SMDP Collaborations in Africa
AFENET – The African Field Epidemiology Network
Developing a Centre for Leadership and Management at the University of Ghana
CDC partners with AFENET and the University of Ghana’s School of Public Health Centre for Leadership and Management Development to strengthen public health management in AFENET member countries: Ghana, Kenya, Uganda, and Zimbabwe. Since its inception in 2005, AFENET has helped conduct outbreak investigations of numerous diseases including plague in Uganda, Rift Valley Fever in Kenya, meningitis and H5N1 in Ghana, and cholera in Zimbabwe. A keystone of the CDC strategy is the establishment of a regional Centre for Leadership and Management. In 2009, the new Centre launched a four-week course: Improving Management in Public Health Interventions (IMPHI).
Improving the Quality of HIV/AIDS Services through Management Capacity Development
CDC staff in Atlanta work with the CDC Global AIDS Program to improve the quality of HIV/AIDS services provided in Botswana—where an estimated 24% of the population is living with HIV/AIDS—by strengthening the management and leadership skills of middle managers. The Institute of Development Management (IDM), a regional organization that conducts training, consulting, and research in Botswana, Lesotho, and Swaziland, serves as the program’s institutional home. The program helps HIV/AIDS program managers learn and apply planning and process improvement tools to improve the effectiveness and efficiency of HIV/AIDS operations at the clinic and district levels. The managers then share their knowledge with colleagues and together they design and implement applied management improvement projects. As a result of one project, the percentage of women who were counseled and tested for HIV/AIDS with their partners increased from 20% to 50%. In another, the percentage of HIV positive pregnant women receiving CD4 screening to predict the risk of developing opportunistic infections and neoplasms increased from 33% to 65%.
Strengthening Care and Treatment through HIV/AIDS Specialists and Laboratorians
In collaboration with the Ethiopian Health and Nutrition Research Institute (EHNRI), CDC-Ethiopia, and the Ministry of Health's HIV/AIDS Prevention and Control Office (HAPCO), CDC is working to improve the access to and quality of voluntary care and anti-retroviral treatment. Ethiopia has a high burden of HIV/AIDS, with recent studies estimating between 1-3% of the population are HIV-positive. The goal of the Ethiopian Public Health Management Capacity Building Program is to improve the speed of antiretroviral therapy (ART) scale-up and the quality of HIV/AIDS care and treatment in support of MOH and PEPFAR objectives. Ethiopian Management for International Public Health fellows are currently implementing process improvement projects designed to improve lab turnaround time, increase accuracy, improve documentation, and increase the percentage of properly prepared lab samples.
Improving TB and HIV/AIDS Work Processes and District Program Planning and Management
CDC is working with the Malawi Ministry of Health and the Global AIDS Program to help hospital and program managers improve the effectiveness and efficiency of HIV/AIDS and TB-related work processes in hospitals and counseling and testing centers. CDC also assists District Health Management Teams (DHMT) with improving health planning and management at the district level to address local needs more effectively. Malawi Management for International Public Health (MIPH) fellows have facilitated quality improvement training for HIV/AIDS and TB public health program managers. These managers, working in teams, completed management improvement projects in their local health care settings. For example, projects at Ntchisi District Hospital resulted in an increase in the percentage of TB patients who received health talks on TB from 0% to 80% and an increase in the percentage of smear-positive TB patients who began treatment within 7 days from 50% to 90%. A project at Kasungu branch resulted in an increase in the percentage of HIV-positive patients referred to support groups from 47% to 98%.
An estimated 1 million people are living with HIV/AIDS in Malawi. rates of tuberculosis have increased rapidly in the past two decades, with an estimated 51,000 new cases, likely well below the actual number, in 2008.
Read more about CDC activities in Malawi.
Integrating Programs to Fight Neglected Tropical Diseases
The Sustainable Management Training Center (SMTC) was established in Jos, Nigeria, in 1996 through a collaboration between CDC, The Carter Center, and the Rollins School of Public Health, Emory University. In 2005, SMTC began providing management and leadership skill-building workshops for personnel implementing a new neglected tropical diseases project funded by the Bill and Melinda Gates Foundation to address onchocerciasis, lymphatic filariasis, schistosomiasis, trachoma, malaria, and Vitamin A deficiency. This new project builds on existing, large-scale integration efforts in central Nigeria that use mass drug administration, health education, and community mobilization to create a fully integrated disease program.
Read more about the program in Nigeria.
Collaborative Quality Improvement across the National Health System
In 2009, Rwanda is implementing a new framework for the oversight of health care programs throughout the country, with a focus on facility-level quality improvement. CDC is collaborating with the Ministry of Health, Rwanda, CDC/GAP Rwanda, and the National University of Rwanda School of Public Health (NURSPH) to put in place a framework for a capacity-building program that will decentralize decision-making from the national level to the district and local levels. During the transition, employees at local levels will be supervised by district and national level managers. The program will provide supervisors with the necessary knowledge, tools, and support to successfully implement the new framework.