pre/post comparisons showed that high quality training, educational outreach, and CQI significantly improved the quality of care for emergencies, malaria, and pneumonia, and enrollment in HIV care.
- IDCAP demonstrates I-TECH’s capacity to measure the effects of training and other interventions to improve care and treatment, such as case scenarios/clinical vignettes, clinical observation, facility performance measures, and population-based mortality.
- The Overview article reports that efforts to improve data collection had an independent effect on the quality of care for two facility performance indicators. In other words, improving health information systems also serves as an intervention to improve the quality of care.
“I am grateful for the curriculum development ‘dream team,’” said Dr. Weaver, “including Ann Miceli and Lisa Rayko Farrar from I-TECH, for outstanding implementation by the Infectious Diseases Institute and University Research Co, LLC, and to Accordia Global Health Foundation for project leadership and Sarah Burnett’s excellent data management and analysis.”
New research published today [September 19] in The Lancet suggests that, with sustained international efforts, the number of premature deaths could be reduced by 40% over the next two decades (2010-2030), halving under–50 mortality and preventing a third of the deaths at ages 50–69 years.
The findings reveal that, between 2000 and 2010, child deaths fell by one-third worldwide, helped by the fourth Millennium Development Goal (MDG) to reduce child deaths by two-thirds; and premature deaths among adults fell by one-sixth, helped by the firth MDG to reduce maternal mortality and the sixth MDG to fight AIDS, malaria and other diseases. With expanded international efforts against a wider range of causes, these rates of decrease could accelerate, say the authors.
The most striking change during 2000–2010 was a two-thirds reduction in childhood deaths from the diseases now controlled by vaccination (diphtheria, pertussis, tetanus, polio, and measles), highlighting what targeted international efforts can achieve. Read the full press release here.
Disease Control Priorities 3 (DCP3) Contribution
The study was authored by a cohort of DCP3 editors, authors, and advisory committee members, including:
- Ole Norhiem - Advisory Committee member
- Prabhat Jha - Series editor
- Margaret Kruk - Essential Surgery volume editor
- Colin Mathers - Essential Surgery chapter author
- Jaime Sepulveda - Advisory Commitee member
- Stephane Verguet - DCP Secretariat staff member
- Gavin Yamey - Communications technical advisory group member
- Dean Jamison - Series editor
- Richard Peto - DCP3 author
Disease Control Priorities Network (DCPN) collaborating institution, the Centre for Global Health Research, and DCPN project sponsor, the Bill & Melinda Gates Foundation, provided funding for this study.
UW Global Health Professor Kristie Ebi presented Aug. 27 at the World Health Organization conference on health and climate in Geneva.
"The conference was a watershed moment in making health central in international and national actions to avoid, prepare for, and cope with the risks of current and future climate change," Ebi said. Her presentation was to help frame the discussions on intersectoral governance.This was the first WHO conference focusing on developing an action plan for WHO and ministries of health on strengthening health system resilience to climate risks, and for promoting health while mitigating climate change. More than 400 people attended the invitation-only conference.
The Human Animal Medicine Project is now officially the Center for One Health Research (COHR), residing in the Department of Environmental and Occupational Health Sciences in the School of Public Health at the University of Washington in Seattle, WA. The Center for One Health Research investigates the health linkages between humans, animals, and their shared environments; including zoonoses, comparative clinical medicine, animals as sentinels, animal worker health, nutrition and food safety, and the human-animal bond. Through transdisciplinary partnerships, COHR develops innovative strategies for healthy coexistence between humans and animals in sustainable local and global ecosystems. COHR is led by director Peter M. Rabinowitz, MD MPH, who is an Associate Professor in the Department of Global Health. For more info, visit their new website.
The Washington Global Health Alliance announced its Second Annual Pioneers in Global Health Awards, three prestigious awards selected by a panel of judges including last year’s Impact Award Winner, Department Chair Dr. King Holmes. Congratulations to Kenneth Stuart, Pathobiology faculty and founder of Seattle Biomed, for winning the Award for Impact!
From the WGHA website:
The second annual Award for Impact, previously awarded at WGHA's Party for the Health of It, recognizes a creative and inspirational leader dedicated to solving global health inequity with a commitment to building partnerships in Washington State as well as on the global stage. Dr. Ken Stuart is a true pioneer. He founded Seattle Biomedical Research Institute more than 35 years ago in Issaquah. Since that time under his leadership, the institute has grown to more than 300 employees and is a leading global health research institute.
“It has been a stimulating and gratifying experience to be a part of the global health research endeavor. When I came to Seattle, the strong research was centered at the University of Washington and Seattle had somewhat of a localized feel. However, Seattle has become an epicenter of global health research through the work of many and their willingness to cooperate on our common goal of eradicating the massive suffering and death that result from the diseases we are working to eliminate,” said Ken Stuart, PhD, founder of Seattle BioMed.
Each award winner was selected because of their demonstrated desire to nurture and grow Washington’s collaborative global health community. Winners will be honored at WGHA’s annual event, the Pioneers of Global Health Awards Dinner, October 9, 2014 at The Foundry.
For more information on the Washington Global Health Alliance’s Pioneers in Global Health Awards:
Director of Communications
Washington Global Health Alliance
Ukraine has one of the most serious HIV/AIDS epidemics in Eastern Europe and Central Asia and is experiencing one of the fastest-growing HIV epidemics in the world. The first case of HIV was identified in 1987; since that time 245,216 cases have been officially recorded, with 31,999 deaths. As of January 1, 2014, more than 134,000 HIV-positive patients were registered with and receiving care and treatment from the state health care facilities.
I-TECH began working in Ukraine in 2011 at the invitation of the U.S. Centers for Disease Control and Prevention (CDC) and the Ukrainian Ministry of Health. Read more about their work to stem the HIV epidemic in Ukraine.
Last month, a distinguished group from the University of Washington’s International Training and Education Center for Health (I-TECH) and Department of Global Health (DGH) visited Addis Ababa and Gondar, Ethiopia, for several days of discussion, workshops, events, and celebration — including the University of Gondar’s 60th anniversary Diamond Jubilee and the inauguration of the University of Gondar Comprehensive Outpatient Center.
I-TECH has had a presence in Ethiopia since 2003, and in that time, has become a guiding force in antiretroviral therapy service delivery and human resources for health, building the capacity of the Regional Health Bureaus (RHBs), universities, and health facilities; introducing innovative initiatives such as task sharing; activating effective monitoring and evaluation interventions; advocating for and implementing TB prevention programs, including MDR-TB; and building the capacity of health facilities and regional labs. The team acts in close partnership with the RHB offices of the Ministry of Health in Afar, Amhara, and Tigray and will be transitioning most of its programs to the RHBs in September 2014.
In advance of this transition, Dr. King Holmes, Chair of the Department, and Dr. Ann Downer, I-TECH Executive Director, met with staff in Addis Ababa during a July 4 coffee ceremony. The meeting was an opportunity to say farewell to some incredibly valuable members of the I-TECH Ethiopia team who are leaving as projects are transitioned to the RHBs and discuss highlights of more than a decade of outstanding work in Ethiopia. Both Department Chair King Holmes and I-TECH Executive Director Ann Downer visited the sites, including a namesake training hall at the University of Gondar: the King Holmes Continuing Professional Development Center. “What a wonderful and humbling experience,” Dr. Holmes said of the visit. “And what a great way to end the trip.” Read more and check out photos from the trip.
In the fall, Health Equity Circle (HEC) students are working directly with Sound Alliance under the supervision of Dr. Rick Arnold to offer UCONJ 624: Health Equity and Community Organizing in Autumn 2014. This course will equip students from the six health sciences schools to work together to develop community organizing skills focused on upstream action for health equity. Through HEC, students will have the opportunity to participate in a campaign with community members during the 2014-2015 academic year.
Students can email David Fernando directly for course access (email@example.com). We look forward to offering students novel and quality experiences to support health equity.
Health Equity Circle (HEC) is a SoM started interdisciplinary registered student organization. We are committed to student development through interdisciplinary advocacy and community organizing opportunities in the greater Seattle area.
A new Scientific American (SA) article special issue highlights the 12 recommendations of an Institute of Medicine (IOM) report, Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health, published in 2010. DCP3 series editor and Project Director and Clinical Associate Professor Dr. Rachel Nugent was a member of the committee that prepared the report and expounds on recommendation 9 in the special issue. She urges countries to define resource needs by using the most up-to-date data about in-country capacity.
Nadia Arang (BS, Microbiology, Minor, Global Health 2014) began full-time work at Seattle BioMed just a week after graduating from the UW. She researches how malaria parasites get inside the human liver, where they grow and multiply. "The research has a very clear and direct impact on human life," Arang says. "It's very easy to stay engaged."
UW students help kids with the polio eradication game at the Seattle Center