Implementation and evaluation of a Project ECHO telementoring program for the Namibian HIV workforce
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(2020) 18:61
RESEARCH
Open Access
Implementation and evaluation of a Project ECHO telementoring program for the Namibian HIV workforce Leonard Bikinesi1* , Gillian O’Bryan2, Clay Roscoe3, Tadesse Mekonen4, Naemi Shoopala3, Assegid T. Mengistu1, Souleymane Sawadogo3, Simon Agolory5, Gram Mutandi3, Valerie Garises6, Rituparna Pati7, Laura Tison7, Ledor Igboh7, Carla Johnson7, Evelyn M. Rodriguez7, Tedd Ellerbrock7, Heather Menzies7, Andrew L. Baughman3, Laura Brandt8, Norbert Forster8, John Scott9, Brian Wood10, Kenton T. Unruh10, Sanjeev Arora11, Michelle Iandiorio11, Summers Kalishman11, Sarah Zalud-Cerrato11, Jutta Lehmer11, Stephen Lee12, Mohammed A. Mahdi12, Samantha Spedoske12, Alexandra Zuber13, Brigg Reilley14, Christian B. Ramers15, Ndapewa Hamunime1, Gabrielle O’Malley2 and Bruce Struminger11
Abstract Background: The Namibian Ministry of Health and Social Services (MoHSS) piloted the first HIV Project ECHO (Extension for Community Health Outcomes) in Africa at 10 clinical sites between 2015 and 2016. Goals of Project ECHO implementation included strengthening clinical capacity, improving professional satisfaction, and reducing isolation while addressing HIV service challenges during decentralization of antiretroviral therapy. Methods: MoHSS conducted a mixed-methods evaluation to assess the pilot. Methods included pre/post program assessments of healthcare worker knowledge, self-efficacy, and professional satisfaction; assessment of continuing professional development (CPD) credit acquisition; and focus group discussions and in-depth interviews. Analysis compared the differences between pre/post scores descriptively. Qualitative transcripts were analyzed to extract themes and representative quotes. Results: Knowledge of clinical HIV improved 17.8% overall (95% confidence interval 12.2–23.5%) and 22.3% (95% confidence interval 13.2–31.5%) for nurses. Professional satisfaction increased 30 percentage points. Most participants experienced reduced professional isolation (66%) and improved CPD credit access (57%). Qualitative findings reinforced quantitative results. Following the pilot, the Namibia MoHSS Project ECHO expanded to over 40 clinical sites by May 2019 serving more than 140 000 people living with HIV. Conclusions: Similar to other Project ECHO evaluation results in the United States of America, Namibia’s Project ECHO led to the development of ongoing virtual communities of practice. The evaluation demonstrated the ability of the Namibia HIV Project ECHO to improve healthcare worker knowledge and satisfaction and decrease professional isolation. Keywords: HIV, Project ECHO, Community of Practice, Namibia
* Correspondence: [email protected] 1 Directorate of Special Programmes, Namibian Ministry of Health and Social Services (MoHSS), Ministerial Building Harvey Street, Windhoek, Namibia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, s
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