International Projects

Integrated Infectious Disease Capacity Building Evaluation

CHS Project
CHS is involved in many projects. Photo by CHS.

Overview

The Integrated Infectious Disease Capacity Building Evaluation (IDCAP) project evaluated a cost-effective method to build capacity among non-physican clinicians in sub-Saharan Africa for the prevention/ treatment of infectious diseases. A comprehensive surveillance system of 36 health facilities and their patients measured the impact of a novel package of classroom training, distance learning and on-site support services on individual competence, facility performance and health outcomes.

idcap

Key Activities

Objective #1
Create an optimal capacity-building program for the integrated care and prevention of infectious disease, based on the hypotheses that a core curriculum focused on non-physician clinicians (i.e., clinical officers and nursing officers) and complemented by on-site support (OSS) for multidisciplinary clinic teams can cost-effectively improve individual and clinic performance.

The project built on existing training programs, including the World Health Organization’s Integrated Management of Adult Illnesses program, to develop an optimal, integrated package of capacity-building activities for appropriate prevention/ care of infectious disease. The project had two main components:

  • Integrated Management of Infectious Disease (IMID) Curriculum: This integrated curriculum for non-physician clinicians on the prevention/ care of infectious disease and the practice of continuous quality improvement (CQI), was delivered at IDI with extensive clinical sessions. It was designed to prepare trainees to conduct peer training courses when they return to service.
  • On-site support: OSS consists of CQI activities and a set of responsive Multidisciplinary Team Training (MDT) modules for use in clinics by teams of medical officers, clinical officers, nurses and midwives, laboratory technicians and record keepers.

Objective #2
Evaluate the effectiveness of IMID and the incremental impact and cost-effectiveness of OSS through their staggered introduction among sites and by testing key hypotheses. Two arms of 18 clinics received randomized and staggered introduction of IMID and OSS. The two arms were compared to test three hypotheses:

  • An integrated IMID course can prepare non-physician clinicians to perform key clinical tasks at acceptable standards of care;
  • OSS significantly improves clinic performance and health outcomes; and
  • OSS can be cost-effective.

Achievements

  • Completed a baseline assessment that shows significant deficiencies in infectious diseases care processes and the need for capacity building.
  • Established data surveillance systems in all 36 facilities to collect routine clinical and laboratory data in support of the project’s performance indicators.
  • Implemented an OSS program in 36 rural health facilities throughout Uganda, training over 700 non-physician clinicians.
  • Developed the following training tools:
    • IMID core course curriculum,
    • Booster courses curricula,
    • Distance learning tools,
    • Multidisciplinary training courses,
    • Clinical decision guides,
    • A revised outpatient record form (Medical Form 5), and
    • Emergency triage, assessment and treatment guidelines and monitoring tools.
  • Linked the CQI process to the Ministry of Health institutionalization process to ensure sustainability.

Quick Facts

Geographic Focus
36 sites (general hospitals and health center IVs) randomly selected from all Ugandan regions

Funders
Accordia Global Health Foundation