DURATION 18 months
STARTING DATE 1st January 2021
GEOGRAPHIC REACH Zambia
PARTNER University Teaching Hospital HIV AIDS Programme (UTH-HAP)
The project aims to address fundamental barriers to viral hepatitis in Zambia by putting in place a multi-faceted, decentralized, integrated healthcare worker training program.
The purpose of Accelerating the Hepatitis B Response in Zambia (ACCELERATE) is to catalyse substantial increases in hepatitis B testing and treatment in Zambia by cultivating a core group of local hepatitis experts, increasing healthcare professional competency and raising awareness among community health workers.
Zambia is a landlocked country in Southern Africa that has a disproportionately high burden of infectious diseases (ID) including human immunodeficiency virus (HIV), tuberculosis, and viral hepatitis. The Zambian Ministry of Health (MoH) has already put into place several major interventions to control viral hepatitis.
Zambia had already met several 2020 hepatitis elimination targets including (a) >90% coverage of 3 dose vaccine for infants, (b) >95% screening of blood donations, and (c) >50% injection safety. However, several fundamental and operational barriers still exist to achieve the 2030 hepatitis elimination target (a) lack of local hepatitis experts, (b) low awareness among healthcare professionals and the general population, and (c) low competency among healthcare professionals, (d) major gaps in diagnosis and treatment and use of the hepatitis B birth dose vaccination.1
Addressing these barriers will raise awareness among policy makers stakeholders to support a national and sustainable effort to eliminate viral hepatitis in Zambia.
A core group of 10-15 professionals will be intensively trained and mentored at UTH-HAP to become local hepatitis experts. These trained experts will provide clinical care to at least 50 hepatitis B monoinfected patients each.
Across the 10 provinces, at least 500 community health workers and 500 health work practitioners will participate in activities at one of at least 100 outlying health facilities, representing a catchment population of approximately 5,000,000 Zambians (~30% of the Zambian population).
To address low population awareness and low clinical capacity among HCPs, ACCELERATE will integrate the project ECHO Sub-Saharan Africa (Extension for Community Healthcare Outcomes – https://hsc.unm.edu/echo/ ) led by the University of Cape Town. ECHO is an established guided practice model for medical education that is already in use in Zambia for other disease areas.
10 to 15 local experts will be trained, and each will provide clinical care to at least 50 hepatitis B mono-infected patients.
10 ECHO hepatitis clinical mentors (one per province) will support 100 sites that will participate in ECHO trainings on treatment of viral hepatitis reaching at least 500 HCPs (80 medical doctors, 250 nurses, 100 pharmacists, and 70 other medical personnel).
Hepatitis knowledge will be increased among the training participants.
30,000 individuals will be tested for HBV and at least 2,000 individuals will initiate HBV antiviral therapy.
This multi-faceted training experience is expected to help Zambia build a cadre of local experts who can sustain the hepatitis B response beyond the end of ACCELERATE.
By disseminating information about the program and its impact at key Africa meetings, ACCELERATE program can become an evidence-supported training model for other African countries to consider adopting.
Also, the curricula for clinical training and for ECHO-based training will be made available for future use and would also look to extend the reach of the training to other institutions.
ACCELERATE will promote wider use of Project ECHO for hepatitis, not just for experts, but for front-line facilities in other African countries.
World Health Organization. Global health sector strategy on viral hepatitis 2016-2021. Towards ending viral hepatitis. 2016.