Our Projects

HRSA is committed to sustainable control of the HIV/AIDS epidemic. Building on HRSA’s experience to improve HIV and health services in the United States, HRSA seeks to provide leadership and resources to assure access to and retention in high quality integrated care and treatment services for vulnerable people living with HIV/AIDS globally.

Key components and strategies of the Global Program include:

  • Supporting training activities and partnerships to develop human and organizational capacity
  • Designing innovative care and support models to remove barriers to care
  • Assessing the effectiveness of specific models of care to promote adaptation of best practices
  • Enhancing the capacity of program partners to collect, monitor, and evaluate data for quality of care

Current Projects

Str*engthening *I*nter-*P*rofessional *E*ducation *(STRIPE) To Improve HIV Care Across Africa (April 2019-March 2020)

The project aims to strengthen inter-professional HIV treatment and care service training provided by former Medical Education Partnership Initiative (MEPI) and Nursing Education Partnership Initiative (NEPI) institutions and their partner facilities to ensure the ability of health professional graduates to deliver high quality, team-based, person-centered care to people with HIV (PLHIV) focusing on the transition from graduate school to practice.

This President’s Emergency Plan for AIDS Relief (PEPFAR) funded project has three phases:

Phase I (April- July 2019): University of California, San Francisco (UCSF, HEALTHQUAL) and MEPI/NEPI senior faculty developing inter-professional quality improvement training modules on HIV/AIDS treatment and care (both in-class and clinic-based trainings) for MEPI/NEPI institutions.

Phase II (August-October 2019): UCSF and appropriate MEPI/NEPI senior faculty will conduct train-the-trainer courses, introducing the inter-professional training modules to MEPI/NEPI faculty and preceptors who in return will deliver the courses in MEPI/NEPI institutions; and

Phase III (November 2019- March 2020): Trained MEPI/NEPI faculty and preceptors will train final year students and residents (pre-licensed graduates under practical training) with inter-professional training modules at selected MEPI/NEPI institutions’ training sites including some PEPFAR-supported clinics/hospitals.

Initial stage of the project plans to include 13 former MEPI institutions and 12 former NEPI institutions in 14 African countries.

Implementing Partner:

University of California, San Francisco (HEALTHQUAL)

Geographic Scope:

Botswana; Democratic Republic of Congo; Ethiopia; Ghana; Kenya; Lesotho; Malawi; Mozambique; Nigeria; South Africa; Tanzania; Uganda; Zambia and Zimbabwe

Bi-directional Lessons Learned Along the HIV Treatment Cascade between the Ryan White HIV/AIDS Program and PEPFAR Programs

This initiative will conduct a study of the HRSA implemented domestic Ryan White HIV/AIDS Program (RWHAP) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program.  The goal is to identify lessons learned, successful models, interventions and experiences that can be translated into the global health arena and into the domestic HIV service delivery to improve health outcomes along the treatment cascade in the U.S. and international settings. This will be accomplished through a comprehensive literature review and a Stakeholder Meeting, and the information collected will culminate in a White Paper to inform program and policy decisions moving forward.

Implementing Partner(s)

  • Abt Associates

Geographic Focus

U.S. and PEPFAR countries

International AIDS Education and Training Centers

The International AIDS Education and Training Centers (IAETC) work with in-country partners to provide support in health systems strengthening to countries in their efforts to control the HIV/AIDS epidemic. The diverse capacity building by the IAETC includes direct treatment including antiretroviral therapy and voluntary medical male circumcision. They have done substantial capacity building in Ministries of Health including via secondment with eventual hiring by host governments. Training and education is only one aspect of the IAETC’s work, and these activities are increasingly shifting to the site level consistent with the direction of PEPFAR.

IAETC's activities focus on strengthening human resources for health, HIV care and treatment, health information systems and data to inform testing, care, treatment, and support. The IAETC program promotes sustainable health systems strengthening through the engagement with partners in-country, including local organizations and Ministries of Health and Education.

Achievements:

  • Botswana: With I-TECH support, the Ministry of Health & Wellness has made great strides in HIV testing services, laboratory systems continuous quality improvement, monitoring and evaluation of HIV and tuberculosis, health informatics, and operations research. I-TECH Botswana has been providing direct service delivery and technical assistance in support of the Government of Botswana’s health priorities, specifically targeting the first 90 of the UNAIDS 90/90/90 goals.
  • Mozambique: Technical support to the Ministry of Health (MOH) has been focused on addressing the shortage of health care providers in the country through clinical training and curriculum revision and development. I-TECH also works to improve the quality of HIV prevention, care and treatment services, including antiretroviral treatment (ART) and voluntary medical male circumcision (VMMC)
  • Caribbean: With I-TECH support, technical assistance to the Ministry of Health & Wellness has focused on continuous quality improvement, clinical mentoring, health systems strengthening, eLearning, and instructional design. Currently, the team is doing pioneering work in modeling how to improve provider-patient communication and clinical skills with key populations—in this case, gay and bisexual men, other men who have sex with men (MSM), transgender women, and sex workers. I-TECH’s current work in the Caribbean supports activities to improve retention in care, treatment adherence, and virologic suppression. I-TECH implements programs to improve access and quality of care for all people living with HIV (PLHIV) and specifically key population groups affected by HIV. Regionally, I-TECH currently works in Jamaica, Trinidad and Tobago, and recently concluded programming in both Barbados and Suriname in September 2018.

Implementing Partner(s)

  • International Training & Education Center for Health (I-TECH) at the University of Washington

Geographic Scope

Barbados, Botswana, India, Jamaica, Kenya, Mozambique, South Africa, Suriname, Trinidad and Tobago, and Ukraine

International Twinning Center

The International Twinning Center facilitates, manages, and provides technical support for peer-to-peer institutional partnerships (north-south and, increasingly, south-south) between organizations with shared characteristics to achieve a common goal—to strengthen health systems and human resources for the provision of quality, sustainable HIV/AIDS services, by empowering PEPFAR countries to meet internal and regional needs for these services.

The International Twinning Center strengthens health systems and supports care and treatment in a number of essential areas, including:

  • Increasing the capacity of healthcare workers
  • Introducing new healthcare cadres; Accrediting pre- and in-service curricula
  • Strengthening country/regional health and allied workforce
  • Tracking the deployment of trained professionals in high-burden areas
  • Building the capacity of professional associations
  • Creating new models of care

Implementing Partner(s)

  • American International Health Alliance (AIHA)

Geographic Scope

Ethiopia, Cambodia, Kenya, Kyrgyzstan, Mozambique, South Africa, Tanzania, Uganda, Ukraine, and Zambia

Quality Improvement Capacity for Impact Project

The Quality Improvement Capacity for Impact Project (QICIP) represents a broadening of the former project to include a variety of approaches supported by evidence of effectiveness, with field-based support and a platform for sharing knowledge between and among facilities and countries.

QICIP works to build the capacity of host country health systems to improve the effectiveness, efficiency, patient-centeredness, safety, accessibility, and equity of the services that they provide. The QICIP is available to provide assistance to country teams seeking to address deficiencies arising from Site Improvement through Monitoring System (SIMS) assessments and gaps along the clinical care cascade, particularly those that represent barriers to achieving epidemic control. Using a knowledge sharing platform will help catalyze and spread successful interventions to other countries and sites.

Implementing Partner(s)

  • International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University
  • HEALTHQual International at University of California San Francisco (UCSF)

Geographic Scope

Asia Regional (Laos & Thailand), Angola, Cambodia, Cameroon, Kenya, Malawi, Mozambique, Namibia, Nigeria, Papua New Guinea, South Africa, Tanzania, Vietnam, Zambia, Zimbabwe

Resilient and Responsive Health Systems Initiative

The Resilient and Responsive Health Systems (RRHS) Initiative supports the enhancement of the capacity in the primary health care system, with a focus on health worker training, supply and quality. The purpose of the RRHS Initiative is to rebuild/strengthen the health workforce, strengthen national governance and coordination frameworks, and create platforms for cross-regional and/or initiative-wide collaborations to promote inter-professional sharing and the adoption of evidence-based practices, innovative models and educational standards. Some of this work will be accomplished through enhancing skills of health workers at all levels from community health workers to physicians, strengthening training institutions through multi-level capacity building activities and strengthening professional boards and organizations.

Implementing Partner(s)

  • International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University
  • Brigham & Women’s Hospital

Geographic Scope

Democratic Republic of Congo, Liberia and Sierra Leone

Resilient and Responsive Health Organizations Initiative

The Resilient and Responsive Health Organizations (RRHO) Initiative will support the creation of capacity building plans and the provision of technical assistance focused on the building or enhancing of organizational capacity in a variety of priority areas including program and financial management, grants management, leadership and governance, personnel management, and evaluation and monitoring. The purpose of the RRHO Initiative is to strengthen the capacity of impact partners supported under the HRSA Resilient and Responsive Health Systems Initiative, a five-year program to strengthen Human Resources for Health (HRH). By strengthening the organizational capacity of impact partners in each country, HRSA seeks to maintain the ability of each institution to continue playing a positive role in addressing the HRH needs and to benefit health care providers and the populations they serve.

Implementing Partner(s)

  • John Snow Institute (JSI)

Geographic Scope

Democratic Republic of Congo, Liberia, Sierra Leone and South Sudan

Health Workforce for the 21st Century (FY 2018 – 2022)

Health Workforce for the 21st Century (HW21) is a five-year HRSA initiative supporting high HIV burden countries to meet 95-95-95 goals by 2030 by building competent and confident health workers and effectively supporting governments to employ, deploy, and retain them.

Current project technical areas:

HW21 is closing health workforce gaps to increase access for people living with HIV (PLHIV) to testing, care, treatment and support to ensure sustained viral suppression.

Human Resource Information Systems:

Strengthening use of information systems to guide human resources planning, decision-making, deployment, and retention

Community Health:

Supporting the formal scale-up of community health workers to provide prevention and treatment services based on clients’ needs including increasing the demand and community capacity for index-case testing, oral pre-exposure prophylaxis (PrEP), and differentiated models of care

Behavioral Health and Social Work:

Highlighting successful adherence strategies to antiretroviral therapy and retention in care by identifying best practices in addressing depression and substance abuse

Enhancing HIV/TB Mentorship via Technology and Case-Based Learning:

Creating communities of practice through telementoring and case-based learning for providers at facility level via the ECHO© model

Health Workforce Modeling:

Supporting planning and costing human resources for health needs for an efficient response towards HIV epidemic control

Expanding Nursing Practice:

Initiating and strengthening education and mentorship of the HIV nurse practitioner in order to support clients’ care and success in HIV prevention, care, treatment, and retention

Achievements:

Human Resources for Health Simulation Model (HRHSM)

HW21 has developed a web-based HRH microsimulation modeling tool to support HRH planning and costing. This tool leverages domestic experience with HRSA’s U.S. Health Workforce Simulation Model. The model is adaptable to the national, subnational, and site level to generate projections of the need for specific types of cadres and skills mix to answer questions such as how does the implementation of alternative care delivery and/or different service delivery models (DSD) impact HRH needs and what HRH skill mix is required as countries move towards epidemic control. HRHSM can analyze gaps between current numbers of employed healthcare workers (HCW) and projected need of cadres, as well as show how current HCWs can be optimized to address projected need. The model can inform eventual transition for countries to absorb PEPFAR supported HRH.

Implementing Partner:

  • Jhpiego

Geographic Scope:

Cote d’Ivoire, Ethiopia, Namibia, Uganda, and Zambia

Optimizing Momentum Toward Sustainable Epidemic Control (FY 2018-2022)

The Optimizing Momentum Toward Sustainable Epidemic Control (OPCON) Project is designed to support innovative, flexible and high-impact projects to improve HIV program outcomes, equity, efficiency and sustainability.  OPCON can assist countries in addressing the challenges faced in reaching epidemic control, sustaining achievements, and exploring innovations to measure progress.

Implementing Partner(s)

  • International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University

Geographic Scope

Cote d’Ivoire, Mozambique, Zambia and Zimbabwe

Past Projects

 

Date Last Reviewed:  August 2019