Launch of Zimbabwe HIV training and Service Delivery Programs

In February 2014 the Ministry of Health and Child Care (MoHCC) in collaboration with International Training and Education Center for Health (I-TECH), Zimbabwe Association of Church-Related Hospitals (ZACH), local and U.S.-based partners, launched three programs to build local capacity and provide comprehensive services to combat HIV/AIDS in Zimbabwe. The programs are funded by The U.S.

President’s Emergency Plan for AIDS Relief (PEPFAR) with technical support from the Centers for Disease Control and Prevention (CDC). These programs are supporting training of more than 8,000 health care workers and providing clinical mentorship to health care workers at 1,500 sites with a strong monitoring and evaluation component.

I-TECH and partners are supporting the Training and Mentoring Program, that seeks to develop and deliver comprehensive in-service training on HIV prevention, treatment, care and support services including management of opportunistic infections for people living with HIV to 8,000 health care workers across the country over five years.  In addition, the mentorship program provides health care workers with access to ongoing learning and feedback on clinical issues.  Health workers will receive refresher trainings via distance learning technologies.

ZACH is implementing an HIV prevention, care and treatment program supporting the following services: opportunistic infections (OI) management, antiretroviral treatment (ART), HIV testing and counseling (HTC) and prevention of mother-to-child transmission of HIV (PMTCT).  The program will benefit 36 of its mission hospitals distributed in all eight provinces in Zimbabwe.

ITECH and ZACH have provided Voluntary Medical Male Circumcision (VMMC) services with PEPFAR funding since May 2013, delivering VMMC services that are well integrated into the national health care delivery system in 21 districts.

I-TECH is also supporting the establishment of a national training database, TRAINSMART, that monitors who where and what trainings health workers receive to help ensure that the right training is offered to the right cadres and avoid duplication of training efforts.

Improving Health Care in Zimbabwe:

March 26-28, 2014 The Ministry of Health and Child Care (MOHCC), AIDS & TB Programme in collaboration with HEALTHQUAL International and the Centers for Disease Control and Prevention, Zimbabwe (CDC-Zimbabwe) conducted a two-day national quality improvement (QI) training session for 20 coaches. This was the second round of training, which is designed to build and strengthen the capacities of MOHCC personnel in QI coaching and mentoring under Zimbabwe’s National Quality Assurance Program.  The first 20 participants received training from March 12-21, 2014.

The 40 training participants were expected to establish multidisciplinary QI coaching teams to improve health care provision, data collection, processing, and analysis.  Improvement is also expected in the development of targeted quality improvement projects in core areas of HIV care.

HEALTHQUAL was initiated in Zimbabwe in 2011. To date, 140 health workers from 38 facilities have been trained in performance measurement; 20 of these facilities have completed the baseline assessments. An additional 40 health workers from 10 facilities were trained and have started implementing QI interventions to improve performance on critical quality indicators. The project plans to reach 83 health facilities in 2014 and 350 in 2015.

Strengthening Zimbabwe’s health information systems:

On June 5, 2014 the United States and its partners provided support to the strengthening of Zimbabwe’s health ministry internal and public information systems to facilitate timely reporting of disease outbreaks, health program data and disease surveillance. The United States (U.S) President’s Emergency Plan for AIDS Relief (PEPFAR), through the U.S. Centers for Disease Control and Prevention (CDC) is providing US$19 million funding and technical support to MoHCC under two separate cooperative agreements with Research Triangle International and UZ Department of Community Medicine Surveys, Evaluations, Assessments and Monitoring (DCM-SEAM) for health systems strengthening specifically focusing on health-related strategic information.

Among the new information and communication technologies unveiled is an upgraded version of the District Health Information System database (DHIS-2.0).

The new software has been successfully rolled in all 63 districts representing eight provincial and four city health information offices. To date, several previously parallel information systems have been integrated into DHIS 2.0. The successful roll out of this system has resulted in the timely availability of key reports such as the National Health Profile, Basic Services Trends Reports and quarterly Monitoring Reports capturing information about HIV/AIDS, WDSS, Psychiatric, Malaria, IMMIS, the Village Health Worker Form and the electronic Early Infant Diagnosis information systems.

Official Launch of National Infection Prevention and Control Guidelines:

In June 2013 the Ministry of Health and Child Welfare (MOHCW) launched the National Infection Prevention and Control (IPC) Guidelines which will strengthen infection control practices in health care facilities nationwide to prevent the transmission of infectious diseases, including tuberculosis (TB), among patients and staff.  The IPC guidelines were finalized with financial assistance from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through CDC/Zimbabwe and Biomedical Research and Training Institute (BRTI) under the Zimbabwe Infection Prevention and Control Project (ZIPCOP). The overall objective of the project is to support the MOHCW in strengthening IPC in health care facilities in Zimbabwe. The U. S. government through PEPFAR and CDC/Zimbabwe supports ZIPCOP with US$4 million over five years (2011-2016).

In line with the above in April 2014 the MOHCC organized an annual National Infection Prevention and Control Conference in collaboration with the Zimbabwe Infection Prevention and ZIPCOP and the Infection Control Association of Zimbabwe (ICAZ). The two day conference was attended by representatives from the Provinces, Central Hospitals, City Health Departments, and Private Hospitals.

PEPFAR through CDC Zimbabwe continues to provide funding and support to the ZIPCOP Consortium. To date ZIPCOP has made the following achievements: developed, launched and distributed National IPC Guidelines; renovated 10 facilities to reduce the risk of healthcare-associated infections; and trained 57 trainers in IPC who have gone on to cascade the training to another 285 health workers. ZIPCOP has also distributed personal protective equipment (PPE) to 40 health facilities and provided them with guidance to order the correct equipment in future, which includes gloves, light and heavy duty aprons, sharps containers, and face masks with visors.

Strengthening the Masters’ Level Public Health Training Program in Zimbabwe:

On June the Ministry of Health and Child Care (MoHCC), and the University of Zimbabwe, Department of Community Medicine (UZ DCM) with support from the U.S. Centers for Disease Control and Prevention (CDC/Zimbabwe), African Field Epidemiology Network (AFENET) and Training in Epidemiology and Public Health Interventions Network (TEPHINET) are commemorated the MPH Project’s 20th anniversary under the theme; ‘20 years of Public Health Training and Service: Looking back and inspiring the future’. The Masters in Public Health program was introduced in 1993.

The United States Government, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and CDC/Zimbabwe has supported the MPH programme over the past fourteen years through cooperative agreements. Currently, the programme is in the fourth year of a five-year, $2-million cooperative agreement (2011-2015) with CDC.