healthefoundation the ugandan experience · 2012-11-20 · uganda, mildmay, taso, atic) and...
TRANSCRIPT
HealtheFoundationThe Ugandan experience
Dr Nadine Pakker
18 May 2009
UgandaUganda
HealtheFoundation in Uganda
2004
� Dr Fransje van der Waals
� Cordaid
� Joint Clinical Research Centre
Masindi
Nakasongola
Kases
e
Hoima
Kib
aale
KibogaLuwero
Apac
Mukono
Kamp
ala
MubendeKabarole
Nebbi
Arua
Gulu
Adjumani
Kabale
Mbarara
Rakai
SembabuleMasaka
Kalangala
JinjaIganga
Busia
Mbal
eTororo
KapchorwaPallisa
Kumi
Katakwi
Moroto
Kotido
Kitgum
Soroti
Lira
Mpigi
Bushenyi
Rukungiri
Kamuli
Ntungamo
Moyo
SUDAN
KENYA
TANZANIARWANDA
Kamwenge
Kyenjojo
Kayunga
Kanungu
Yumb
e
Pader
Sironko
Nakapiripi
ritKaberamai
do
BugiriMayugeWakis
o
DRC
Kisoro
Bundib
ujo
27 January 2004
� Round Table Meeting: launch of HIVeDucation with participants from all training organizations in Uganda (UCMB, JCRC, Academic Alliance, Hospice Africa Uganda, Mildmay, TASO, ATIC) and Ministry of Health
� Annual report 2006:Uganda was the first African country where the computer-based format of HIV education was instantly accepted as a useful and timely tool to train the many health care workers who are needed to roll out the treatment program.
27 January 2004
� Joint venture between Cordaid, JCRC and
HealtheFoundation in logistics and finance
� Collaboration of JCRC with Nyakibale
hospital and other hospitals in the Nyakibale
district
February - April 2004
� Uganda HIV epidemiology module (MoH)
� Clinical cases by physicians from JCRC and Prof Katabira
� Initiation workshop
HIVeDucation
Nyakibale
44 participants
Initiation workshop Nyakibale
April 2004
Nyakibale follow up
� Support team
– IT support: UICT
– Continuous support:
Mrs Hanipha Kakooza
– Evaluation: I-Tech
University of Washington
Prof Marcia Weaver
Nyakibale follow up workshop Mbarara25 August 2004
Lectures
Clinical cases
Drug adherence test
Focus groupRole play
DVD
PLWHA
33 participants
Nyakibale follow up workshop Mbarara25 August 2004
Nyakibale follow up workshop Mbarara25 August 2004 / 7 April 2005
Physician 41%
Clinical officer 25%
Nurse 30%
Counselor 4%
Profession
100%73%Completed 1 or more courses
53%39%Completed 10 or more courses
41%30%Completed all 15 courses
Conclusions Nyakibale training course25 August 2004 / 7 April 2005
� Strong assembly of enthusiastic trainers created� Training program appreciated by the trainees:
language understandable, courses useful and informative for both ARV and non-ARV clinics and information applicable
� Trainees enjoyed the training method
� Appreciation expressed by all levels of health care workers
� Positive impact on both HIV knowledge and computer skills
� Certificates provided a strong motivation
Conclusions Nyakibale training course25 August 2004 / 7 April 2005
� Learning method could be improved by “print” option
� Technical problems with use of USB stick
� Computer access biggest problem, internet access almost impossible
� More interaction requested during self-learning period and follow-up workshop
� Formal accreditation for HIVeDucation preferred by
trainees
Conclusions Nyakibale training course25 August 2004 / 7 April 2005
� Additional modules suggested:
– Palliative care
– Pharmacokinetics
– Disclosure
– Nutrition
HIVeDucation 2006 - 2007
� Acknowledgement by Ministry of Health Uganda
� Computer donation through Close the Gap
� Added modules: Palliative care and Pharmacology logistics
� During follow-up workshop more attention for nutrition (scenario) and disclosure (trigger tape)
� Challenges <–> solutions group activity
� Change in software program
� Print option
� Participant portal
HIVeDucation 2006 - 2007
Participants
� Hospice 46
� UCMB 96
� TASO 167
� JCRC - Mpigi 48
Hospice workshop July 2006
Mpigi workshopMarch 2007
UCMB workshop
September 2006
HIVeDucation UCMB
37
12
15
29
24
27
34
6
19
16
18
18
20
21
21
27
79
75
110
104
96
116
97
92
108
37
72
96
88
64
116
137
36
56
58
40
50
42
40
71
53
64
59
53
53
58
48
39
74
63
64
69
70
90
94
97
93
96
94
97
97
99
99
92
Natural history and pathogenesis
ARV interactions
Lab diagnostics and monitoring
ARV drug resistance
ARV toxicity
Palliative care
HIV-TB
OI’s
Pediatric HIV
Clinical monitoring of HIV
Counseling on adherence
Initiation ARV
Principles ARV
pMTCT
VCT, prevention and care
Epidemiology
Do
ne
Pre
Dif
f
Tim
e
HIVeDucation UCMB
Mean increase in scoreComputer use
Daily 12%
Often 18%
Rarely 22%
Never 48%
19%
20%
26%
19%
Increase post-testPre-testGroup
50%
45%
57% 19%22%Doctors
24%34%Nurses
22%44%Other
2007 Pediatric HIVeDucation
� Collaboration with the PENTA group
� 50 Ugandan pediatricians
� Follow-up activities and workshop needed to
optimize training effect
Challenges
� Workload
� Computer access
� Virus
� Online versus offline
– Participant portal
– Continuous medical education
HealtheFoundation 2008 - 2009
HealtheFoundation and INTERACT - AMC-CPCD Foundation
The Infectious disease Network for Treatment
and Research in Africa
Building capacity for clinical research in Africa
– Tuberculosis, HIV, malaria
– Uganda and Rwanda
– 2006 – 2011
– NWO-WOTRO
– European Union
HealtheFoundation 2008 - 2009
� HIVeDucation
– KCC 96 participants
� TBeDucation
– KCC 67 participants
– IDI 40 participants
HealtheFoundation 2008 - 2009
� HIVeDucation Mentoring program
Training - of - Trainers
15 mentors
45 mentees
Acknowledgements
HealtheFoundation AmsterdamPartnering institutes UgandaFacilitators UgandaParticipants UgandaDonors