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立医院的能力建设，以改善艾滋病毒检测、与护理的联系、抗逆转录病毒治疗的启动、 坚持和保持护理，这是一个被称为艾滋病毒护理级联的连续体。KNH和NASCOP的领导层已经确定，在撒哈拉以南非洲的地方、国家和地区解决这一护理级联中的“知识差距”是艾滋病毒研究的首要任务。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。该计划将由自2003年以来担任华盛顿大学艾滋病研究和培训计划（AITRP）主任的Carey Farquhar博士和KNH研究部副主任John Kinuthia博士领导。将提供两个互补的长期培训轨道：1）在实施科学的3年MPH/博士三明治计划将在美国西雅图（第1年）和内罗毕举行，肯尼亚（2-3年级）和2）a 1-一年的证书课程，其中将包括3个月的相关课程在华盛顿大学，然后由卫生研究所提供的两个额外的华盛顿大学课程完成，通过远程学习进行评估（IHME），并完成一个指导研究项目。参加培训的候选人将在KNH或在卫生部担任长期职位，并在KNH任职，他们可能来自医学或公共卫生的不同领域，包括护理和药学。除了长期培训外，我们还将提供为期两周的短期培训，培训对象将是更多的KNH和MOH专业人员（短期培训200人，长期培训16人），其中包括可能在附属分散公共设施工作的人员。这种短期培训将建立更广泛的机构能力，提高对关键研究概念和做法的认识，并确定未来长期培训的最佳人选。包括KNH和UW以及内罗毕大学热带和传染病研究所（UNITID）的教师在内的团队将在正式的指导计划中提供指导。在5年的奖励期内，国际卫生培训和教育中心（I-TECH）将对近期和长期成果进行外部监测。我们设想该计划将建立KNH研究部门成为一个强大的计划，以其在实施科学培训和研究方面的专业知识而闻名，并通过影响国家政策和生产高质量，本地相关的研究来改善KNH及其墙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.