Providing technical support for implementation of integrated service delivery models in lower-income countries
The Center for Integration Science Programs team supports Ministries of Health and implementing partners in lower-income countries with developing the plans, budgets, facilities, training and mentorship programs, and systems for procurement, supply chain management, and monitoring and evaluation needed to decentralize and integrate delivery of care for severe conditions that cause avoidable death and suffering among the world’s poorest children and young adults. (Phases 3 and 4 of the NCDI Poverty Network’s four-phase theory of change)
Support for PEN-Plus initiation and scale-up
The team’s current work focuses on support for implementation of the PEN-Plus model for decentralizing delivery of integrated chronic care services for a set of severe conditions that includes type 1 diabetes, sickle cell disease, and rheumatic and congenital heart disease through clinics at first referral level hospitals led by specially trained nurses and other mid-level providers. The team is working directly with Ministries of Health and implementing partners in ten NCDI Poverty Network countries that initiated PEN-Plus programs in 2022 and are opening PEN-Plus clinics and training sites at 18 hospitals in 2022-2023. In addition, the team provides ongoing technical support to Ministries of Health for national scale-up of PEN-Plus in four countries that successfully initiated the model between 2012 and 2018.
Support for PEN-Plus initiation
The CIS Programs team leads support for implementing partners and Ministries of Health in countries initiating PEN-Plus programs and coordinates support from the Training team for curriculum and training material development, the Research and M&E team for evaluation and impact assessment, and the Administrative team for program management, budgeting, and procurement. Programs team support for the ten countries that initiated PEN-Plus in 2022 includes:
Supporting program planning and management within and across the 10 countries – The CIS team supports implementing partners and Ministries of Health with developing and monitoring their program plans and budgets, tracking program milestones, and facilitating meetings and tracking documents to monitor implementation. In addition, to inform adjustments and adaptations in programming going forward, the team collates implementation and programmatic details across sites, including similarities and differences in which conditions are included, which providers are delivering services, and what strategies are being employed for training, procurement, and monitoring and evaluation.
Providing technical support to maximize program learning and successful implementation across sites – Drawing on Center for Integration Science resources, lessons from existing PEN-Plus sites, and subject matter experts engaged through the PEN-Plus Partnership, the CIS Programs team shares knowledge, experience, and resources for PEN-Plus initiation through regular site visits and country-specific technical calls, a series of cross-site learning forums, technical materials development, and coordinating learning visits between sites and connections to clinical and other experts.
Developing and sharing technical materials and other documentation – To ensure that the PEN-Plus intervention is packaged in a collaborative, informed, and detailed way to support initiation and scale-up at country level and inform the broader policy and advocacy agenda with WHO AFRO, UNICEF, and other key partners, the CIS Programs, Training, and Research & M&E teams have developed and shared documentation covering all aspects of program implementation. Topics covered include: Staffing; Training; Medications, Labs, and Equipment; Care Pathways; Infrastructure; Data Systems; Evaluation; Reporting; National Operational Planning; and Integration Science.
Support for national scale-up of PEN-Plus
The CIS Programs team also provides and coordinates technical support to the four countries that are currently at various stages of scaling PEN-Plus services nationally – Rwanda, Malawi, Liberia, and Haiti.