PIH to Support COVID-19 Response Across U.S.

PIH launched a new initiative, the U.S. Public Health Accompaniment Unit.

Posted on May 13, 2020

Angelique Nyiragashikazi (left), lab manager at PIH-supported Kirehe District Hospital in eastern Rwanda, explains a poster showing her lab's accreditation process to Dr. Anatole Manzi, PIH's deputy chief medical officer and lead for the Learning Collaborative within PIH's U.S. Public Health Accompaniment Unit. Photos by Zack DeClerck / Partners In Health

Despite its vast clinical infrastructure, the United States’ struggle to respond to COVID-19 has exposed weaknesses in the public health system, which are proving to be particularly devastating for vulnerable populations. For the past three decades, Partners In Health (PIH) has been at the forefront of global health interventions in the most resource-poor settings around the world, including widespread response to epidemics such as HIV, tuberculosis, cholera, and Ebola.

When the novel coronavirus pandemic swept the globe in early 2020, PIH was asked by the Commonwealth of Massachusetts to mount an unprecedented contact tracing initiative to help local boards of health cope with the expected surge of positive cases of COVID-19, the resulting disease.

PIH recognized the opportunity to share its decades-long and unique expertise with many U.S. partners, who are desperately struggling to implement complex interventions such as contact tracing not only to flatten but to shrink the curve of the virus, help protect communities and health care workers, and return to normal life.

A Vision For the Future

Since its very beginning, PIH has brought the benefits of modern clinical expertise to the most resource-poor settings around the world. Over the years, PIH has built, in close partnership with local ministries of health, a vast and unique experience implementing nimble and effective public health interventions.

PIH leaders have always known that such experience could be valuable to many other governments across the globe, including resource-rich nations like the U.S. The replication of those hard-earned lessons at the global level is the ultimate step in PIH’s theory of change, which is built on the integration of direct provision of care, rigorous research, and professional training.

This moment is a perfect opportunity to shift the paradigm of global public health towards an inclusive and equitable redistribution of health resources.

And that is why PIH is launching the U.S. Public Health Accompaniment Unit, which will engage U.S. government agencies, local jurisdictions, and their implementing partners with two interrelated components: 1) direct technical advisory services and 2) a newly formed Learning Collaborative.

Technical Advisory Services

Dozens of states and cities have requested PIH’s advisory services to strengthen contact tracing efforts as part of their public health response to the pandemic. PIH is beginning its advisory work in Newark, N.J., and the states of Ohio, and North Carolina, and is in discussions with a second cohort of sites.

What type of technical advisory can partners expect to receive?

The scope and intensity of technical advisory varies according to partners’ needs. PIH services will vary from cross-cutting response design to specific workstream advising and implementation accompaniment. The learning collaborative will unite a broad ecosystem of PIH partners and other stakeholders, providing trainings, webinars, videos, quality improvement projects, discussion forums, and peer-to-peer learning opportunities to accelerate effective COVID-19 response.

Track 1: Technical advisory services

PIH will advise partners on select aspects of their approach, as needed. PIH is currently assisting several states and municipalities with strong commands of the fundamentals of contact tracing and/or focused on relatively small communities, seeking higher-level or one-off advising.

Track 2: Comprehensive implementation accompaniment

PIH will embed small teams of advisers for two to four months to co-create their contact tracing program and help design broader COVID response efforts. PIH leaders will advise partners on all aspects of the approach: community partner identification; communication strategy; effective information flow between state and local departments of health; identification and engagement of key stakeholders; contact tracing workflow, team structure, and supervision structure; scripts and protocols for investigation, tracing, and social support; technology and data use considerations; and the identification of social support needs for individuals in quarantine.

Learning Collaborative

The Learning Collaborative is an open partnership between PIH and U.S. public health entities aimed at sharing lessons, developing custom frameworks, and rapidly mounting contact tracing efforts and effective public health responses to fight the COVID-19 pandemic, focusing on the needs of the most vulnerable. PIH hopes that the Learning Collaborative will evolve into a vibrant cadre of global health allies with the common goal of strengthening local health systems and shaping inclusive health policies.

Tier 1: Open-source codified approach
Partners will have access to the Learning Collaborative’s online toolkit, so they can develop, rapidly share, and utilize best practices in contact tracing and the design of a broader COVID public health response. The toolkit is accessible by all public entities wishing to make use of these insights as they design their own programs.

Tier 2: Engagement in a deep dive learning community
Periodic learning sessions will gather all members of the collaborative to share best practices and essential tools for effective contact tracing and overall response to Covid-19. Following each learning session, Partners In Health’s experts will provide an intensive and ongoing support through real-time feedback and coaching to members of the collaborative. A set of best practices will be developed and shared with all members of the collaborative who will adapt and apply them in their own settings.

Over the next year, PIH aspires to expand this initial U.S.-based, COVID-focused learning community. Lessons learned from the U.S. and global members of the collaborative will be critical for future epidemic prevention and control. Individual members of the collaborative will form a cadre of leaders not only for contact tracing, but also for holistic response to pandemics. PIH envisions sustaining this workforce through a structured community of practice for emergency preparedness and response. The alumni will constitute a structure community of practice for emergency preparedness and response. The alumni will constitute a reserve force capable of responding to COVID-19 and other pandemics.

Dr. Joia Mukherjee at State House announcement on contact tracing in MA — Dr. Joia Mukherjee, PIH's chief medical officer and lead on the new U.S. Public Health Accompaniment Unit, at the announcement in early April of PIH's collaboration with Mass. Gov. Charlie Baker (background) in statewide contact tracing efforts.

PIH's Unique Approach to Contact Tracing

The PIH mission is centered around a preferential option in health care for the most vulnerable communities. The organization's philosophy has been forged by numerous collaborative partnerships, social medicine principles, and an uncompromising appetite for radically bold interventions often deemed unattainable by many organizations.

Rich with lived experiences and research-proven interventions acquired over many years, and thanks to strong partnerships with renowned academic and medical institutions such as Harvard Medical School, Brigham and Women’s Hospital, and the University of Global Health Equity (UGHE), PIH is uniquely positioned to steward a progressive approach to public health—an approach anchored in the belief that every life holds equal value, and that community-based partnerships are the key to cure long-standing health inequities.

PIH's distinctive approach to contact tracing includes:

Ownership by the public sector
Focus on the most vulnerable and connecting communities to social support systems
Pairing human connection with technology

How to Get Involved in PIH's U.S. Public Health Accompaniment Unit

consulting on an eye care appointment in Sierra Leone during the Ebola epidemic — Katie Bollbach (center), director of the U.S. Public Health Accompaniment Unit, helped establish West African operations in Sierra Leone during the Ebola epidemic and, here, visits an eye care program for survivors.

Apply for assistance

U.S. partners seeking technical advisory for their COVID-19 response or interested in becoming members of the Learning Collaborative can send a request by filling out this application form. A member of our team will be in contact in a timely manner to set up a preliminary meeting to assess needs.

Partners who are not yet ready to apply and have general questions about the Learning Collaborative can send an email to TAinfo@pih.org. For more detailed information, visit the U.S. Public Health Accompaniment Unit and read our Frequently Asked Questions. Read our Terms and Conditions.

Donate

The initial seed investment for the U.S. Public Health Accompaniment Unit was provided by The Audacious Project in April 2020. This funding will allow PIH to accompany select U.S. public health partners for the first 12 months. To fully implement a sustainable vision and expand the scope of the partnership, PIH seeks additional funding partners. For more information about how to support this initiative, please contact TAdevo@pih.org.

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