Placement Organization: Clinton Health Access Initiative
Placement Location: Kampala, Uganda
Eligible Citizenship: Ugandan
About: The Clinton Health Access Initiative (CHAI) is a global health organization committed to strengthening integrated health systems in the developing world and expanding access to care and treatment for HIV/AIDS, malaria, and tuberculosis. CHAI’s solution-oriented approach focuses on improving market dynamics for medicines and diagnostics; lowering prices for treatment; accelerating access to lifesaving technologies; and helping governments build the capacity required for high-quality care and treatment programs.
Established in 2002 by President Clinton as the Clinton HIV/AIDS Initiative, CHAI initially focused on addressing the limited access to HIV/AIDS treatment faced by developing countries, where more than 90 percent of individuals living with HIV/AIDS reside. By working in collaboration with governments and NGO partners, CHAI has helped more than 2 million people access the medicines needed for treatment, which represents nearly half of all the people living with HIV and on treatment in developing countries. Building on its model, CHAI has expanded its scope to include efforts to strengthen health care delivery systems and to combat malaria and childhood illness.
Position Overview: CHAI is a flexible organization that responds to the most pressing needs within the Ugandan health sector. As such, all staff (GHC fellows included) are engaged in multiple projects, which are developed based upon the potential for impact. One such project in which GHC fellows are likely to engage is described below.
In Uganda, it is estimated that roughly 20,000 infants are infected with HIV through transmission from their mother each year. This is the second leading cause of HIV transmission in the country. Yet through the provision of appropriate drugs during the pregnancy and breastfeeding period, this number could be drastically reduced. In 2012, the government of Uganda started transitioning from the use of one drug regimen, “Option A” prophylaxis for prevention of mother to child transmission (PMTCT), to another drug regimen, “Option B–PLUS for PMTCT.” Providing prophylaxis treatment for HIV+ pregnant women, with the aim of eliminating the risk of a mother transmitting HIV/AIDS to her baby, is a major priority of the government as it tries to turn the tide on new HIV/AIDS infections in Uganda.
CHAI has been deeply involved in supporting the Ministry in this transition to a new drug regimen. However, the new drug regimen can only achieve maximum efficacy if mothers are retained in the system and adhere to treatment throughout the ante-natal and post-natal period. A CHAI/MOH study found that only 40% of mother-baby pairs successfully completed the PMTCT algorithm, indicating severe challenges with loss to follow up (LTFU) that will impede the national target of virtual elimination of mother-to-child transmission of HIV (eMTCT). CHAI is now working closely with the Ministry of Health to develop strategic innovations that will address the retention challenges identified at facilities. Innovations will be piloted in a few facilities, with the ultimate goal of national scale up.
The incoming GHC fellows will help drive the development and rollout of these strategic innovations. The strategy focuses on three core intervention areas:
- Use of the central-level Ministry of Health Early Infant Diagnosis database to track lost mothers and babies, in order to facilitate follow-up, as well as real-time monitoring of facility performance
- Innovative interventions (including stickers and incentives) to increase the uptake and efficacy of facility-level patient tracking tools
- Use of mHealth technologies (phone and SMS follow up) to reach lost mothers and increase retention of mother-baby pairs
Global Health Corps fellows will work with CHAI’s PMTCT Coordinator and the Ministry of Health to develop, pilot, evaluate, refine and scale nationally this package of interventions. The work will require continual adjustments to the models to reflect observed implementation challenges, as well as efforts to obtain broad stakeholder buy-in for the initiative in order to achieve national support scale up.
- Support the development of innovations that improve retention of mothers and babies in the PMTCT care algorithm
- Roll out pilot programmes of the developed innovations in selected facilities, in collaboration with the Ministry of Health
- Document and share findings from the pilot programmes with the Ministry of Health and other key stakeholders
- Support the Ministry of Health in the rollout of the highest impact innovations across the country
Required Skills and Experience:
- At least two years of work experience in a demanding, results-oriented environment
- Excellent problem solving, analytical and quantitative skills, including proficiency in Excel and PowerPoint
- Strong communications skills—both written and oral—and the ability to develop relationships with both rural health care workers, and high-level Ministry officials
- Interest in working long hours on a regular basis
- Ability to handle multiple tasks simultaneously, set priorities, and work independently
- Ability to learn on the job quickly and absorb/synthesize a broad range of information
- Ability to work within limited budgets and human resources.
- Ability to multi-task and to be effective in high-pressure situations
Preferred Skills and Experience:
- Experience working in a developing country
- Experience working in public health and/or the private sector
- Experience in supporting national Ministries of Health
- Advanced degrees in management, medicine, public health, or other relevant fields
Living Conditions: Fellows will be provided with housing, health insurance and a living stipend of $1200/month. Fellows will also receive an award of $1500 upon successful completion of the fellowship year. Flights to and from the placement site and all other costs associated with GHC programming are included. All work-related expenses (e.g. transport, phone, Internet) will be provided by CHAI.