Attachment Sites
Fellows will be matched to an Attachment Site in their own country, except for the USA Fellows who can be matched in any of our four African partner country. In each country, there are about five Attachment Sites, as indicated in the tables below. The Attachment Sites provide a range of possible locations, including government (Ministry of Health), nongovernment organizations (NGOs), and academic institutions. Also, there are a variety of possible types of projects, including program development, program assessment, research, and others.
B O T S W A N A
The Ministry of Health would allow Afya Bora Fellows the opportunity to gain experiential skills and develop projects. Building capacity at the Ministry for enhancement of currently running programmes and future programmes is also critical for national development.
Health Statistics Unit
The Department of Public Health includes the Disease Control Division (Prevention of Blindness, Malaria and Vector control, TB Control, Integrated Disease Surveillance & Response, Non-communicable Diseases Programme); Health Promotion and Education; Child Health; Environmental Health; Food and Nutrition; Mental Health; Occupational and Rehabilitation; Sexual & Reproductive Health Divisions. These divisions advise and also take action on all matters of public health issues. They significantly contribute to the reduction of disease burden and improve health of the people and the national productivity. The Department can generate project for the Fellows based on their interests. The Department has offered to host Fellows and provide mentorship, work space, internet connectivity and other forms of communication.
I-TECH is an international NGO which has been operating in Botswana since 2004 to build capacity for addressing the HIV/AIDS epidemic. In collaboration with its partners, including the Ministry of Health and the University of Botswana, I-TECH offers technical assistance to achieve government health priorities and build human and institutional capacity in training, strategic information, and operations research I-TECH Botswana has qualified supervisors who will provide adequate academic and experiential skills to Fellows.
Botswana-UPenn Partnership (BUP)
The Government of Botswana, the University of Botswana and the University of Pennsylvania formed the Botswana-UPenn Partnership in response to the HIV/AIDS epidemic. UPenn is taking a broad interdisciplinary approach to train health care personnel throughout Botswana in prevention and treatment of HIV/AIDS and its complications and to develop outstanding post-graduate training programs at the University of Botswana. The BUP can offer experience in global health to Fellows, and collaborate to develop joint research programs that address issues relevant to the health in Botswana.
The Community Relief Day Care Centre (CRDCC) is a local NGO established in Tlokweng by Botswana Retired Nurses Society (BORNUS). The vision of CRDCC/Bornus is to be a credible and dynamic community-based organisation and relieve the burden of care on HIV-infected individuals and families. CDRCC/BORNUS has worked closely with the School of Nursing, University of Botswana. The School of Nursing has used the Centre as an attachment site for its students to enhance experiential and practical skills in dealing with community health care delivery. The Centre is a potential attachment site and would work closely with the School of Nursing in mentoring Fellows interested in community health care services.
C A M E R O O N
The Cameroon Baptist Convention Health Services (CBCHS) is a nonprofit, Faithbased healthcare organization, which started over 60 years ago in a small village (Mbem) in Donga/Mantung Division of the North West Province. It has over the years expanded into six of Cameroon's 10 regions: Northwest, Southwest, Center, West, Adamawa, and Littoral. Services offered by the CBCHS range from village Primary Health Care to highly specialized hospital based care with an integration of other social services. It comprises 6 hospitals, over 25 integrated Health Centers, 50 primary Health Centers, Pharmaceutical procurement and distribution department, a Baptist Training School for Health Personnel (BTSHP), a Center for Clinical Pastoral Education and Social Services (CECPES), Services for People with Disabilities, among others. In 1999, the CBCHS created a community based AIDS education program called AIDS Care and Prevention Program (ACP). In 2004, USAID named the CBCHS as a “best and promising practice” in the Prevention of Mother to Child Transmission of HIV (PMTCT) in the Central and West African subregions. Because of the results it yielded, the CBCHS was empowered to become the regional training center in PMTCT and reproductive health for 18 countries in West and Central Africa with support from Action for West Africa Region (AWARE).
Through PEPFAR, the CDC Cameroon Office provides technical assistance to help the Ministry of Health (MOH) implement an effective, efficient HIV program. CDC works closely with the MOH to tailor their HIV national response to the unique characteristics of the local epidemic for maximum health impact. The scale-up of high quality prevention services to reduce HIV transmission from mother to child and the integration of prevention of mother-to-child transmission (PMTCT) services is a key priority. With CDC support, these services are being integrated into mainstream maternal neonatal and child health care. By the close of 2012, CDC has supported the scale-up of PMTCT programs in 555 clinics across the country. Other key activities include improving and expanding HIV/counseling and testing, TB/HIV integrated service delivery, blood safety, and early infant diagnosis. Health system strengthening support includes building country capacity in the areas of workforce development, epidemiology, surveillance, health information systems, and program monitoring and evaluation to assess impact and make rapid course corrections to keep pace with changes in the local epidemic.
K E N Y A
The Kenyatta National Hospital Comprehensive Care Centre (CCC) is located in the Rahimtulla Wing of the hospital, and is a center of excellence and best practices for HIV treatment and care. The CCC sees 120 patients per day, and has 10,000 patients total. The CCC has 75 full-time staff and is funded by PEPFAR. The CCC is connected to the University of Nairobi, and has previously hosted Fellows from different programs (for example, Fellows from NASCOP come for three months). The CCC would like to provide their up and coming leaders with more training in health science management and finance. Projects for Fellows may include monitoring and evaluation, and evaluation of various aspects of the clinical programs.
The National AIDS and STD Control Programme (NASCOP) was established in 1987 to spearhead interventions in the fight against HIV/AIDS. The Ministry of Health (MOH) organizes the national campaign to address HIV/AIDS through this division. Through NASCOP the MOH coordinates with the Ministry of Medical Sciences and the Ministry of Prevention. The programme develops policy guidelines, provincial AIDS coordinators, regional planning, surveillance, and some social science research based interventions. At NASCOP Fellows would learn policy, strategic planning, proposal development, management, and operations research. Some examples of projects include helping with revising guidelines for circumcision, monitoring and evaluation, and adherence evaluation.
African Medical Research Foundation (AMREF) is an NGO with more than 50 years experience in Africa. Funded by PEPFAR, CDC, USAID, Global Fund, EU and others, AMREF seeks to strengthen health systems and to design and enhance interventions that improve access to health. AMREF is best at supporting implementation and service delivery at community and health facility levels, AMREF provides training and works with governments for community and institutional development. AMREF has five strategic directions: making pregnancy safe and expanding reproductive health; reducing morbidity and mortality among children; scaling up HIV, TB and malaria responses; prevention and control of diseases related to water, sanitation and hygiene (WASH); and increasing access by disadvantaged communities to quality medical, surgical and diagnostic services. AMREF has 47 projects all over Kenya. AMREF also has an established research and advocacy arm.
The CDC - KEMRI collaboration focuses on malaria prevention, treatment, and control. The collaboration has developed partnerships with local and international institutions in Kenya—the University of Nairobi, Kenyan Ministry of Health, the UK Wellcome Trust Laboratories, US Walter Reed Army Institute of Research, and the Royal Dutch Tropical Institute. During the past three decades, CDC and KEMRI have helped reduce the burden of malaria by conducting studies that range from, in the early years, monitoring the malaria parasite's resistance to the widely used antimalarial chloroquine, to today, participating in the clinical trial for the most promising malaria vaccine to date. The two partners have also conducted research to develop and evaluate interventions such as insecticide-treated bed nets, artemisinin-containing combination treatment, and intermittent preventive treatment for pregnant women. In 2009, the CDC - KEMRI Research and Public Health Collaboration has more than 80 public and private partners who work together on public health priorities: HIV/AIDS prevention, care, and treatment programs; rapid response to disease outbreaks, including cholera, influenza, and viral hemorrhagic fevers such as Ebola, Marburg, and Rift Valley; research in new prevention, diagnostic, and treatment methods for malaria, tuberculosis, sexually transmitted diseases, and diarrhea; and enhanced disease surveillance, health policy development, program implementation, and technical assistance.
I-TECH Kenya
I-TECH is an international NGO which aims to build capacity for addressing HIV/AIDS. In collaboration with its partners including the Ministry of Health, and the Ministry of Local Government I-TECH builds human and institutional capacity in training and strategic information. I-TECH Kenya provides technical assistance and support for the use of Electronic Medical Records in Kenya. This is being done in close collaboration with the Kenya Ministry of Health and other stakeholders, including the US Health Resources & Services Administration (HRSA) and the US Centers for Disease Control & Prevention - Global Aids Program (CDC/GAP). Funding for these activities is provided through the (US) Presidents Emergency Plan for AIDS Relief (PEPFAR).
In Kenya, FHI 360 works to improve lives in sustainable ways by developing programs that are evidence-based and grounded in rigorous research. Our country portfolio includes integrated programs designed to address some of the most pressing challenges facing communities across Kenya, including in the key areas of health and education. FHI 360 started working in Kenya in the mid-1980s, focusing on providing technical support to family planning programs and later helping to shape the national HIV/AIDS response. Today we continue to collaborate with the Government of Kenya and our partners to strengthen HIV prevention, care and treatment; reproductive health; and family planning services — through research and innovative approaches to improve service delivery and access. FHI 360’s portfolio includes programs to improve tuberculosis and malaria services and to address emerging health challenges, including cardiovascular disease and other noncommunicable diseases. We are also working to strengthen laboratory services for disease surveillance and diagnosis. In education, we are partnering with the government and local organizations to improve the education of girls, enhance the quality of teacher training and accelerate integration of information and communication technology into teaching and learning.
T A N Z A N I A
The Benjamin Williams MKapa HIV/AIDS Foundation is an NGO looking at gaps in the healthcare system, specifically human resources. The purpose of their program is to recruit, train, deploy and retain skilled professionals to support the aggressive implementation of Tanzania response to HIV/AIDS, including but not limited to the National Care and Treatment Program. They particularly are interested in building the workforce in underserved areas for HIV and building capacity, with strengths in human resource management, developing professionalism, ethics, etc. They have have trained 275 District Health Officers (Medical and Nursing, DMO, DNO) who provide HIV care, and with recent Global Fund funding, they plan to train another 430. They have very good MOH collaborations, many of their trainees have been streamlined into Ministry of Health district positions.
African Medical Research Foundation (AMREF)
African Medical Research Foundation (AMREF) is an NGO with more than 50 years’ experience in Africa. Funded by PEPFAR, CDC, USAID, Global Fund and others, AMREF seeks to strengthen health systems and to design and enhance interventions that improve access to health through their active participation. The Tanzania office for AMREF is different from Kenya AMREF in that they are focused about 80% on implementation whereas Kenya focuses about 80% training, although Tanzania does have some training, and like Kenya, they offer some short course. They have 26 projects in Tanzania, of which 60% are HIV/AIDS related.
MDH is a PEPFAR-funded collaboration. MDH focus is in three of Dar es Salaam’s municipalities, where they are charged with improving infrastructure for HIV treatment. MDH provides day to day technical advice, data management, monitoring and evaluation, and other coordinating services for clinics like IDC, (see above), etc. They are searching for opportunities to strengthen the health system, and they collect a vast amount of data to inform the Ministry of Health.
The East, Central and Southern Africa College of Nursing (ECSACON) was established in 1990 as an executing arm of the East, Central and Southern Africa Health Community (ECSA-HC) in the area of nursing and midwifery. The Arusha-based ECSACON arm brings together 16 regional states. The member states are Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Rwanda, Seychelles, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. ECSA-HC’s mandate is to promote and encourage efficiency and relevance in the provision of health-related services in the region, while its mission is to promote the highest standards of health for individuals, families and communities in the ECSA region. As an executing arm of the ECSA-HC, ECSACON is charged with the responsibility of promoting and strengthening professional excellence in nursing and midwifery in the ECSA region. The underlying principles that led to the formation of ECSACON, A College Without Walls, include the harmonization of nursing and midwifery standards, improvement of the nursing and midwifery professions, creation of regional uniformity in the Nurses Acts, clear definition of the nurses and midwives’ roles, and the strengthening of nursing and midwifery research activities.
This fellow would work with the ECSACON, an Afya Bora Alumni and the African Health Profession Collaborative for Nurses and Midwives (ARC) primarily on the expansion and monitoring and evaluation of the online continuing and professional development (CPD) library for nurses and midwives currently hosted on the ECSACON website. One goal of this library is to contribute to the sustainability of newly created national level CPD programs in 8 countries linked to re-licensure by making high quality CPD content more accessible in the region. There will be flexibility for the fellow to develop skills in monitoring and evaluation, quality improvement and program marketing and dissemination. This fellow will also be exposed to elements of nursing policy and regulation, and may have the opportunity to travel to international meetings with ECSACON. Finally, since ECSACON is housed in the ECSA-Health Community offices in Arusha, there could be opportunities to work on secondary projects with other ECSA colleges, such as the College of Surgeons of ECSA (COSECSA), housed within the ECSA-HC.
National AIDS Control Program (NACP) is a secretariat of the Ministry of Health, that implements and coordinates the national response to HIV/AIDS. NACP is engaged in health sector coordination of services (i.e. condoms, HAART, VCT, etc.), developing planning, organizing resources, implementing, M&E, etc. NACP is funding through the Tanzanian government, the Global Fund, and PEPFAR. Afya Bora Fellows are both at the central office, and at the district level; both sites would have fellows focus on monitoring and evaluation.
National Resource Center for PMTCT Program
The HIV PMTCT Unit of the Ministry of Health and Social Welfare (MOHSW) coordinates all the activities of PMTCT implementing partners in Tanzania, to ensure standardized service-provision by all implementing partners following national PMTCT guidelines, standard operating procedures and monitoring, and evaluation and reporting requirements.
U G A N D A
The JCRC is focused on training scientists and researchers in HIV/AIDS, and they also plan to expand their focus to other infectious and chronic diseases. They have over 35 active research projects, including social science related research projects focused on HIV/AIDS. JCRC is a growing center, and are building a new office in Kampala presently. They are exploring expansion of their scope into collaborations with the MOH and policy related work, including partnerships with Makerere and other universities. Fellows attached to the JCRC would be expected to work on projects related to HIV clinical research, as well as working with MOH on policy related to HIV treatment and care. The JCRC offers degrees, such as an MPH, in conjunction with Makarere and Case Western Reserve, and this possibility is opens to Fellows training under the Afya Bora Consortium.
The mission of this collaboration is to support clinical research capacity building in Uganda for HIV. MUJHU run a number of research projects in collaboration with Johns Hopkins University, and focus on building the capacity of Ugandan colleagues. They have had fellows in various sites, including SPH-CDC fellows. Fellows attached to this site could do projects supportive of some of the central research, such as developing nutrition education for mothers enrolled in a study. The site has expressed interest in having trainees with M&E, leadership and management skills, and the site researchers are interested in operational research, and they are interested in perhaps having their own nurses as part of the program to gain management skills.
The Ugandan Ministry of Health has several mandates which include: setting standards (i.e. writing policy and guidelines); building capacity of districts; technical assistance to national and regional partners, monitoring and evaluation, quality assurance, coordination, resource mobilization, and operational research. The MOH in Uganda has multiple opportunities for fellows, and has had fellows attached with them (including from CDC-SPH fellowship program). In our meetings with representatives at the ministry, there was a clear demand for management skills, lab skills, policy, monitoring and evaluation, resource mobilization, planning, etc. The National AIDS Control Program is currently rolling out recently revised HIV prevention, care and treatment guidelines that are targeting key populations (MARPS) and have widened eligibility for ART, particularly in children and HIV/TB co-infected clients.
The MOH has many mentors depending on interest area of possible fellows. Among the many attachment opportunities for fellows, there are opportunities to define competencies needed for various MOH positions. There are also opportunities to design and evaluate strategies for strengthening retention in care and adherence to ART especially for mothers in the elimination of MTCT program (Option B+), for strengthening TB-HIV collaboration including the rollout of Isoniazid prophylaxis for HIV-infected persons, for scaling-up Pediatric HIV care, for strengthening the national Integrated HMIS systems and to improve M&E and operational research for HIV care programs.
This institute is a free-standing NGO focused on infectious disease research and building capacity for research in Uganda. Fellows involved in this site could participate in research at the institute’s many sites in Uganda, and also could be involved in lab training in diagnostics. The institute has an abundance of mentors available, including many JHU faculty. The institute also has a training program in HIV which is a three-week course, and optional four-week module course which fellows could take advantage of. This site has a clinical platform where fellows could both work and learn while being involved in one of almost forty funded projects. There are also a number of other short courses that fellows would be able to take advantage of if attached at this site.
The research center is focused on viral related research, including HIV, but importantly many other diseases as well. The center has 1,200 staff at Entebbe and in field stations. The center is focused on basic research, epidemiology and clinical science. The center has about 90 total fellows per year at various levels of training and in various sites. The Uganda Virus Research Institute already has mentor training, and have fellows get together weekly to increase their community, and this would be very receptive and supportive of an Afya Bora Consortium fellow to join. This site wants to develop future scientists, and some trainees might find positions in their organization after completion of the fellowship.
T A N Z A N I A