Improving the HIV Care Cascade in Kenya through Implementation Science Training

描述(由申请人提供)：华盛顿大学(UW)与三个肯尼亚机构(内罗毕大学、肯雅塔国立医院、肯尼亚医学研究所)有30年的合作历史，并与肯尼亚卫生部，特别是国家艾滋病和性病控制计划(NASCOP)有着密切的联系。拟议的培训赠款将侧重于肯尼亚最大的教学和转诊医院肯雅塔国家医院(KNH)的能力建设，以改善艾滋病毒检测、与护理的联系、抗逆转录病毒启动、 坚持和保留在护理中，这是一个被称为艾滋病毒护理级联的连续体。KNH和NASCOP的领导层已将解决撒哈拉以南非洲地方、国家和区域这一护理级联中的“知识缺口”确定为艾滋病毒研究的首要优先事项。为了满足这一需求，华盛顿大学与KNH和内罗毕大学合作，提出了实施科学和健康指标方面的培训，这两个领域研究交付挑战和现实世界的结果，以改善医疗保健计划和基础系统。该项目将由2003年以来担任华盛顿大学艾滋病研究和培训项目(AITRP)主任的Carey Farquhar博士和KNH研究部副主任John Kinuthia博士领导。两个互补性的长期培训课程将提供：1)为期3年的实施科学公共卫生硕士/博士夹心课程，将在美国西雅图(1年级)和肯尼亚内罗毕(2-3年级)进行；2)为期1年的证书课程，包括在华盛顿大学3个月的相关课程，然后完成由健康指标与评估研究所(IHME)通过远程学习提供的另外两个UW课程，以及完成一个有指导的研究项目。参加培训的应聘者将在KNH担任长期职位，或在卫生部任职，并可能来自不同的医学或公共卫生领域，包括护理和药剂业。除了长期培训外，我们还将提供为期2周的短期培训，将惠及更多的KNH和卫生部专业人员(短期200人，长期16人)，并将包括那些可能在附属的分散公共设施工作的人。这种短期培训将建设更广泛的机构能力，促进对关键研究概念和实践的认识，并确定未来长期培训的最佳候选人。包括来自KNH和UW的教师以及内罗毕大学热带和传染病研究所(TunID)的团队将在一个正式的指导计划中提供指导。近期和长期成果将由国际卫生培训和教育中心(I-TECH)在5年获奖期内进行外部监测。我们设想，该计划将把KNH研究部门打造成一个在实施科学培训和研究方面公认的强大计划，并通过影响国家政策和产生高质量的、与地方相关的研究来改善KNH及其以外的艾滋病毒护理级联。

DESCRIPTION (provided by applicant): The University of Washington (UW) has a 30 year history of collaboration with three Kenyan institutions (University of Nairobi, Kenyatta National Hospital, Kenya Medical Research Institute) and has strong ties to the Kenya Ministry of Health, particularly the National AIDS and STD Control Program (NASCOP). The proposed training grant will focus on building capacity at Kenyatta National Hospital (KNH), the largest teaching and referral hospital in Kenya, to improve HIV testing, linkage to care, antiretroviral initiation, adherence and retention in care, a continuum known as the HIV care cascade. Leadership at KNH and NASCOP has identified addressing "know-do gaps" in this care cascade locally, nationally and regionally in sub- Saharan Africa as a top HIV research priority. To meet this need, the University of Washington, in collaboration with KNH and the University of Nairobi, propose training in implementation science and health metrics, two fields studying delivery challenges and real-world outcomes in order to improve healthcare programs and underlying systems. The program will be led by Dr. Carey Farquhar, Director of the UW AIDS Research and Training Program (AITRP) since 2003, and Dr. John Kinuthia, Deputy Chair, Department of Research at KNH. Two complementary long-term training tracks will be offered: 1) a 3-year MPH/PhD sandwich program in implementation science which will take place in Seattle, USA (year 1) and in Nairobi, Kenya (years 2-3) and 2) a 1-year certificate program which will include 3 months of relevant coursework at the UW followed by completion of two additional UW courses offered by the Institute for Health Metrics and Evaluation (IHME) via distance learning, and completion of a mentored research project. Candidates for the training will have permanent positions at KNH, or at the Ministry of Health with appointments at KNH, and may be from different fields of medicine or public health, including nursing and pharmacy. In addition to the long- term tracks, we will offer short-term training lasting 2 weeks which will reach a larger number of KNH and MOH professional staff (200 individuals short-term vs. 16 long-term), and will include those who may be working in affiliated decentralized public facilities. This kind of short-term training will build broader institutional capacity, promote awareness of key research concepts and practices, and identify the best candidates for future long- term training. Teams including faculty from KNH and UW, as well as from the University of Nairobi Institute of Tropical and Infectious Diseases (UNITID) for those doing their PhD, will provide mentorship within a formal mentoring program. Immediate and long-term outcomes will be monitored externally by the International Training and Education Center for Health (I-TECH) during the 5-year award period. We envision the program will build the KNH research department into a robust program recognized for its expertise in implementation science training and research, and also improve the HIV care cascade at KNH and beyond its walls by influencing national policies and producing high-quality, locally relevant research.