Chronic Care Programmatic Training

ABOUT THE COURSE

Chronic Care Programmatic Training is a fully online, two-week course whose overall objective is to increase the competencies of project managers in the provision of quality programmatic management of patients with chronic diseases within a resource-limited context. 


TARGET AUDIENCE

  • This is the first time this course is being run so it is a pilot, exclusively for PMRs, deputy medcos and medcos in projects managing chronic diseases.   
  • This is a programmatic not a clinical course, so the focus is up-skilling participants in project management not clinical care. This includes projects dealing with adults, adolescents and children with any chronic disease, or any condition requiring repeated follow-up (eg HIV, TB, NCDs, mental health, the provision of contraceptive service, sickle cell disease).
  • English fluency is essential (at least level B2 according to the standard language fluency guide).
  • Following receipt of applications there will be a careful selection process, choosing those best suited to this course.


DURATION

This course runs over two full working weeks during which the afternoons are spent studying prepared material in preparation for online live sessions for three hours the following morning. Participants will also be expected to complete a workplace assignment in the six weeks following the course. 


LEARNING OUTCOMES

Module 1: Landscape analysis

  1. Explain the specifics needed for chronic care versus acute care 
  2. Outline the current global targets and key international policies, guidelines and recommendations for Chronic Diseases prevention and treatment
  3. Explain the principles behind MSF Key priorities for Chronic Disease, stipulated in the action plan 2023-2025

Module 2: Patient centred care and exit strategies activities in programmes with diverse operational priorities 

  1. Explain what is patient-centred care? 
  2. Explain the importance and challenges of providing patient centred care for one or more chronic disease in programmes with diverse operational priorities  
  3. Describe the process of introducing and managing patient centred chronic disease activities in programmes with diverse operational priorities in partnership with existing stakeholders  
  4. Reflect on key components and main limitations of MSF handover strategies for chronic diseases 

Module 3: Cascade Analysis and organization of services

  1. Explain the concept of cascade analysis
  2. Identify components of the cascade generic to all chronic diseases
  3. Identify challenges/barriers in the implementation of these cascades
  4. Describe the steps in the patient flow 
  5. Describe the importance of task shifting and task sharing in the delivery of chronic care       
  6. Identify the need and list the steps of an appointment and lost to follow up tracing systems based on priorities and resources
  7. Design a follow-up schedule for chronic patients, including clinical, refill visits, counselling and laboratory

Module 4: Entry into care: Screening, Linkage, Prevention and Treatment 

  1. Explain the existing entry into care strategies for chronic diseases in the health facilities and in the community 
  2. List the hard-to-reach populations for entry into care for each chronic disease and explain why.  
  3. Describe the essential enablers of the HC system to facilitate entry into care and explain the challenges in trying to implement it 
  4. List the main preventive strategies for chronic diseases and their main programmatic challenges 

Module 5: Differentiated service delivery (DSD) for chronic disease 

  1. Assess the need for differentiated service delivery (DSD) for chronic disease in their settings   
  2. List the key enablers for differentiated service delivery 
  3. Use the elements and building blocks to design a model of differentiated service delivery for chronic disease 
  4. Use standard operating procedures to implement the four WHO-defined DSD models for clients established on chronic disease medication  
  5. Adapt the four standard DSD models for specific populations (e.g children and adolescents, pregnant and breastfeeding women, key populations)  

Module 6: Referral pathways for chronic disease 

  1. Ensure clinical systems are in place for the effective identification of complicated disease: 
  2. Analyse the gaps in the health systems that allow complications to develop 
  3. Choose referral destinations that are appropriate for the patient and his/her community 
  4. Ensure effective communication in the referral process between the patients, their community and the health system 
  5. Effectively analyse the impact of the referral process

Module 7: Adapting services for provision of Chronic Care to specific population groups 

  1. Describe the definition and scope of Specific Populations 
  2. Identify and analyze specific populations barriers and root causes to accessing care for chronic diseases within specific patient groups 
  3. Identify of strategies for Overcoming Barriers 
  4. Describe how to design Care Delivery Models for and with specific populations groups

Module 8: Understanding PSEC/HP in CC 

  1. Explain what PSEC/HP actually means and how it applies to Chronic Care programmes  
  2. Identify the PSEC/HP components in the Chronic Care cascade of care (at health facility and community level)  
  3. Explain the roles of different staff in PSEC/HP, adapted to the different scenarios 
  4. Identify challenges/enablers to support or work with patients' family/caregivers and communities 

Module 9: Monitoring and evaluation through the whole Project Cycle 

  1. Describe why we monitor and evaluate programs from the entry up to the exit phase  
  2. Define a “cohort” and explain approaches to monitoring for chronic care  
  3. Select the indicators from the standard indicator list and targets (based on project activities and context)  
  4. Ensure Quality of Care indicators as a core component of their Monitoring and Evaluation System 
  5. Explain how to collect information in a systematic way (what to collect, how, who, where) 
  6. Critically analyse, appraise and interpret data for the purposes of routine reporting  
  7. List main principles of data protection 

 Module 10: Advocacy and Operational Research  

  1. Describe the role of MSF towards chronic care advocacy,  including the importance of operational research, Access Campaign and community involvement  
  2. Choose the most appropriate advocacy strategy within the global and local context  
  3. Apply stakeholder mapping for identifying allies in function of advocacy priorities 
  4. Describe communication tactics to achieve your advocacy aims 
  5. Develop an advocacy strategy with the above information 


LIST OF CONTENTS

The following topics will be covered

  • Landscape analysis
  • Chronic care in programmes with diverse operational priorities
  • Cascade of care analysis and organization of services
  • Entry into care, screening, linkage, prevention and treatment
  • Differentiated models of care for patients established on treatment
  • Referral pathways for chronic disease
  • Adapting services for provision of chronic care to specific population groups
  • Understanding patient support, counselling and health promotion in chronic care
  • Monitoring and evaluation through the whole project cycle
  • Advocacy and Operational Research

 

METHODOLOGY

  • The two full weeks of daily activities consists of a three-hour morning session, working in facilitated small groups or plenary sessions, practising the application of what has been learnt in the preparatory reading. The afternoons are dedicated to doing this essential preparatory study for the following day and, sometimes, includes assignments following the morning’s activities.  
  • Participants have the opportunity to interact with experts in the field of programmatic care for chronic diseases and to do hands-on learning while practising on real-life case scenarios from a variety of MSF settings
  • Interactive methodologies, case history reviews, group and individual work, the group as a peer-to-peer source of learning and the presenters as learning facilitators are all considered important pillars in the learning methodologies for this course.
  • The completion of the workplace assignment is an essential component of the learning methodology, taking the learning during the course directly into each participant’s workplace
  • Additional post-course continuation of learning will be facilitated via the development of communities of practice of course graduates. 


EVALUATION

There is no formal evaluation apart from feedback on the assignment submitted within six weeks of the end of the two-week course.


CERTIFICATION

To receive a badge and a certificate, participants are required to study all the course material, attend all the live online sessions and, within six weeks of completion of the course, complete and submit an assignment which will be graded by the course tutor.


REQUIREMENTS/PRE-REQUISITES

The participant must be in a job profile within the target audience as noted above. Participants must, with few exceptions be currently working in or on their way to work in an MSF project in which there is management of one or more chronic diseases.


ENROLMENT

Enrolment is only on provision of personalised access to the course after selection through the usual application and selection channels (pool managers/HRCOs, etc.).  


RELEASE & UPDATE

The course will be run for the first time from 30 October to 10 November 2023.


VALIDATION

This is an intersectional course validated for MSF staff in all the OCs in the above-mentioned target group.


TECHNICAL CONSIDERATIONS

Pre-requisites for enrolment on this course are the following:

  • It must be conducted on a laptop not a tablet or cell phone.
  • There must be sufficient internet connection to allow both audio and video connection throughout the live sessions.