Areas of Work


Giving mid-level providers the knowledge and skills to lead decentralized, integrated care clinics

The Center for Integration Science training team, working in collaboration with partners in lower-income countries and subject matter experts from clinical, academic, and policy institutions across the NCDI Poverty Network, provides support to implementing partners and countries on developing training programs for nurses, clinical officers, and other mid-level providers delivering decentralized, integrated care by developing curricula, open-source training materials, and an e-learning platform.

To date, the team has focused mainly on leveraging experience, partnerships, and broad program visibility to provide responsive support and guidance to implementing partners and countries that are initiating and scaling up implementation of the PEN-Plus model for integrated chronic care services for severe NCDs at first-level hospitals. (Phases 3 & 4 of the NCDI Poverty Network’s four-phase theory of change)

Training support for PEN-Plus implementation

The Training Team is taking the lead in developing:

  • a standardized curriculum;
  • a comprehensive set of materials for a PEN-Plus training program that is responsive to country needs and can readily be adapted for implementation; and
  • an e-learning platform for the core PEN-Plus conditions.

Twenty-nine technical, research, and advocacy organizations focused on type 1 diabetes, sickle cell disease, and rheumatic and congenital heart disease have contributed existing materials, input, and feedback to developing the training curriculum and materials through participation in the PEN-Plus Partnership’s Training Working Group.

The training team has developed a working library of training materials that includes training slide decks and clinical protocols for management and treatment of chronic conditions across eight clinical areas, including: cardiovascular disease; diabetes; sickle cell disease; respiratory disease; renal; liver; mental health; and palliative care. Version 1 of the materials is now available to implementing partners on a shared drive. And the training resources will be continuously improved and expanded through an iterative process based on countries’ needs and feedback.

The training team is also developing and piloting an e-learning platform for the core PEN-Plus conditions. The e-learning platform has been designed to be responsive to country needs and complementary to other PEN-Plus training and programmatic materials. Training modules for heart failure and cardiovascular disease have been completed and piloted, and diabetes modules are under development.

In addition to this foundational training for providers in new PEN-Plus programs that are opening their first clinics and training sites, the team’s training framework also includes working with in-country partners to develop programs for master trainers; advanced training, refreshers, and continuing education; and accreditation and formal certification and advanced degrees for PEN-Plus providers.

An introduction to PEN-Plus training

Gedeon Ngoga, Director of PEN-Plus Training for the Center for Integration Science and the NCDI Poverty Network, discusses the PEN-Plus model and PEN-Plus training.