Effects of the ECHO tele-mentoring program on HIV/TB service delivery in health facilities in Zambia: a mixed-methods, retrospective program evaluation.

Background: In the quest to ensure that quality healthcare is provided to all citizens through building healthcare worker capacity and extending reach for expert services, Zambia's Ministry of Health (MoH) in collaboration with its partners PEPFAR through the CDC and HRSA, began to implement the Extension for Community Healthcare Outcomes (ECHO) tele-mentoring program across the country through the Health Workers for the 21st Century (HW21) Project and University Teaching Hospital HIV/AIDS Project (UTH-HAP). This ECHO tele-mentoring approach was deemed pivotal in helping to improve the human immunodeficiency virus (HIV) service delivery capacity of health care workers.

Method: The study used a mixed method, retrospective program evaluation to examine ECHO participants' performance in the management of HIV/AIDS patients in all the 10 provinces of Zambia.

Case Study: Using Task Analysis to Determine the Status of Education and Practice of Medical Licentiates for the Provision of Anesthesia in Zambia.

Task analysis methodology was used to identify gaps in the education and practice of Medical Licentiates, a cadre of primary care health providers in Zambia, related to the provision of anesthesia. Findings of the analysis indicate that Medical Licentiates who work in facilities where there are no fully qualified anesthesiologists or physicians often feel obligated to provide these services in order to save lives although they lack sufficient formal education or clinical practice opportunities. The government translated the findings into immediate modifications to the education, training and practice of anesthetic tasks by Medical Licentiates by developing an elective course within the pre-service education program and upgrading the certification of Medical Licentiates to a bachelor's degree.