EXTENSION FOR COMMUNITY HEALTH OUTCOMES (ECHO)

PROJECT DURATION

February 2021 to February 2023

STATEMENT OF PURPOSE

To increase access to specialist care countrywide by developing professional communities of learning and practice of TB care in the country.

PROJECT BACKGROUND

The Ministry of Health and Child Care through the National Tuberculosis and Leprosy Control Programme (NTP) in partnership with Africa University (AU) with funding from USAID as subaward of JSI in Zimbabwe launched the Zimbabwe TB Extension for Community Healthcare Outcomes (ECHO) project in 2020 as ECHO Phase 1. In  2021, ECHO Phase 2 was initiated. The project intends to increase access to TB specialist care countrywide by developing professional communities and networks of learning and practice of tuberculosis (TB) care in the country. To achieve this, the NTP adopted the Extension for Community Healthcare Outcomes (ECHO) project initiative in partnership with Africa University.

ECHO platform is a collaborative tool which uses aspects of telemedicine and video conferencing to address health system disparities by offering long-distance training on medical education and care management across geographic borders particularly in rural and underserved areas.

The NTP in partnership with Africa University launched the ECHO project in 2020 targeting Gweru Provincial Hospital and Thorn Grove Infectious Diseases Hospital (Phase 1). Three fruitful TB ECHO sessions were conducted in this phase.   Phase 2 was targeting all district hospitals and Kwekwe general hospital in Midlands province and three (3) polyclinics in Bulawayo metropolitan province.

Milestone activities

With the rollout of ECHO 2 as continuation of ECHO 1, the ECHO 2 selected participating sites and equipment was installed to facilitate conducting of ECHO 2 Sessions from various TB cases emanating from the selected sites.

Activity 1: Procure and install Phase 2 equipment at selected sites

Activity 2: Conduct the first batch of TB ECHO Phase 2 sessions with cases coming from Bulawayo and Midlands provinces

Activity 3:  Evaluate the quality of first Phase 2 ECHO sessions

Activity 4: Conduct the second batch of ECHO Phase 2 sessions with cases coming from Bulawayo and Midlands provinces

Activity 5: Review progress of the ECHO sessions and build a sustainable plan for national rollout in Phase 3

Key deliverables under ECHO phase 2 include the following:

  • A stakeholder engagement, before the adoption and adaptation, was conducted and an activity plan was drawn.
  • Selection of high burdened TB provinces.
  • Assessment of ICT infrastructure needs of the selected provinces
  • Purchase and distribution of the equipment.
  • Orientation meeting for cadres at national and sub-national levels.
  • Selection of the TB experts basing on areas of specialty.
  • Drafting of the curriculum (covering DSTB, DRTB, Childhood TB, Leprosy, Medicines, Laboratory, M & E).
  • Conducting ECHO sessions, thirty-two (32) sessions have been conducted to date

Anticipated outputs, outcomes, results and impacts of ECHO Phase 2

The major outcome is the increased access to specialist knowledge countrywide by developing professional communities of learning and practice of TB care in the country. This will result in Improved knowledge and capabilities of peripheral facilities through enhancing access to expert medical and public health knowledge on TB care as well as strengthened drug sensitive tuberculosis (DSTB), drug resistant tuberculosis (DRTB) & Leprosy diagnosis, management and care. Case-based learning will be enabled while promoting best practices and monitoring of outcomes.

ECHO 3 PROJECT DURATION  

April 2022– June 2023

Implementation of ECHO Phase 3

ECHO phase 3 is being rolled out to 9 sub hubs and 64 district hospitals, with all the TB cases in need of a tele-radiologist having access to tele-radiology technical assistance. ECHO 3 will also purchase equipment for the 9 sub hubs that will serve as sub hubs for coordination of ECHO activities within their respective provinces and routers for all district hospitals (75 additional spokes. ECHO phase 3 will cover the entire country and include the following topics:

Anticipated outputs, outcomes, results, and impact of ECHO Phase 3

This TCG expects the following outcomes/ results

  • The teleradiology consultant recruited; the teleradiology curriculum completed and the teleradiology services successfully added to the ECHO Program
  • ECHO platform rolled out to 9 sub hubs and 75 spokes with all the TB cases in need of a teleradiologist having access to teleradiology technical assistance.
  • TB ECHO sessions conducted weekly with cases coming from all provinces
  • The sustainability plan drafted and cases for the next phase scheduled; A study to assess improvement in staff knowledge through ECHO conducted.