case study | TechChange | The Institute for Technology and Social Change

The Asian & Pacific Islander Wellness Center (A&PI Wellness Center) partnered with TechChange to develop a two-part training course designed for clinical and non-clinical providers to provide HIV education in California. For the first time ever, these trainings combined both the self-paced and facilitated course structures. Participants will be asked to proceed at their own pace through the Articulate Storyline-based APIWC 101 course, before taking part in the four-week facilitated course that features chats with guest experts.

HIV Today – The Context
We have come a long way when it comes to HIV treatment. Thirty years of research and campaigns have transformed HIV from being a death sentence into a chronic condition that permits those who properly manage it to live relatively normal lives. The problem is, only one in four HIV-positive Americans currently follow all recommendations for managing HIV.

According to the Center for Disease Control (CDC), only 25% of HIV-positive Americans reach viral suppression, the current end-goal of HIV treatment. This means that the other 75%, or roughly 825,000 of the 1.1 million Americans estimated to be HIV-positive, are not receiving the support they need to successfully navigate through the obstacles to seek care. As a result, these individuals are not getting the treatments they need to manage and maintain their personal health and consequently, have a greater risk of transmitting the virus to others.

Many agencies have encouraged use of the HIV Care Continuum, also called the HIV Treatment Cascade, as a tool to visualize the proportion of HIV-positive individuals engaged at each stage of care.

Source: AIDS.gov

This cascade shows an estimated percentage of how many people fall out of care at each step along the way to viral suppression. Nearly one in five HIV-positive Americans do not know their positive status, keeping them from engaging in the cascade at all. Of those that are initially linked to care, nearly half fall out of treatment before being prescribed antiretroviral therapy (ART).

Even more important than this cascade is the breakdown of HIV prevalence by race and sexual preference. African Americans, for example, bear the biggest burden. According to a 2013 CDC report, African Americans makes up 14% of the US population, accounting for 44% of Americans living with HIV. The burden is similarly unequal for other minorities and men who have sex with men (MSM).

source: CDC

These statistics highlight the need for responses tailored to the communities most affected by HIV; these groups are more likely to face poverty and racism, as well as distrust with the medical system. When societal challenges are combined with the challenges of navigating HIV, people tend to drop out of care. Diverse communities require varied responses that are culturally aware and take into account the needs of disenfranchised groups.

The Challenge of Scaling HIV Prevention
Response to HIV requires service providers to play clinical and non-clinical roles. Many counselors, social workers, advocates, lawyers, and clinicians frequently work with HIV-positive individuals and in the field of HIV prevention and treatment; it is vital that they understand both the medical and complex social realities faced by their clients.

Born out of a grassroots movement to combat the HIV/AIDS crisis in A&PI communities in the late 1980s, the A&PI Wellness Center works to address the health needs of marginalized and vulnerable groups, regardless of race, ethnicity, gender identity, sexual orientation, or immigration status. In collaboration with Project Inform, the A&PI Wellness Center developed the California Statewide Training and Education Program (CSTEP), a curriculum that sets the standard in HIV treatment and technically and culturally competent training for clinical and non-clinical providers working in the HIV field.

An eLearning Solution

Participants will advance to APIWC 201 upon completion of the first course (APIWC 101). Hosted on TechChange’s facilitated course platform, this online course will provide more in-depth information about barriers to care and supporting clients in a dynamic era of HIV treatment. The month-long 201 course integrates elements of the self-paced course into the facilitated learning environment – participants are able to review the 101 content as well as slides specifically produced for the 201 course, share their knowledge with other providers in the forums, and interact with experts during live events. The ability to work with experts is what really sets this training apart – participants hear from former presidential advisors on HIV policy, specialists in linking HIV-positive people to care, HIV trainers, and those with decades of experience researching the virus and advocating for those affected.

Participants are able to engage with experts such as Dr. Cynthia Gómez (pictured above) during live events. These events are recorded and made available for later review.

The content of both courses is available 24/7 so that providers are able to take part whenever their schedules allow, while the forums and weekly live sessions add a social dimension uncommon in online learning. As all participants have some experience with HIV prevention or treatment, this course provides a unique opportunity for collaborative learning; providers can learn from the experiences of one another, share resources, and strengthen their networks of HIV prevention and treatment specialists.

In the first month alone, the training attracted over 70 participants from a variety of organizations. Additionally, the combined course has little in the way of overhead costs and can easily be repeated or scaled for different audiences, making it a viable strategy for training providers across California, with the goal of improving health outcomes and supporting HIV-positive individuals as they move toward viral suppression.

To register for these free online courses on HIV prevention training, please click here.

Charlie Weems and Emily Fruchterman of TechChange record a live session at the TechChange recording studio in Washington, DC.

Emily Fruchterman, Catherine Shen, Charlie Weems, and the A&PI Wellness Center contributed to this blog post.

If your organization is interested in developing online training with TechChange, please contact info@techchange.org.

A group of girls in Zambia learn about Zambia U-Report (Photo credit: Mark Maseko – UNICEF 2013)

Information Communications Technology for Development (ICT4D) holds exciting promise, especially on the African continent where we have so many systemic problems that could benefit from different mindsets and new ways of looking for solutions. When I was making my first serious foray into the world of ICT4D in 2012, I first heard about TechChange courses from a friend. When I went to the website, I was very excited to see that they were offering courses that I had been trying to take and hadn’t been able to find anywhere, least of all in Zambia. My plan was to take one course in mHealth: Mobiles for Public Health but the course was so interactive and I learned so much from the course content, online sessions and other learners’ experiences that I ended up taking the following 3 courses in just about as many months!

The result: Zamba U-Report, a SMS-based youth counseling and engagement platform that allows young people to ask trained counselors questions, take part in polls and influence decision making at policy level.

Here are some of the lessons I have learned through my course work at TechChange and applying them to ICT4D in Zambia:

1. Validate the need for your solution
Before diving into an ICT4D solution, focus on the problem you’re addressing first and establish if there is a valid need for the solution. Too often, a tremendous amount of resources are wasted when people jump ahead to create a ICT4D solution first and then try to find a problem to wrap around it.

In building Zambia U-Report, we first identified the problem as high HIV infection rates among young people in Zambia.

2. Involve the end users
Make sure you’re not just building solutions from your desk at an office. The end user of the solution must be involved in the very initial design of the solution, and give feedback throughout the process of prototyping and quality assurance (QA). You would be surprised at how often the community you are trying to help may already know what needs to change to improve their lives.

After identifying Zambian youth affected by HIV, we then involved them in designing the U-Report SMS solution and coming up with the key strategic objectives. These young people regularly give feedback and are involved in any further planning or reviews of the programme. The first year of this program’s pilot in 2 provinces has seen 50,000 young people voluntarily sign up and engage the 24/7 trained counselors by asking them questions on HIV, STIs and other sexual reproductive health issues.

3. Invest in continuous learning to keep up with ICT4D issues
TechChange courses have enabled me to better articulate and sell the idea of using technology for development to my office and I was able to contribute to various projects including one I am very proud of, the Zambia U-Report (an SMS-based youth engagement and HIV counselling platform). I have since changed jobs from ICT Officer to Innovations/Technology for Development (T4D) Officer.

To get the most from these courses, students need to commit the time required to write the blogs, take part in class conversations, read recommended materials, and engage with the instructors and other participants. It is always interesting and there is always something new to be learned from the very diverse group of people you meet in any given TechChange course.

Of course, there are more lessons learned in implementing an ICT4D programme and I would like to engage other industry practitioners. Looking forward to taking the Technology for Monitoring and Evaluation course as it will tie in very well with my work with programs helping adolescents and young people!

Priscilla Chomba Kinywa is the Innovations and T4D Officer at UNICEF Zambia. She holds a BSc Business Computing, CCNA certification, a post-graduate Diploma in Business Administration and various certifications in using technology tools and skills for international development work including TC105: Mobiles for International Development, TC309: mHealth – Mobiles for Public Health, and TC103: Tech Tools and Skills for Emergency Management. Priscilla has more than 13 years’ experience in ICT, working with WFP for six years and UNICEF for seven. She has also supported the creation of different innovative solutions to challenges that face Zambian children, adolescents and women. Among these are Zambia U-report, a SMS-based youth counselling, engagement and participation platform that has over 58,000 young Zambians signed up; and Programme Mwana, an intervention that uses SMS to reduce the time it takes for HIV test results for infants to reach a mother in rural Zambia from the labs in Lusaka and Ndola. Also see Priscilla’s work highlighted earlier this year on UNICEF here.

By Sairah Yusuf, TC141: Mapping for International Development (Fall 2013) alumna

Before taking this Mapping for International Development course last fall, I had absolutely no previous background on mapping tools, so everything about digital mapping was new to me. For my course final mapping project, I created a digital map of the countries and locations of participants of an international training camp held by Generations For Peace (GFP) in November 2013 (Amman Camp 2013). Given my involvement in evaluating the impact of this training, I wanted a way to visualise the effectiveness of the training.

Here are the steps that I took for my introductory experience in creating a map for my work at Generations For Peace:

Step 1: Define the purpose of your map

Throughout the course, the importance of defining the purpose of your digital map as a first step emerged with debates regarding representation and privacy concerns. My aim with this map is to understand the cascading effect over time of these Generations For Peace volunteers, who will be passing on their skills to new volunteers in their home countries in the Middle East. By maintaining this map from November 2013 to November 2015, I hope that it will be possible to visually demonstrate the geographical impact of this training.

Step 2: Select your dataset

I used data from Amman Camp 2013, including the home country of each individual trained and the geographical reach of the training. I felt that this data was simple enough to work with, given that this was my first exposure to mapping. That said, I had to create the dataset from scratch, entering street addresses/locations for each participant.

Geocoding data in the MENA region proved to be the biggest challenge because geocodes for most street addresses (which were predominantly in Arabic) could not be found in the APIs I used. In addition, we had trainees from the occupied Palestinian territories at the GFP Camp. I struggled with pinpointing their locations on the map since the occupied Palestinian territories did not show up as a country option in many of the geocoding tools I tried. I had to get around this by tagging individuals from this region as hailing from Israel and then manually changing the name later to reflect their location. This issue was important to deal with because I did not want any of these trainees to view the map I had created and feel like I had misrepresented where they were from in any way due to geo-political sensitivities.

Step 3: Select your mapping tool or software

The Mapping course featured a variety of tools including Google Maps Engine, MapBox, Ushahidi, OpenStreetMap, CaerusGeo, and Palantir. I chose the Mapbox/TileMill combination over other options because I felt it allowed me to customise my map more – I could colour in different countries and introduce different levels of interactivity within the map.

Step 4: Choose your design

My design choices were partly shaped by wanting to keep my map easily readable, using block colours and simple labels, and also to keep my map customisation as simple as possible since this was my first mapping exercise. I also wanted the countries in question to stand out quite clearly.

By introducing dots in different colours for new individuals these volunteers train in their own countries, over the course of 2 years, for example, this would show how much of a geographical “spread” the training from Nov ’13 had. It would also help distinguish between volunteers with different levels of training. For example, as time goes on and individuals complete GFP programmes and further training, it is possible to change the colour of the dots representing those who were trained at the original Camp to red, demonstrating their status as a GFP “Pioneer.” Any new volunteers they train can be represented in “blue.” The idea is therefore to improve this map and maintain it over a period of time to represent these changes.

Filling out more details in the second click feature can provide relevant information about each individual – what they’ve done in the past and what programmes they are working on now, for Generations For Peace.

Takeaways:

Basic mapping software can actually be quite accessible, even with very little technical training. However, there’s definitely something of a “glass ceiling” in its use, after which more technical expertise is required. Overall, Mapping for International Development was a really great course, and I’ve already recommended it to others! This online course covers debates in the field in some depth, but also focuses on mapping tools in the field in enough detail to have a platform to build on afterwards.

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Are you new to digital mapping as well? Would your work benefit from geographically visualising projects and impact? Register now for our online course on Mapping for International Development.