HIV/AIDS Twinning Center
Since its launch in late 2004, AIHA’s HRSA-supported HIV/AIDS Twinning Center Program (TCP) has established and managed more than 55 capacity-building partnerships and initiatives in 14 countries — Botswana, Cambodia, Côte d’Ivoire, Ethiopia, Jamaica, Kenya, Mozambique, Namibia, Nigeria, Russia, South Africa, Tanzania, Uganda, and Zambia.
AIHA twinning programs maximize voluntary contributions of professional expertise, equipment, and materials, to leverage donor resources effectively. Since 1992, AIHA has managed more than $328 million in USG grants and awards, accompanied by $293 million in in-kind contributions by our U.S. twinning partners. This includes more than $110 million in USG funds through the TCP, leveraged by over $41 million in in-kind contributions of professional time, equipment, supplies, and other material support from our U.S. partners involved in the program.
Partnering to Build Sustainable HSS/HRH Capacity
AIHA utilizes a wide range of evidence-based, cost-effective approaches for health systems strengthening (HSS), developing human resources for health (HRH), and other needed capacity building.
In accordance with the PEPFAR Blueprint for Creating an AIDS-free Generation, AIHA’s TCP activities focus on:
- Making strategic and scientifically sound investments to maximize impact and efficiencies; working with partner countries, civil society, faith-based organizations (FBOs), and the private sector;
- Supporting activities that minimize stigma and discrimination with attention to gender equality; and
- Proactively monitoring and improving HIV outcomes and seeking
AIHA’s Multi-pillar Approach to HSS/HRH
Using a multi-pillar approach for HRH strengthening, AIHA increases the number and quality of trained physicians, nurses, mid-level health professionals, managers, biomedical technicians, pharmacists, and other allied health staff, who are then integrated into national and local health systems where they provide quality HIV/AIDS-related services.
Depending on the needs of the recipient country,
this multi-pillar approach may include:
- Strengthening educational institutions in recruitment, teaching methods, and curricula;
- Training of trainers to build capacity through pre- and in-service training programs;
- Collaborating with national authorities to support human resource mapping, planning, task-shifting, and retention;
- Collaborating with service providers to ensure their needs are being appropriately met by educational institutions; and
- Engaging and supporting regulatory bodies and professional associations for certification, accreditation, and licensing of graduates.
With PEPFAR support, AIHA’s twinning programs strengthen health systems in a number of key areas, including: increasing the capacity of healthcare workers; introducing new cadres; accrediting pre- and in-service curricula; professional health and allied workforce strengthening; building the capacity of professional associations; creating new models of care; and through the long-term placement of skilled professionals via the Volunteer Healthcare Corps (VHC).
AIHA builds successful, mutually-supportive relationships with host country stakeholders at multiple levels of the health sector, from national ministries and schools of the health professions to hospitals, clinics, and grassroots service organizations. Our proven ability to collaborate with all stakeholders helps to ensure that twinning projects promote local ownership and create synergy with host country goals from day one, thus ensuring they are sustainable.
Snapshot of AIHA TCP Accomplishments: 2004-2016
- Established more than 55 twinning partnerships and other capacity building initiatives in 14 countries in Africa, Eurasia, and the Caribbean, leveraging $76 million in USG funds with $34 million in in-kind contributions from US partners.
- Provided in-service training for more than 35,000 health and allied care providers and graduated more than 13,000 individuals from pre-service programs at partner institutions worldwide.
- Placed 105 highly skilled professionals in long-term assignments in five African countries through the Volunteer Healthcare Corps (VHC); these volunteers collectively contributed more than 23,545 professional days to strengthen health system capacity in host countries.
- Developed a Para Social Worker (PSW) Training Model in Tanzania, later adapting it for use in Ethiopia and Nigeria, which has trained more than 6,700 PSWs to provide essential services for orphans and vulnerable children.
- Supported the education, training, and professional development of a new, government-accredited cadre of mid-level medical workers called Clinical Associates in South Africa; these university-trained healthcare professionals are playing a critical role in the provision of primary care services, as well as specialized HIV prevention, care, and treatment services in rural, under-served parts of the country. Facilitated policy shifts and advocacy activities through strengthened professional associations in six countries spanning sub-Saharan Africa.
- Supported the development and/or strengthening of a number of other mid-level cadres, including nurses, pharmacy technicians, lab technicians, biomedical technicians, and social welfare assistants.
- Established 27 Learning Resource Centers in eight countries to build institutional and individual capacity to access and utilize evidence‐based knowledge resources, promote evidence‐based practice and use of point‐of‐care applications for professional decision making, and promote the use of information and communication technologies to improve health services and systems.
Sampling of Key Accomplishments at the Partnership Level
- Catholic University of Mozambique and the University of Pittsburgh partnered to improve access to ART and other healthcare services in Sofala Province. In 2009, they opened São Lucas Health Center in Beira. Since then, clinic staff have provided primary medical care to more than 50,000 patients, including managing ART for 1,367 patients living with HIV. The clinic also serves as a rotation site, training students in HIV-related treatment and care.
- Debre Berhan Hospital partnered with Elmhurst Hospital Center from 2007-2014 to build institutional and human resource capacity to improve medical and psychosocial care services, particularly for PLHIV. Thanks to twinning, Debre Berhan has become one of Ethiopia’s leading tertiary care facilities and has become a model for positive change in nursing, hospital administration, and the provision of quality ART, among other things. The hospital was honored as a top performer by the Ministry of Health in 2014, 2015, and 2016.
- The Kenya Conference of Catholic Bishops and their partners at DePaul University developed a school-based prevention program that has reached more than 770,000 children in 1,611 schools across the country.
- Addis Ababa University, in partnership with the University of Wisconsin – Madison, has pioneered emergency medicine in Ethiopia, training more than 6,000 healthcare workers and medical and nursing students in both adult and pediatric emergency medicine since February 2010. They’ve also launched an Emergency Medicine Fellowship Program and designed an emergency medicine subspecialty training program at Addis Ababa University, graduating the first cohort of four residents in October 2013. These physicians are first subspecialists in emergency medicine on the continent to graduate outside of South Africa.
- AIHA’s DREAMS Initiative project in Western Kenya has trained more than 22,000 community members in gender norms, provided mentoring through Safe Space activities to some 13,400 girls between the ages of 10-14, and referred nearly 9,000 girls for medical care, including HIV counseling and testing.
- Working with the University of Kentucky, the Zambia Institute of Mass Communication Educational Trust (ZAMCOM) has trained 463 health workers, media professionals, and policymakers to elevate HIV-related reporting and raise public awareness of HIV and has secured funding from the Zambian Government to support its HIV-related programs.