In March 2017, Uganda launched the country’s first videoconferencing mentoring programme for HIV testers. The programme, Extension for Community Healthcare Outcomes (Project ECHO), will initially run for 17 weeks to enhance HIV testing services at the primary care level where most people seek medical care.
Project ECHO is a global programme that was tailored to Uganda’s HIV testing needs by the HIV Rapid Test Continuous Quality Improvement (RT CQI), which is funded by the U.S. Centers for Disease Control and implemented by the Uganda Virus Research Institute (UVRI) with support from FIND.
Project ECHO uses a collaborative ‘hub and spoke’ model of medical education and care management that primarily focuses on empowering clinicians. It links specialist teams at academic ‘hubs’ with health workers – the ‘spokes’ – in local communities.
Training of health-care workers in Uganda and the region has relied mainly on costly centralized training that requires staff to leave their duty posts for extended periods of time, leading to service interruption. Project ECHO, which uses videoconferencing technology, represents a more cost-effective way of building capacity without requiring staff absences.
The Project ECHO model was first implemented in Africa to provide mentorship to HIV clinicians and practitioners in Namibia. It was then adapted for HIV testing in Tanzania before being adapted for the Ugandan context. On a weekly basis, the project shares best practices through subject matter experts at the hub while providing a forum for service providers to share their practices with each other.
The programme will cover quality assurance for HIV rapid testing; safety, specimen collection and external quality assurance at HIV test sites; records and inventory management; physical facilities; HIV testing algorithms; and any other topics raised by health workers. The Uganda Virus Research Institute (UVRI) will host the hub, while the six spokes will be located in the districts of Buikwe, Jinja, Kayunga and Wakiso.
The project is well-timed. Uganda recently launched HIV testing services guidelines that spell out the policies and practices that govern HIV testing services in the country. Uganda is also in the process of developing a certification programme for HIV sites and testers.
The Project ECHO was launched on 6 March 2017 by the Director General from the Ministry of Health, represented by Dr Linda Nabikata. Representing FIND were Kekeletso Kao, Senior Project Manager and Jesse Wambugu, RTCQI Project Coordinator.