Blended Clinical Training (BCT) Improving Quality of HIV Diagnostics and Treatment Services July 2018 to March 2021 : Supported by Global Fund 5 March, 2019 : CCM Meeting, New Delhi

What is Blended Training It is an approach to training that combines traditional place-based classroom trainings with access to online educational materials. It also provides opportunities for continued interaction with the participants. It also involves field visits to various facilities for onsite learnings. Why Blended Training Targets to train : 8000+ doctors (1200 ART Mos, 1620 ARTC specialists, 1108 LAC MOs, 4400 ICTC MOs) by next year. Traditional place-based trainings ideal but may not practical as : ♦ guidelines revised recently ♦ staff to be trained quickly ♦ extremely limited resources

Why Blended Training Traditional ART MO induction training of 12 days - not done in recent past due to reasons such as funding constraints high turnover of MOs (more frequent trainings needed) shrinking pool of trained resource persons (inadequate to meet the training requirements) disruption of patient care at the ART centers for 12 days (esp. in high load ARTC, single MO ARTC). Well balanced blended training package gives an opportunity to utilize newer modalities of the trainings without compromising expected training outcomes On-line training platform : interactive knowledge-based sessions (MOs can learn while working at ARTC) Class-room training : can focus on practice and attitude of trainees

GOAL OBJECTIVES Supporting NACP - building capacities and skills - ICTC, ART, Lab Services - staff Enable accurate diagnosis, high quality care and treatment of PLHIV Ensure quality documentation and reporting of services Develop content - compliant with national technical and operational guidelines Build knowledge and skills - participatory adult learning pedagogies Institutionalise mechanisms – Knowledge management Learning needs assessment Training scheduling and delivery Tracking participant progress & refresher/mentorship needs Build practice-related competencies - providing stigma-free and high quality HIV services Build competencies - quality documentation and reporting - centralized information systems Develop content that is compliant with national technical and operational guidelines, and build knowledge and skills through participatory adult learning pedagogies Institutionalise mechanisms for knowledge management, learning needs assessment, training scheduling and delivery, and tracking participant progress and refresher/mentorship needs Build practice-related competencies for providing stigma-free and high quality HIV services in the prevention to-care continuum Build competencies needed for quality documentation and reporting to centralized information systems

Blended Clinical Training An e-learning platform - self-paced learning (Needs assessment, Induction, refresher, regular updates) HR information (Learning Information system –Staff of ICTC/ART/LS, trainings, trainees, learning assessment scores, staff turnover) A repository of learning materials and guidelines Communities of Practice (CoP)(e- forum for cross learning and bulletin board) Offline Training (classroom based) Online Training through the Learning Management System (LMS) Blended Clinical Training ♦ TOTs ♦ Induction ♦ Supportive Monitoring Visit / Onsite mentoring (SMV) ♦ Refresher** ** as per requirement and budget availability

Mentoring : Certification : CME credits On-site Mentoring : Supporting Monitoring Visits (SMV) 2% of all trainees assess post-training practices offer support as needed identify additional points for inclusion in future trainings CME credits Extension of learning to private sector HIV physicians and certification SMT will be trained by senior experts, then SMT will travel round the country to train the other MTs On-site Mentoring : Through Supporting Monitoring Visits (SMV), to 2% of all trainees, to assess post-training practices, offer support as needed, and identify additional points to be included into future trainings Certification of all trainers and trainees as part of the programme/ CME credits Extension of learning to private sector HIV physicians and certification

Number and Type of Trainees ~ 16034 (approx.) Type of Facilities SA-ICTC LAC ARTC SRL NRL # of Facilities 5500 1108 540 117 13 Type of Trainees Doctors Nurse (ARTC) Lab Services Total # of Trainees 8328 1200 6506 16034 DOCTORS : 8328 MO ARTC : 1200 MO LAC : 1108 MO SA-ICTC : 4400 ART Specialist : 1620 ** ART Specialist include : 1 Nodal Officer, 1 Lab In-Charge, 1 Pediatrician, 1 Gynecologist / surgeon (3 to 4 staff per ARTC) LAB SERVICES STAFF : 6506 Lab Technicians (LT) : 6116 ARTC : 540 SA-ICTC : 5500 Viral Load and EID : 76 SRL/NRL LT and TO : 260 SRL/NRL In-charge : 130 (virtual training)

Module Development Process NACO to finalize training curriculum NACO has set up TWG TWG : 2 sub-committees Sub-committee 1 CoE / PCoE, CST, BSD, technical experts Finalize content for doctors and nurses Sub-Committee 2 LS division, and technical experts Finalize content for Lab services staff TWG to finalize content, content delivery methodology (online / offline) for each modules for each cadre Making training modules LMS friendly uploading same on LMS Uploading all modules (offline and online) in the repository section of the LMS Printing of the classroom modules and handouts

Senior Master Trainer (SMT) & Master Trainer (MT) SMT : 2-days workshops at central location SMT-Doctors : 30 people, March 2019 SMT-LT : 10 people, held on 12-13 Feb 2019, at Nagpur MT (4-days workshops / batch, 4 to 5 batches across India) MT-Doctors : 100 people, April 2019 MT-LT : 100 people, March 2019 MT - PLHIV : 30 people, ToT in March / April 2019 SMT will be trained by senior experts, then SMT will travel round the country to train the other MTs On-site Mentoring : Through Supporting Monitoring Visits (SMV), to 2% of all trainees, to assess post-training practices, offer support as needed, and identify additional points to be included into future trainings Certification of all trainers and trainees as part of the programme/ CME credits Extension of learning to private sector HIV physicians and certification Certification of all trainers and trainees

5 Regions : Training Locations States/UTs Locations * South Region Telangana, Andhra Pradesh, Karnataka, Kerala, Puducherry, Lakshadeep, Tamil Nadu, Andaman & Nicobar Hyderabad, Vijayawada, Bangalore, North Karnataka, Trivandrum, Chennai, Salem  West Region Dadra & Nagar Haveli, Daman & Diu, Gujarat, Goa, Maharashtra, Chhattisgarh, Madhya Pradesh Ahmedabad, Mumbai, Nagpur, Bhopal North Region Jammu & Kashmir, Himachal Pradesh, Chandigarh, Haryana, Punjab, Uttara khand, Uttar Pradesh, Delhi, Rajasthan Chandigarh, Delhi, Lucknow, Benaras East Region Bihar, West Bengal, Odisha, Jharkhand Kolkata, Bhubaneswar   North-East Region Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Assam, Tripura, Arunachal Pradesh Imphal, Guwahati  * As per location of the CoE, PCoE, RTC, and reference labs Average 28 batches per region (range 21-34 batches)

Implementation Arrangements NACO SACS, CoEs / PCoEs, NRL, SRL National Team and Help Desk Technical Partner : K-Nomics 20 Regional Units (10 in existing CoEs/PCoEs, and 10 in DAPCU / other government facilities SAATHII REGIONAL TEAM (37) ♦ Training Manager (TM) (regional) (19 positions) Hyderabad, Vijayawada, Bangalore, North Karnataka, Trivandrum, Chennai, Salem, Ahmedabad, Mumbai, Nagpur, Chandigarh, Delhi, Lucknow, Benaras, Bhopal, Kolkata, Bhubaneswar, Imphal, Guwahati ♦ Regional Admin & Finance Officer (RAFO) (18 positions) SAATHII NATIONAL TEAM (11) ♦ Senior Technical Manager (STM) ♦ Senior Program Manager (SPM) ♦ Senior M&E Manager (SMM) ♦ Help Desk Coordinator (HDC) ♦ ICT Manager (ICTM) ♦ Technical Consultants ♦ Other admin, finance, M&E staff (4)

Expectations and Next Steps BCT project staff : visit to CoE, PCoE, RTC : assess requirements Support from CoE, PCoE : selecting suitable training venues LMS friendly content Formation of Pilot batch : UAT of LMS by pilot batch LMS – GoLIVE – End March 2019 LS MT workshops : 4 batches across country : March-April 2019 Doctors SMT workshop : March 2019 Doctors MT workshop : April 2019 Training to start : May 2019 NACO to send formal intimation to all SACS, CoE, PCoE, SRL, NRL, RTC, SACS to give ARTC, SA- ICTC, LAC staff details and past training status to SAATHII For CoE - Around 40K for assets, and 11K monthly recurring costs, for RTC - Around 40K for assets, and 7K monthly recurring costs. Recurring costs till Dec 2020. If any additional funds needed, the budget can be adjusted based on project savings.

Thank You

Additional Points

Training Batches and Regional Teams States / UTs ICTC MO LAC MO ART MO ART Specialists ART Nurses LT* LT (VL) Total # TM RAF O Location South Region TS 5 6 2 8   25 1 Hyderabad AP 3 4 10 26 Vijawada KA 12 21 48 Blore, Mysru KL 7 Trivandrum, Chennai, Salem PY TN 31 68 AN West Region DN Ahmedabad DD GJ 9 28 GA Mmbi, Ngpr MH 16 * (SA-ICTC, NRL/SRL, ARTC)

Training Batches and Regional Teams States / UTs ICTC MO LAC MO ART MO ART Specialists ART Nurses LT* LT (VL) Total # TM RAF O Location North CH 1   4 Chandigarh HR 3 2 8 PB 5 13 HP JK DL 10 Delhi RJ 19 * (SA-ICTC, NRL/SRL, ARTC) Central UK 1 2   4 Lucknow UP 12 3 15 38 BR 7 8 19 CG 11 Bhopal

Training Batches and Regional Teams States / UTs ICTC MO LAC MO ART MO ART Specialists ART Nurses LT LT (VL) Tota l # TM RAF O Location East Region WB 9 1 2 12 27 Kolkata OD 7 8   19 Bhubane swar JH 6 North- East Region MN 3 14 Imphal ML MZ 4 NL SK Guwahat i AS 10 TR AR Grand Total 147 37 40 54 211 535 18  * (SA-ICTC, NRL/SRL, ARTC)