Blended Clinical Training BCT Improving Quality of HIV

Blended Clinical Training (BCT) Improving Quality of HIV Diagnostics and Treatment Services July 2018 to March 2021 : Supported by Global Fund 5 March, 2019 : CCM Meeting, New Delhi

What is Blended Training It is an approach to training that combines traditional place-based classroom trainings with access to online educational materials. It also provides opportunities for continued interaction with the participants. It also involves field visits to various facilities for onsite learnings. Why Blended Training Targets to train : 8000+ doctors (1200 ART Mos, 1620 ARTC specialists, 1108 LAC MOs, 4400 ICTC MOs) by next year. Traditional place-based trainings ideal but may not practical as : ♦ guidelines revised recently ♦ staff to be trained quickly ♦ extremely limited resources

Why Blended Training Traditional ART MO induction training of 12 days - not done in recent past due to reasons such as Ø funding constraints Ø high turnover of MOs (more frequent trainings needed) Well balanced blended training package gives an opportunity to utilize newer modalities of the trainings without compromising expected training outcomes Ø shrinking pool of trained resource persons (inadequate to meet the training requirements) Ø On-line training platform : interactive knowledge-based sessions (MOs can learn while working at ARTC) Ø disruption of patient care at the ART centers for 12 days (esp. in high load ARTC, single MO ARTC). Ø Class-room training : can focus on practice and attitude of trainees

GOAL Supporting NACP - building capacities and skills - ICTC, ART, Lab Services - staff • Enable accurate diagnosis, high quality care and treatment of PLHIV • Ensure quality documentation and reporting of services OBJECTIVES • Develop content - compliant with national technical and operational guidelines • Build knowledge and skills - participatory adult learning pedagogies • Institutionalise mechanisms – - Knowledge management - Learning needs assessment - Training scheduling and delivery - Tracking participant progress & refresher/mentorship needs • Build practice-related competencies - providing stigma-free and high quality HIV services • Build competencies - quality documentation and reporting centralized information systems

• An e-learning platform - self-paced learning (Needs assessment, Induction, refresher, regular updates) Blended Clinical Training Offline Training (classroom based) Online Training through the Learning Management System (LMS) • HR information (Learning Information system –Staff of ICTC/ART/LS, trainings, trainees, learning assessment scores, staff turnover) • A repository of learning materials and guidelines • Communities of Practice (Co. P)(eforum for cross learning and bulletin board) ♦ TOTs ♦ Induction ♦ Supportive Monitoring Visit / Onsite mentoring (SMV) ♦ Refresher** ** as per requirement and budget availability

Mentoring : Certification : CME credits On-site Mentoring : - Supporting Monitoring Visits (SMV) - 2% of all trainees - assess post-training practices - offer support as needed - identify additional points for inclusion in future trainings v CME credits v Extension of learning to private sector HIV physicians and certification

Number and Type of Trainees ~ 16034 (approx. ) Type of Facilities SA-ICTC LAC ARTC SRL NRL # of Facilities 5500 1108 540 117 13 Type of Trainees Doctors # of Trainees 8328 Nurse (ARTC) Lab Services 1200 6506 DOCTORS : 8328 LAB SERVICES STAFF : 6506 Lab Technicians (LT) : 6116 MO ARTC : 1200 MO LAC : 1108 MO SA-ICTC : 4400 ART Specialist : 1620 ** ART Specialist include : 1 Nodal Officer, 1 Lab In-Charge, 1 Pediatrician, 1 Gynecologist / surgeon (3 to 4 staff per ARTC) Total 16034 § ARTC : 540 § SA-ICTC : 5500 § Viral Load and EID : 76 SRL/NRL LT and TO : 260 SRL/NRL In-charge : 130 (virtual training)

Module Development Process NACO to finalize training curriculum NACO has set up TWG : 2 sub-committees Sub-committee 1 Co. E / PCo. E, CST, BSD, technical experts Finalize content for doctors and nurses Sub-Committee 2 LS division, and technical experts Finalize content for Lab services staff TWG to finalize content, content delivery methodology (online / offline) for each modules for each cadre v Making training modules LMS friendly v uploading same on LMS v Uploading all modules (offline and online) in the repository section of the LMS Printing of the classroom modules and handouts

Senior Master Trainer (SMT) & Master Trainer (MT) SMT : 2 -days workshops at central location Ø SMT-Doctors : 30 people, March 2019 Ø SMT-LT : 10 people, held on 12 -13 Feb 2019, at Nagpur MT (4 -days workshops / batch, 4 to 5 batches across India) Ø MT-Doctors : 100 people, April 2019 Ø MT-LT : 100 people, March 2019 MT - PLHIV : Ø 30 people, To. T in March / April 2019 v Certification of all trainers and trainees

5 Regions : Training Locations Region States/UTs Locations * South Region Telangana, Andhra Pradesh, Karnataka, Kerala, Puducherry, Lakshadeep, Tamil Nadu, Andaman & Nicobar Hyderabad, Vijayawada, Bangalore, North Karnataka, Trivandrum, Chennai, Salem West Region Dadra & Nagar Haveli, Daman & Diu, Gujarat, Goa, Maharashtra, Chhattisgarh, Madhya Pradesh Ahmedabad, Mumbai, Nagpur, Bhopal North Region Jammu & Kashmir, Himachal Pradesh, Chandigarh, Delhi, Lucknow, Haryana, Punjab, Uttara khand, Uttar Pradesh, Delhi, Benaras Rajasthan East Region Bihar, West Bengal, Odisha, Jharkhand Kolkata, Bhubaneswar North-East Region Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Assam, Tripura, Arunachal Pradesh Imphal, Guwahati * As per location of the Co. E, PCo. E, RTC, and reference labs Average 28 batches per region (range 21 -34 batches)

Implementation Arrangements NACO SACS, Co. Es / PCo. Es, NRL, SRL National Team and Help Desk 20 Regional Units (10 in existing Co. Es/PCo. Es, and 10 in DAPCU / other government facilities SAATHII REGIONAL TEAM (37) Technica l Partner : KNomics SAATHII NATIONAL TEAM (11) ♦ Senior Technical Manager (STM) ♦ Senior Program Manager (SPM) ♦ Senior M&E Manager (SMM) ♦ Help Desk Coordinator (HDC) ♦ ICT Manager (ICTM) ♦ Technical Consultants ♦ Other admin, finance, M&E staff (4) Hyderabad, ♦ Training Vijayawada, Manager (TM) Bangalore, North (regional) (19 Karnataka, positions) Trivandrum, Chennai, Salem, Ahmedabad, Mumbai, Nagpur, ♦ Regional Chandigarh, Delhi, Admin & Finance Officer Lucknow, Benaras, Bhopal, Kolkata, (RAFO) (18 Bhubaneswar, positions) Imphal, Guwahati

Expectations and Next Steps 1. NACO to send formal intimation to all SACS, Co. E, PCo. E, SRL, NRL, RTC, 2. SACS to give ARTC, SAICTC, LAC staff details and past training status to SAATHII 1. BCT project staff : visit to Co. E, PCo. E, RTC : assess requirements 2. Support from Co. E, PCo. E : selecting suitable training venues 3. LMS friendly content 4. Formation of Pilot batch : UAT of LMS by pilot batch 5. LMS – Go. LIVE – End March 2019 6. LS MT workshops : 4 batches across country : March-April 2019 7. Doctors SMT workshop : March 2019 8. Doctors MT workshop : April 2019 9. Training to start : May 2019

Thank You

Additional Points

West Region South Region Regi States ICTC on / UTs MO TS AP KA KL PY TN AN DN DD GJ GA MH 5 5 12 5 0 21 0 0 0 9 0 16 LAC MO 6 1 0 7 1 1 0 0 0 1 ART ART MO Specialists Nurses 2 3 4 1 0 4 0 0 0 2 0 7 2 4 6 1 0 6 0 0 0 3 0 9 2 3 4 1 0 4 0 0 0 2 0 6 LT* 8 10 21 6 0 31 0 0 0 12 1 28 LT Total RAF TM (VL) # O 1 1 1 25 26 48 21 1 68 0 0 0 28 1 68 1 1 2 Location 1 1 1 Hyderabad Vijawada Blore, Mysru 3 3 Trivandrum, Chennai, Salem 1 1 Ahmedabad 2 2 Mmbi, Ngpr * (SA-ICTC, NRL/SRL, ARTC) Training Batches and Regional Teams

Regi States ICTC on / UTs MO LAC MO ART ART MO Specialists Nurses LT* North Central CH HR PB HP JK DL RJ 0 3 4 1 1 3 5 1 2 0 0 1 0 1 0 0 1 2 0 0 1 1 0 1 2 1 0 2 0 0 1 2 1 3 5 2 1 3 8 UK UP BR CG 1 12 7 4 1 1 0 0 0 3 1 1 0 4 2 1 0 3 1 1 2 15 8 4 LT Total RAF TM (VL) # O 1 4 8 13 4 3 10 19 4 38 19 11 Location 1 1 Chandigarh 1 1 Delhi 2 2 Lucknow 1 1 Bhopal * (SA-ICTC, NRL/SRL, ARTC) Training Batches and Regional Teams

Region East Region North. East Region States / ICTC LAC ART ART UTs MO MO MO Specialists Nurses LT WB 9 1 1 2 1 12 OD 7 0 1 2 1 8 19 JH 2 0 1 1 0 2 6 MN 2 6 1 1 1 3 14 ML 1 0 0 1 2 MZ 1 0 0 1 1 1 4 NL 2 0 1 1 1 2 7 SK 0 1 0 0 1 AS 3 0 1 1 1 3 TR 1 2 0 0 0 1 4 AR 1 4 0 0 0 1 6 147 37 40 54 40 211 Grand Total LT Tota TM RAFO Location (VL) l # 1 1 6 27 10 535 1 1 Kolkata 1 1 Bhubane swar 1 1 Imphal 1 1 Guwahat i 19 18 * (SA-ICTC, NRL/SRL, ARTC) Training Batches and Regional Teams