Marseille 2007
| Abstract #271 - Clinical mentoring: A cost-effective and essential component of effective, rapid ART scale-up | ||||
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Session: 26.95: Posters B (Poster) on Tuesday in Chaired by Authors: Presenting Author: Mrs Larisa Bomlitz - International Center for Equal Healthcare Access (ICEHA), United States |
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| Additional Authors: Mrs Katie Graves-Abe, Dr K Mayer, Dr B Boyle, Dr M Charles, Ms Rachel Mair, | ||||
| Aim: While developing countries provide didactic training in HIV care to their workforce, they still face an extreme shortage of healthcare workers who have practical clinical expertise and/or experience with basic operational systems in clinics. This cripples public health systems ability to rapidly expand ART and HIV prevention programs. Clinical mentoring, as a complement to didactic training, rapidly and effectively transfers HIV clinical skills from one HIV practitioner to another. Clinical mentoring consists of hands-on clinical coaching by experienced HIV healthcare providers who coach colleagues in developing countries for defined periods of time and on a pro bono basis on optimal HIV care delivery within the resources available and according to local guidelines. | ||||
| Method / Issue: Between 09/2004 and 12/2006, ICEHA provided 4500 days of clinical mentoring to over 615 healthcare workers across the developing world. Local healthcare workers in clinics designated as entry points for ART are the recipients of clinical mentoring. The International Center for Equal Healthcare Access (ICEHA) (www.iceha.org) recruits, prepares, deploys and manages experienced medical professionals to serve as clinical mentors in developing countries. ICEHA partners with Ministries of Health and local NGOs to provide onsite logistics and management. The deployment of each ICEHA clinical mentor for a 6 week field assignment costs approximately $6000 and is complemented by an additional $12,000 to $28,000 in in-kind contribution of time from individual clinical mentors. By combining the expertise from volunteer clinical mentors with existing infrastructure and management capabilities on the ground allows for the most cost-effective use of resources to optimize HIV care. | ||||
| Results / Comments: Clinical mentors equip local colleagues with the skills necessary to take care of their own patients. Clinical mentors deploy in a series of teams comprised of one physician and one nurse and each assignment is typically 6-12 weeks with all expenses paid. 25% of clinical mentors commit to a second assignment within 18 months of their initial field positions. Over two years, ICEHA has successfully replicated clinical mentoring programs, at a national level, in Cambodia, Ethiopia, Kiribati, Lesotho, Nepal, Rwanda, and Vietnam. Within 4-5 months of clinical mentoring each clinic typically increased its patient flow from 0 to 1200, with HIV care provided by the local healthcare workforce. As a result thousands of patients receive HIV care, delivered by their own providers, when none existed before. | ||||
| Discussion: Although thousands of experienced HIV/AIDS clinicians in the West possess extensive knowledge they are willing to share, this resource remains mostly untapped in the fight against AIDS. ICEHA connects developing countries need for an experienced local healthcare workforce with this abundance of practical expertise in the West. Adding clinical mentoring to national HIV/AIDS strategies rapidly creates much needed HIV treatment expertise among the local healthcare workforce while making optimal use of available funds. Clinical mentoring optimizes quality of healthcare delivered within existing resource limitations, strengthens operational systems necessary for HIV care, and contributes to rapid and cost effective development of sustainable healthcare workforce. | ||||
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