Since 2005, International Training and Education Center for Health (I-TECH) has collaborated with the Malawi Ministry of Health (MOH) and other government institutions and local partners to provide embedded senior technical advisors (known in Malawi as Technical Assistants (TAs)) to support essential functions and PEPFAR funded priorities. Over the past five years, I-TECH has been CDC Malawi’s implementing partner for recruitment, hiring, and management of highly skilled TAs who are seconded to the MOH and other local institutions. I-TECH TAs have an impressive track record of using national data to catalyze HIV and TB policy and program change. Examples of this include: instituting Option B+ to reduce MTCT and maternal morbidity and mortality; leading initiatives to rationalize and improve essential distribution systems for HIV medicines and commodities; participating in WHO guideline development groups; coordinating with Global Fund to ensure crucial additional HRH and commodity investments; and building institutional and individual capacity to respond to epidemic outbreaks. In addition to performing direct analytic and management services as seconded staff, I-TECH TAs have engaged in ongoing mentoring with colleagues at their host institutions, many of whom have gone on to pursue advanced degrees and assume leadership positions in Malawi-based institutions. However, due to macroeconomic constraints and insufficient national budget allocations for health service delivery, there is an ongoing need for HRH support in order to achieve and sustain epidemic control. I-TECH proposes to leverage its strong reputation for HRH expertise, performance and collaboration to respond to this need.
In response to the CDC-RFA-GH20-2053 RFA, I-TECH proposes over the next five years to build on foundational support through three technical assistance strategies to support HRH needs and build institutional capacity building to Government of Malawi (GoM) ministries and other local institutions. First I-TECH proposes to build institutional capacity for evidence-based management of the national HIV and TB programs through the deployment of high-quality TAs to selected priority GoM institutions to contribute to the achievement and sustaining of HIV epidemic control. TAs will also support national and facility level translation of evidence into practice to support translation of locally generated evidence, PEPFAR initiatives and guidance, and other global evidence into practice. Secondly, the proposed project will also provide leadership in monitoring and evaluation of PEPFAR HRH investments at the national and site level to assess impact and inform strategy improvements. Strengthened M&E systems will generate data which will be used to bolster evidence-based management of HIV and TB programs and enable sustained control of the HIV epidemic. Finally, the proposed project will collaboratively development a plan with CDC and host institutions of seconded staff, to map and monitor the capacity building and transition processes from international TAs to host institution staff and/or national TAs.
The long-term outcome of the proposed activities will be improved capacity of MOH and other key departments in its ministries to 1) lead, manage and oversee the national HIV and TB prevention care and treatment program (2) adapt and implement WHO standards and policies and translate them into guidelines and SOPs, and (3) increase institutionalized capacity to respond to outbreaks and evidence-based public health decisions. Key to increasing management capacity will be ongoing improvements in data sources, quality, analysis, interpretation and use to improve health policy, programs, supply chain, and patient centered service delivery.