Addressing health workforce crisis in rural health facilities through the Integrated Infectious Disease Capacity Building Evaluation (IDCAP) of midlevel health practitioners in Uganda

M. Namaalwa1, S. Naikoba1, T. Kendle2, S. Kinoti3, L. Mpanga-Sebuyira1, K. Willis2, M. Weaver4

1. Infectious Diseases Institute, Kampala, Uganda; 2. Accordia Global Health Foundation, Washington, D.C. ; 3. University Research Company – Center for Health Services, Washington D.C.; 4. University of Washington;

The OSS training of Multi Disciplinary Teams at the

health facility will:

Improve individual health professionals’ clinical performance

Improve site performance Improve patient health outcomes within the facilities’

populations Ensure effective and cost effective care and integration of

infectious diseases services.

Image 1: A nursing officer presenting a case during an MDT session at an IDCAP intervention site.

OSS Results

Image 2: A breakout session following MDT with enrolled nurses and midwives and nursing assistants at an IDCAP intervention site.

Accordia’s IDCAP Partners

Accordia’s IDCAP is a 3-year program funded by the Bill and Melinda Gates Foundation with the goal of evaluating the cost-effectiveness of building capacity among mid-level health practitioners in sub-Saharan Africa for the treatment and prevention of infectious diseases. IDCAP will measure the impact of a novel package of classroom training, distance learning, and on-site support services on individual competence, facility performance, and health outcomes in the surrounding communities.

About IDCAP

Challenges

Lessons Learned

OSS Participation per Cadre (preliminary results)

Hypotheses

There is an inadequate healthcare workforce to effectively manage the disease burden in rural health facilities. As a result, mid level practitioners (MLP), i.e. clinical officers and nurses, have traditionally taken on the roles reserved for medical officers, such as managing patients on anti-retroviral therapy (ART), patients having malaria, tuberculosis and other infectious diseases.

The MLP are inadequately prepared with the necessary skills and knowledge to perform these tasks. IDCAP offers an Integrated Management of Infectious Diseases training program to MLP and On-Site Support (OSS) to multidisciplinary teams.

Introduction

Describe IDCAP’s onsite support services (OSS).

Objective

IDCAP worked with district and health facility in-charges to identify staff responsible for the routine care of patients with HIV, tuberculosis, malaria and other infectious diseases.

Mobile teams comprising of a medical officer, clinical officer, laboratory technologist and district maternal and child health nurse visit sites once per month for two

consecutive days. Mobile teams were trained in the integrated

management of infectious diseases, mentoring, and continuous quality improvement (CQI).

Multi disciplinary site teams at 18 Phase A sites are comprised of medical officers(n=11), clinical officers(n=54), registered nurses (n=53), enrolled nurses and midwives(n=97), lab personnel (n=46), nursing assistants(n=88), and others(n=82) (counselors, dispensers and medical records officers).

Breakout sessions curriculum target 3 groups: 1) clinical officers and registered nurses, 2) enrolled nurses, midwives, and nursing assistants, and 3) laboratory staff.

Selected MLP are offered mentoring, including clinical officers(n=44), registered nurses(n=38), enrolled nurses and midwives(n=27), and lab personnel(n=43)

Staff participating receive a certificate based onattendance in OSS sessions:

Full attendance of two Integrated Management of Infectious Diseases course trainees at each site

70% attendance for other clinic staff

Method/Design

IDCAP OSS Schedule

The OSS package of activities were initiated sequentially over the first three visits. MDTs took place at OSS visits 1-6B/O sessions took place from OSS visits 3-6. C&M include OSS visits 2-6

Session 927

Abstract Number: 2449