HealtheFoundation The Ugandan experience. Dr Nadine Pakker 18 May 2009

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1 HealtheFoundation The Ugandan experience Dr Nadine Pakker 18 May 2009

2 Uganda Uganda

3 HealtheFoundation in Uganda

4 2004 Dr Fransje van der Waals Cordaid Joint Clinical Research Centre SUDAN Gulu Moroto Nebbi Lira Apac Katakwi Nakapiripi Masindi Kaberamai rit do Soroti Hoima Kumi Kapchorwa Nakasongola Pallisa Sironko Bundib Kib Kiboga Kamuli Mbal Luwero Kayunga ujo aale Kabarole Mubende Jinja Iganga Tororo e Bugiri Kyenjojo Mukono Busia Wakis Mayuge Kases Kamwenge Kamp e Sembabule Mpigio Masaka ala DRC Bushenyi Rukungiri Kanungu Ntungamo Kisoro Kabale RWANDA Mbarara Yumb e Moyo Arua Adjumani Rakai Kalangala Kitgum TANZANIA Pader Kotido KENYA

5 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.

6 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

7 February - April 2004 Uganda HIV epidemiology module (MoH) Clinical cases by physicians from JCRC and Prof Katabira Initiation workshop HIVeDucation Nyakibale 44 participants

8 Initiation workshop Nyakibale April 2004

9 Nyakibale follow up Support team IT support: UICT Continuous support: Mrs Hanipha Kakooza Evaluation: I-Tech University of Washington Prof Marcia Weaver

10 Nyakibale follow up workshop Mbarara 25 August 2004 Lectures Clinical cases Drug adherence test Focus group Role play DVD PLWHA 33 participants

11 Nyakibale follow up workshop Mbarara 25 August 2004

12 Nyakibale follow up workshop Mbarara 25 August 2004 / 7 April 2005 Profession Physician 41% Clinical officer 25% Nurse 30% Counselor 4% Completed 1 or more courses Completed 10 or more courses Completed all 15 courses 73% 39% 30% 100% 53% 41%

13 Conclusions Nyakibale training course 25 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

14 Conclusions Nyakibale training course 25 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

15 Conclusions Nyakibale training course 25 August 2004 / 7 April 2005 Additional modules suggested: Palliative care Pharmacokinetics Disclosure Nutrition

16 HIVeDucation 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

17 HIVeDucation Participants Hospice 46 UCMB 96 TASO 167 JCRC - Mpigi 48

18 Hospice workshop July 2006 Mpigi workshop March 2007

19 UCMB workshop September 2006

20 HIVeDucation UCMB Done Pre Diff Time Epidemiology VCT, prevention and care pmtct Principles ARV Initiation ARV Counseling on adherence Clinical monitoring of HIV Pediatric HIV OI s HIV-TB Palliative care ARV toxicity ARV drug resistance Lab diagnostics and monitoring Natural history and pathogenesis ARV interactions

21 HIVeDucation UCMB Computer use Daily 12% Often 18% Rarely 22% Never 48% Mean increase in score 19% 20% 26% 19% Doctors Nurses Other Group 22% 34% 44% Pre-test Increase post-test 57% 19% 45% 24% 50% 22%

22 2007 Pediatric HIVeDucation Collaboration with the PENTA group 50 Ugandan pediatricians Follow-up activities and workshop needed to optimize training effect

23 Challenges Workload Computer access Virus Online versus offline Participant portal Continuous medical education

24 HealtheFoundation 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 NWO-WOTRO European Union

25 HealtheFoundation HIVeDucation KCC 96 participants TBeDucation KCC 67 participants IDI 40 participants

26 HealtheFoundation HIVeDucation Mentoring program Training - of - Trainers 15 mentors 45 mentees

27 Acknowledgements HealtheFoundation Amsterdam Partnering institutes Uganda Facilitators Uganda Participants Uganda Donors