HIVAIDS Portal/IAS/Operations Research Curriculum Development

Project Overview
'''Health Care Workers/Programmers/Managers investigate the impact of their programmes:

Improving the lives of people living with HIV through health workers’ professional development in Operations Research by developing an inter-agency community of practice for curriculum development'''

Background
The HIV pandemic remains the most serious infectious disease challenge to public health, especially in sub-Saharan Africa where AIDS is still the leading cause of death. There is growing international recognition that greater investment in comprehensive research is needed to expand our knowledge and understanding of the operations of HIV programmes, in the context of the rapid scale-up of HIV prevention, treatment and care in resource-limited countries within a public-health approach. The Sydney Declaration (2007), the Consensus Statement (2008) and the recent Vancouver 2nd Global Experts Summit (February 2009) bear witness to the international sectors' advocacy of this policy priority.

While global health initiatives and international public-private partnerships have made considerable progress towards advancing the capacity of the health workforce in delivering treatment, care and support, they face considerable challenges in developing effective and sustainable models for applied clinical learning and training support. In addition, sustainable improvements in programme operations now require that health care worker’s reflective capacities, and their critical awareness to monitor and analyse their work practices in relation to the quality of care they are delivering, are continuously developed so as to make a difference to people living with HIV and, concurrently, strengthen health systems.

Operations Research
Operations Research (OR) is a body of knowledge and practice aimed at increasing operations efficiency, efficacy and return-on-investment by “learning by doing”. Cited by many global organizations and funders such as the World Bank and the Clinton Foundation, OR is considered crucial to the modern design, delivery and monitoring and evaluation of accelerated, large scale and sustainable HIV prevention, treatment and care, and to the achievement of Universal Access and the Millennium Development Goals.

Despite the Operations Research Framework produced by The Global Fund to Fight AIDS Tuberculosis and Malaria (The Global Fund), the World Health Organisation Tropical Diseases Research Centre (WHO TDR) and associated agencies in 2008, no standardized curriculum yet exists to harmonise, develop and implement best practices in training those at the frontline – health care workers/program managers – to do OR which investigates and identifies:


 * the impact of their HIV programmes,
 * which approaches are effective in the field, which are not, and their associated rationales,
 * the number and quality of services and programme outputs and outcomes, and
 * the ways in which to optimize programme inputs and processes.

Purpose
The purpose of this proposal is to ultimately improve the lives of people living with HIV, and other infectious diseases, by developing the professionalism of the health workforce of resource-limited countries in conducting OR. The rational for the proposed 3-Os learning model itself is the growing recognition that realizing this ambition will require not the mere provision of small-scale direct training on the ground by various independent actors, but first reconceptualising capacity building as continuous professional distance education (CPDE). This will require leading the design of a flexible open curricular package for OR education, and its’ accompanying open access educational resources, through a series of action research cycles for pilot testing, revision and refinement, guided by an active online research community of participants, mentors and facilitators who will also monitor and evaluate the ongoing mainstreaming of the curriculum they develop over the next three to five years.

To accomplish this goal, rather than deploying a one-off project team, this proposal will create an inter-agency collaborative community of practice of programmers, scientists, educators, and public health resource persons to steward the knowledge creation and dissemination processes, thereby sustaining professional and institutional learning across four leading international actors in HIV OR that have - and continue to - successfully collaborate on a variety of policy and programming initiatives: (list agencies). A new partner who will bring expertise in e-learning and open educational resource (OER) development is the International Centre for Open Education (OER Foundation).

Professional and Curriculum Development Innovation
This proposal presents a unique opportunity for an educational intervention that directly addresses and combines both international public health training and research agendas for improving the quality of lives of people living with HIV in several innovative ways. The intervention will:


 * Develop an OR curriculum specific to the identified needs of practitioners, that combines conceptual knowledge and skills building in analytic tools for the measurement and optimization of impact, drawing on case-studies of Best Practices, and the communication of research findings in journals and fora;
 * Deliver the curriculum through a blended learning approach (face-to-face trainings with online communities), around the 3-Os model, complemented by collaboratively produced open educational resources, thus drawing on the latest advances in continuous professional distance education conceptual frameworks, and resulting in increased productivity and a greater return on investment, as well as allowing the opportunity for customizing to local situations;
 * Make practicing health care workers, programmers and the communities they serve central to researching their work by applying what they learn to investigate their practice, with the goal of continuously improving the operational efficacy of their own clinical programmes specifically, and the quality of HIV and health research from resource-constrained settings broadly;
 * Fill a knowledge gap in the theory and practice of HIV professionals’ education by conducting action research and cultivating a living professional and curriculum development community of practice that reflects and nurtures inter-agency, multi-region and multi-disease fertilization of perspectives on the issues and challenges of health care worker training during the scale up of the public health approach to HIV prevention, treatment and care.

Strengthening NGOs contribution to the AIDS response
This proposal builds on strategic shifts in global health, and leverages on a growing body of training, research, policy and programming developments in health and education internationally, which are exploring the best ways to develop and translate new insights and evidence on pervasive public health problems by building the research capacity of health care workers, so as to be able to promote and instill an HIV OR culture and the wider application of its’ results. Relevant recent developments include, inter-alia:

International Commitment

 * There is increasing international commitment to the IAS Sydney Declaration (2007) that called for allocating 10% of all resources for HIV programmes to research.

Coordination of Training and Research Under Joint Leadership

 * Coordination of Training and Research under (list agencies), a consensus statement in 2008 underscored the importance of building an enabling professional environment and training staff to conduct research into the operation of HIV programmes to address existing knowledge gaps in the public health approach to delivering antiretroviral therapy and care.

Alignment of Research Priorities with Capacity Building Programmes

 * Recent announcements in the HIV/AIDS sector reveal that stakeholders increasingly are demanding value for money for capacity building. The added-value to the response will increase by building a sustainable model community of HIV and health professionals across agencies and sectors, improving their skills in - and knowledge of - what and how they do what they do.

Synergizing OR for policy change and Intensifying Inter-Agency Partnership
This proposal presents a unique opportunity to respond to the call made at the recent Vancouver 2nd Global Experts Summit and at IAS 2009 for key actions by leading agencies. An inter-agency community of practice in OR curriculum development will break new ground in strategies to accelerating inter-agency partnerships for global health collaboration, joint problem solving and knowledge sharing, through embedding a long-term, high-impact project, and by mobilizing human and financial investment for capacity-building initiatives and the implementation of a robust OR agenda simultaneously.

Expertise and Experience in Professional Development
As for past conferences, NGOs conduct targeted professional development (mainly in the form of didactic workshops) on OR around conferences, with on-site mentoring. Over the years, NGOs have built in-house capacity by applying the lessons from the evaluation of past educational programmes, and developing a model of practice that integrates topical seminars, conference mentoring, scientific writing training and mentoring, and online discussion groups. The 3-Os is the model to integrate and align these separate initiatives.

Building on this, the learning experience of participants to be trained in this proposal will be enriched and facilitated through intervening at a prior stage of professional development, namely the design of a standardized curriculum, implemented at trainings in conjunction with future conferences and by partner agencies in country, and monitoring and evaluating its effects, thus deepening our understanding of, and contribution to, the practice, transferability and scalability of all health workers professional development.

Sustainable Capacity Building Ethic

 * With the approaching 2010 target for achieving the goals of universal access to comprehensive HIV prevention, treatment and care, NGOs are responding by pro-actively initiating learning approaches that pay attention to the gaps in early career HIV professionals’ skills and knowledge, employing experiential and adult learning methodologies with leading faculty and speakers.

OR training will enable health care workers to learn as they practice, giving them voice and respecting local and particular knowledge, rather than imposing additional ineffective one-off training burdens. The partnership of four international agencies in this proposal will ensure professional development programming is sustained as the curriculum is scaled up and continuously improved.

Mentoring by the first batch of trainees of new ones will induct more and more health care workers into a growing HIV OR professional learning community, supported with an online social network, enhancing their identity and commitment to fighting AIDS. Enabling such processes can also equip health care workers to contribute to improving the OR aspects of their country’s proposals for The Global Fund, and to requesting for support to apply what they learn about OR, by developing their research writing and publishing dispositions.

Summary
The 3-Os team invites you to join us in backing this innovative proposal, and dedicating funding to ensure the proposal meets its vision of training 25,000 health care workers over 5 years. With our innovative 3-Os learning model, there is a potential to cost-effectively reach an additional 20% or more learners. By jointly developing a community of practice to produce, test, trial, and mainstream a curriculum in OR education, this proposal will sustain the next generation of health care professionals’ learning, having been equipped with research capacities to investigate the impact of their HIV/disease programmes, thus continuously improving the quality of lives of people living with HIV.

ToRs for CoP
TORs for Operations Research Community of Practice