Touch is committed to expanding access to HIV/AIDS services across sub-Saharan Africa. Studies show that though the region contains 12% of the global population, it bears 71% of the global burden of HIV. Sub-Saharan Africa also faces a severe healthcare worker deficit. To stop the spread of HIV/AIDS, and to enable equitable access to care, healthcare workers must be allocated efficiently. We used our Prioritization and Optimization Analysis (POA) algorithm to help Data.Fi and USAID build a user-friendly tool that allocates healthcare workers providing HIV/AIDS services. POA supports USAID, the President’s Plan for AIDS Relief (PEPFAR), and the CDC in their work to end the HIV/AIDS epidemic.

To treat people with HIV/AIDS and stop the spread, healthcare workers—such as doctors, pharmacists, and community health workers—must be placed where they can most effectively serve those in need.

That’s why Touch collaborated with Data.Fi and USAID, using the algorithm from our POA tool, to create a Human Resources for Health Needs and Optimization Planning Solution. It helps our partners understand the existing need for healthcare workers and to assign them where they are needed most.

Achieving the United Nation’s goal to end the AIDS epidemic by 2030 is ambitious but attainable, requiring coordination and partnership across sectors and countries. Touch is proud of our ongoing partnership with USAID to set healthcare workers up for success, and glad to have worked with Data.Fi on this crucial Solution, which will improve lives for years to come.

Touch Foundation is pleased to announce that Massimiliano Pezzoli has been appointed Touch Foundation’s Executive Director.

Massi has been with Touch for over 8 years and has effectively led our program efforts for most of that time. Under his program leadership, Touch has built an extraordinary program team and has successfully developed and implemented programs that have improved access to healthcare in sub-Saharan Africa. He has played a major role in in both Touch’s geographic and programmatic expansion.

Celia Felsher, Touch’s President and Chief Executive Officer, said “We are very excited about Massi stepping into the position of Executive Director. Massi will now be responsible for all of the programmatic and operational functions at Touch, working with me and the Touch Board in leading our efforts to continue increasing our impact across sub-Saharan Africa.”

Before joining Touch, Massi was a Senior Manager at McKinsey & Co., where he spent four years serving major clients in the private health sector and in government and regulatory authorities across Europe, America, and the Middle East. Massi holds a PhD in Biomedical Engineering from the Georgia Institute of Technology, an Executive MSc in Health Economics, Policy and Management from the London School of Economics, and an MSc in Aerospace Engineering from the Polytechnic of Milan.

Lowell Bryan, Touch’s Chairman of the Board, stated that “Massi has continually shown his commitment to Touch and our mission and we are looking forward to working with him in his new role.”

Touch Foundation is committed to achieving the United Nation’s Sustainable Development Goals (SDGs), focusing on strengthening health systems to ensure a better and more sustainable future for all. We believe that healthcare workers are the ultimate drivers of SDG 3 (ensuring health and well-being for all). When designing and implementing programs like Prioritization and Optimization Analysis (POA), we collaborate with global actors to ensure long-term, locally led change that supports the equitable distribution of healthcare workers and accelerates the realization of the SDGs.

The COVID-19 pandemic has solidified what many of us already knew: healthcare workers, in adequate numbers and with the proper mix of skills to meet the needs of the communities they serve, is a nonnegotiable part of ensuring health and well-being for all people, everywhere (SDG 3). We created POA (Prioritization & Optimization Analysis) to improve the allocation of limited healthcare workers given the demand for health services, as well as real world budget and supply constraints. Using this tool, governments in sub-Saharan Africa and other health workforce planners can deploy healthcare workers to facilities and communities with the greatest need.

Since our inception, Touch Foundation has supported the training of over 6,000 healthcare workers and we’ve used POA, with the support of local governments and PEPFAR, in 4 sub-Saharan African countries to allocate members of the health workforce where they’re needed most. These essential workers are at the heart of achieving SDG 3.

Though significant progress has been made to achieve the Sustainable Development Goals, we still have a long way to go, and countries in sub-Saharan Africa face some of the largest deficiencies in health access. This region carries nearly one quarter of the world’s disease burden while possessing only 3% of its healthcare workforce and only 1% of its financial resources for healthcare. Now, more than ever, given the dramatic setbacks caused by COVID-19, we must buckle down on our collective action over the next 10 years to achieve the health-related SDGs. Working towards good health and well-being will be the keystone in achieving all 17 Goals, from gender equality to decent work and economic growth.

Training, effectively allocating, and supporting healthcare workers is key to achieving nearly every SDG target related to health and well-being. These include ambitious reductions to the global maternal mortality ratio and neonatal mortality rates, ending the AIDS epidemic, and strengthening emergency preparedness and response. With healthcare workers equitably distributed, and thus facilities better staffed, more services become readily available, making it far easier for patients to access care.

To have a sustainable and catalytic impact, we recognize the importance of collaboration across business, government, philanthropy, and civil society partners. That’s why we’re excited to continue our engagement with the United Nations Global Compact and Every Women Every Child, and continue actively partnering with leaders around sub-Saharan Africa to ensure that healthcare workers can fill in the biggest gaps.

Learn more about our POA program here.

Learn more about our work to promote maternal health here.

Members of the Touch Foundation community gathered virtually on May 18, 2020 to honor our Founder and President for the past 15+ years, Lowell Bryan, for his profound leadership and dedication to saving lives and relieving human suffering. Due to the COVID-19 pandemic, we re-imagined the event and held it online. If you missed it live, not to worry! You can view the event on demand here.

Rik Kirkland, Director of Publishing at McKinsey & Co., moderated our Asante celebration and interviewed Lowell on the urgency COVID-19 adds to the need to address Africa’s infectious disease burden and the potential to deploy digital health at scale to catalyze change in African health systems. The discussion was inspired by a white paper on this topic, which Lowell wrote and which we released during the event.

In the paper, entitled Early Thoughts on Potential of COVID-19 to Promote Digital Health in Africa, Lowell discusses the ways in which digital health has the potential to expand access to healthcare and decrease the infectious disease burden throughout the African continent. You can read the white paper on our website here.

This particular Asante was bittersweet as we honored Lowell for his tireless commitment to Touch Foundation as he stepped down from his position as Touch Foundation’s President. With that, we also welcomed Celia Felsher, longtime board member, who has taken his place. We are thrilled both that Celia has taken on the President role and that Lowell is not going far: he will remain active as Chairman of the Board and on several board committees.

After looking back at our impact over the years and exploring the gravity felt around the world with the COVID-19 pandemic, we ended the night by looking with determination to the future. As Celia said in her closing remarks,

“As has been made abundantly clear from the current COVID-19 pandemic, we are all, regardless of where we live, interconnected, and the strength of healthcare systems everywhere is necessary to ensure the health of all of us. Touch’s work is, therefore, more important than ever.”

You can view the online event here and read more about our programs and Lowell’s history with Touch here.

Written by Liz Pavlovich, MScPH, Business Development Manager at Touch Foundation. She recently traveled to Mozambique, where Touch Foundation is working with HRH2030 on a health workforce analysis.

HIV/AIDS services start with the health professional. Yet healthcare workers are often in short supply in sub-Saharan Africa – the region of the world most affected by the epidemic. Another major constraint is the limited amount of funding available. Finally, while some advances have been made in collecting and using data on the health workforce providing HIVAIDS services, it is often still challenging to get current, reliable data when needed. Yet, this data can power how the global health community most effectively reaches those impacted by HIV/AIDS to ensure that people are tested, and initiated and retained on treatment.

For 15 years, Touch Foundation has developed innovative and data-driven solutions to the training and deployment of the health workforce in Tanzania and elsewhere. Two major health workforce considerations are the skills mix and the geographic distribution. Five years ago, a representative of the Government of Tanzania revealed to us that they had several tens of thousands of requests from districts for new healthcare workers at facilities across the country, but only a fraction of that to deploy, given the low budget available for staffing and modest number of graduates. A solution was needed to make the time-consuming and challenging process of prioritizing these requests easier. With support from USAID and PEPFAR, Touch Foundation created the POA (Prioritization and Optimization Analysis). methodology in 2015 to guide this decision-making process using data on the actual need and real-world budget and healthcare worker shortages.

Recently, we utilized POA, with PEPFAR funding under the USAID HRH2030 Program, to help inform health worker staffing allocations for HIV service delivery in Mozambique. Working with partners, including USAID and CDC, we set out to help stakeholders use data to determine the need and priority of each and every health worker providing HIV/AIDS services at each PEPFAR-supported facility in all provinces of the country. The ultimate goal was to improve the provision of client-centered HIV/AIDS services to achieve epidemic control in Mozambique, a country with one of the world’s highest prevalence rates at 12.6%[1] and lowest health workforce densities.[2]

The POA methodology is simple, yet the results are powerful.  Novel to stakeholders involved in health workforce planning, POA begins by assessing the total number of healthcare workers needed to deliver HIV/AIDS services. To do this in Mozambique, we mapped—from a client-centered perspective—the different types of healthcare workers involved in the clients’ care and the amount of time required from each healthcare worker. For example, a clinically stable client on antiretroviral therapy (ART) will be seen by a pharmacist at a health facility for 5 minutes every 3 months in order to collect their ART refills. They are also seen by a clinical officer for 10 minutes twice a year for adherence counseling, monitoring of their health, and lab services. If the number of stable clients on treatment served by that health facility goes up, so too does the need for pharmacists and clinical officers. A clear picture of who is involved in the care continuum for HIV/AIDS clients enabled us to quantify the total number of the various cadres of healthcare workers needed. Since we also had data on the current health workforce, we could ascertain the health worker shortage by cadre and facility.

Figure 1. Overview of the POA methodology applied in Mozambique for determining the need for healthcare workers providing HIV/AIDS services, and prioritizing and assigning them based on the budget constraints.

The real innovation of POA is that it prioritizes and recommends assignments for all the needed healthcare workers, taking into the account the limited budgets available to cover their salaries. The needed healthcare workers are ranked so that the top priority assignment is the one that is the most ‘overworked’. For example, imagine a situation where one laboratory technician in a busy facility in Mozambique is struggling to keep up with the viral load testing demands of thousands of clients on treatment, a job for several lab techs. Adding another lab tech at this facility would be much higher priority than a lab tech at a different facility with fewer patients. POA goes through this calculus for tens of thousands of needed healthcare workers to produce a comprehensive ranked list.

While in Mozambique in November, I worked with Touch Foundation staff to orient PEPFAR and CDC stakeholders on how to use the recommendations from POA to decide where to deploy healthcare workers across 595 health facilities. The recommended assignments would cover nearly half of the overall shortage of 18,000 healthcare workers, especially among lay cadres like community and facility counselors. Using POA, implementing partners can more efficiently plan, budget, and staff programs delivering critical HIV/AIDS services.

Through this approach, we improve HIV/AIDS service provision where it’s most needed, by staffing facilities with the optimal quantity and skill mix in order to test, initiate treatment, and retain clients. Data-driven decision-making can bring us closer to controlling the epidemic.

This post originally appeared on the HRH2030 website here.

[1] UNAIDS; 2018 for adults (15-49 years). www.unaids.org/en/regionscountries/countries/mozambique

[2] CIA World Factbook; 2017 physician density. https://www.cia.gov/library/publications/the-world-factbook/fields/359.html