The
USAID GH-Tech Project: The Global Health Technical Assistance (GH Tech) Project is an Indefinite Quantity Contract (IQC) that provides health program assessment, design, monitoring and evaluation, and program support services to the U.S. Agency for International Development (USAID) Bureau for Global Health and to regional and other bureaus and to field Missions. Program areas include HIV/AIDS, other sexually transmitted infections, infectious diseases, malaria, TB, maternal and child health, health sector reform and health systems. CAMRIS is a major partner, implementing about one-third of the GH Tech $100 million contract.
GH Tech official webpage
CAMRIS was one of the first contractors to implement USAID strategies to expand and improve TB DOTS service provision. We have worked on policy, capacity building, service configuration and blood supply issues for infectious diseases, including TB, malaria and HIV/AIDS. Tuberculosis (TB) is one of the world’s most devastating infectious diseases. If not effectively managed, the worldwide challenge of TB will increasingly become a costly battle against the more fatal multi-drug resistant forms of the disease. Yet many programs worldwide lack the essential skills and resources to effectively prevent and control TB. As such, TB is a public health priority that demands an immediate and concerted response.
CAMRIS has responded to this urgent demand by making TB prevention and control one of our most important health sector practice areas. We help TB programs improve key technical and management capabilities for more effective implementation. Specifically, CAMRIS works in the following areas within the private and public sectors to stop TB:
- DOTS program development and support
- Training programs
- TB case tracking and referral systems
- Drug logistics
- Multi-Drug Resistant TB programs
- Laboratory services
- Advocacy and informational materials
- Programs for prisons and other enclosed populations
- Surveillance and reporting systems
- Information technology for TB support, including telepathology and telemedicine
- Evaluation
In the Philippines, under a subcontract with Chemonics International for the Philippine Tuberculosis Initiatives for the Private Sector (PhilTIPS) Project, funded by USAID, CAMRIS supported the development of public-private partnerships in the delivery of quality TB-DOTS services by focusing on improvement and standardization of TB case management in the private sector. CAMRIS technical assistance ensured that the needed policies and financial framework are put in place to draw in and sustain the participation of the private sector in TB prevention and control. Specific activities included policy development; direct assistance to the formulation and adoption of policies supportive of public-private mix DOTS services; development, piloting, evaluation and expansion of the DOTS certification system; technical assistance to private health financing groups to assist them to link provider performance with reimbursements; development of appropriate guidelines and regulations; development of business and financial management plans for service models; cost analysis of DOTS services; and financial analysis.
For the South Africa – Technical Assistance for Tuberculosis Control project, CAMRIS expertise enabled policy and decision makers to understand the prevalence of multi-drug resistant tuberculosis, epidemiology of MDR sub strains, and other operational anomalies in the handling of specimens and in the diagnosis and reporting of TB cases. CAMRIS assisted the National Tuberculosis Control Program of South Africa with the development of strategies; expansion of services delivered by non-governmental organizations; training of key staff in TB surveillance and DOTS services; national-level data collection; research and management-oriented evaluation; management and administration of recording, reporting and referral systems; methods of MDR-TB and nosocomial infection surveillance; advocacy to place TB control on the national agenda; DOTS strengthening; support for South African nongovernmental organizations; and TB control in prisons. The project substantially enhanced the Community DOTS programs and the capacity of trainers in TB surveillance, advocacy, education and communication. An improved referral system also strengthened DOTS case management. Link to South Africa Fact Sheet
Central Asia has a growing tuberculosis problem with a number of institutional barriers to transforming services toward currently accepted international Directly Observed Therapy Short-Course (DOTS). Expanding DOTS will lead to expanded case detection and treatment services, improved outcome and tuberculosis control, and improved cost effectiveness. CAMRIS provided policy support and web-based information services to support DOTS implementation in five Central Asian countries (Kazakhstan, Uzbekistan, Tajikistan, Kyrgyzstan and Turkmenistan).
In the area of HIV/AIDS, CAMRIS combines its exceptional record of accomplishment and capability in infectious disease management, health sector project design, strategy development, project management, technical assistance, capacity building, and monitoring and evaluation with additional capabilities of partner organizations. CAMRIS’ extensive field work on tuberculosis policy and programs – in Africa, Asia and the former Soviet Union – has included work on HIV/TB co-infection and the mobilization of international partners for collaboration in that area. CAMRIS staff have experience with HIV/AIDS treatment and prevention programs, including linkages with community-based youth programs, primary care, and maternal and child health and substance abuse services. They have implemented HIV/AIDS work throughout USAID regions, including work to integrate HIV/AIDS services into international health sector reform programs, and they have contributed to high-profile U.S.-based initiatives, such as the Ryan White Program. Link to CAMRIS Partners for HIV/AIDS Programs
Other Global Health Expertise
Health Governance, Health Systems, Policy and Finance
Large-scale integrated health service delivery systems, including ministries of health, social security systems, insurers, local governmental units and provider networks are all constrained by challenges of aligning their resources with priorities. These difficulties limit their performance and consequently the health of the populations they serve. We work with these institutions and systems to build capacity and improve service delivery quality, access and efficiency.
In Honduras, the challenge was to upgrade, reform, and expand the role and capabilities of the National Thoracic Institute for it to become the National Heart and Lung Institute with the capacity to provide improved service delivery and quality of care; to establish teaching and research programs; and to more effectively allocate and manage its resources in order to become the leading healthcare facility for the treatment of cardiopulmonary pathologies in the national health system. To do so required substantial change in the service base, organization, capacity, finance, and administration of the institute. CAMRIS worked to analyze, plan, and manage the change process in the areas of human resources, finance, marketing, information systems, quality improvement, and executive functions through a customized technical assistance process with a high degree of stakeholder involvement.
In Nicaragua, CAMRIS developed an integrated management information system for the Ministry of Health at the central level and for selected regional units, hospitals, and health centers. CAMRIS carried out analysis, design, construction, testing, and documentation of the principal subsystems - including production of services, health status, financial resources management, and purchasing and procurement of goods - and the subsequent development, installation, and training.
In Venezuela, CAMRIS organized and fielded a national project that required recruitment of 48 staff, opening of eight field offices, interviewing 40,000 Ministry of Health employees, and building a human resources management system, all within an eight-month period, winning a special award from the client in the process.
CAMRIS developed and implemented a customized resource allocation model including supporting software and training at the state and local level. This system led to a phased reallocation of resources based on evidence-based criteria.
Basic Services, Maternal and Child Health and Reproductive Health
The implementation of basic health services, including services for women and children, requires effective planning and management, as well as critical understanding of how these services can be configured for maximum uptake and sustainability in underserved communities.
For the El Salvador APSISA (Apoyo a los Sistemas de Salud) Project, CAMRIS provided technical services including community development, management strengthening, logistical oversight, and program services with the goal of improving access and availability of basic health care services to underserved and unserved segments of the Salvadoran population, particularly in rural areas.
In the Philippines, USAID required technical services to evaluate a major national family health project and design a new $45 million program to assist local governments to improve delivery and financing of family planning, TB treatment, HIV/AIDS surveillance, and Vitamin A and maternal and child health services. CAMRIS carried out a comprehensive evaluation of the USAID program and designed the Philippines Local Enhancement and Development for Health (LEAD) Project. The resulting project design, implemented by Management Sciences for Health, assisted in reducing total fertility, increasing the use of modern method contraceptives, improving TB treatment success rates, and maintaining low HIV/AIDS seroprevalence rates.
Guatemala Child Survival - CAMRIS worked toward expanded coverage and local-level services for immunizations, diarrheal disease control, and ARI treatment. In addition, CAMRIS provided technical assistance and support to improve administration and financial management systems.
Capacity Building of Local Service Providers
CAMRIS provides highly customized support to organizations from the NGO, corporate, and governmental sectors. Especially important is our ability to combine technical work in public health with management development tailored to local needs and capacities. We work with government and NGOs so that they can become effective in their work and sustainable; we work with healthcare providers to improve quality and effectiveness.
Our work on NGO strengthening spans decades, and includes direct services to dozens of NGOs. These have included major international NGOs, such as CARE International, as well as local community groups such as the Fundación Pablo Jaramillo and ASME-X in Ecuador and the Fundación del Ojo in Colombia. Fundación Pablo Jaramillo in Cuenca in the south of Ecuador was able to improve its cost recovery while also increasing targeted services and this platform was leveraged into a service delivery contract with the national health care system under a World Bank funded project. As a result, a large population was transformed from a local, heavily subsidized NGO to a major regional provider with targeted, high-quality basic services, increased capacity, and enhanced sustainability.
For the APOLO project in Ecuador, a USAID-funded project to develop a group of community-based health service NGOs, CAMRIS created successful health provider systems through local NGO channels and clinics, to improve women and children’s accessibility to quality and affordable health care. Support to this project included strategic planning implementation of technical assistance in management and finance; design and implementation of a cost-plus pricing system to strengthen the financial stability of major non-governmental service providers; design of local service delivery networks and a local franchising network, design and implementation of a membership plan to expand coverage and organize demand for basic services; support for the design and development of information systems and a monitoring and evaluation system.
For the Government of the United Arab Emirates, CAMRIS prepared and supported implementation of a system-wide capacity improvement program to strengthen services throughout the country under the military medical system. This system includes 14 hospitals and numerous satellite clinics. CALMRIS developed all operational plans, staffing plans, technology planning, delivery schedules and related capacity building support.
Private Sector