Capacity Building for frontline Health workers,
Laboratories and broad diagnostic strengthening,
Institutional strengthening…
CCCRN has played significant roles in strengthening human resources within the health sector in Nigeria. Our approach ensures cadre to cadre training and mentorship with extensive supportive supervision. Beyond technical assistance offered on CCCRN care and treatment projects, the organization has received dedicated funding for human resource capacity development through CDC funded cooperative agreements – 1U2GGH000946 and 1U2GGH000916.
The Centers for Disease Control and Prevention in 2012 awarded CCCRN a cooperative agreement (1U2GGH000946) to strengthen regulatory agencies and pre service training institutions to review curricula and train health workers on management of HIV and related infections. The outcomes were improved training environment in 13 Pre-service institutions (Schools of Nursing, Colleges of Health Technology and University of Nigeria Nsukka) in Imo, Ebonyi and Enugu States; and enhanced capacity of the medical tutors through TOT and longitudinal mentoring. Over 3,000 pre-service graduated from these institutions with enhanced skills to support HIV epidemic control.
The Partnership for Medical Education and Training project (1U2GGH000916) was awarded in 2012 as a five-year award to institutionalize in-service trainings for HIV management in Nigerian tertiary health facilities. Through the award, CCCRN established thirteen (13) training centers in tertiary health facilities located in Federal Capital Territory, Gombe, Nassarawa, Benue, Ekiti, Lagos Enugu, Imo, Ebonyi, Rivers, Akwa Ibom, Cross Rivers, Kaduna states. The strategy serves the purpose of integrating HIV trainings within existing service delivery structures, minimizing costs of space or facilitators, while strengthening human capacity and infrastructure at these institutions. Engagement of trainers within these institutions enables trainings to be conducted by a stable work force of experience hands that derive their remuneration from the Government. While more than 130 national trainers have been included into the pool of trainers, over 8,600 health care workers have received in-service trainings in Adult ART, Pediatric ART, PMTCT, HCT, TB/HIV and other trainings in Infectious diseases.
As an accredited CME provider with the Medical and Dental Council of Nigeria, CCCRN provides regular update opportunities for medical professionals in all the states of our work through private funds or funded through our partnerships with AbbVie, National Agency for Control of AIDS and the World Bank.
CCCRN has supported a vast network of laboratories, strengthening their capacity for multiple diagnostic and patient monitoring platforms. Our team includes equipment maintenance experts, Quality experts, ASLM trained professionals and SLMTANs.
Under the SEEDS project, CCCRN supported 48 clinical laboratories for CD4, Chemistry and Hematology platforms, 8 GeneXpert platforms and 2 molecular PCR laboratories in University of Nigeria Teaching Hospital and Annunciation Hospital Enugu. Through a bike rider sample referral mechanism, the project ensured an efficient networking of satellite sites to nodal laboratories for analysis of patient samples.
CCCRN provides technical assistance for Quality assurance for tests through multiple strategies and support accreditation for eligible laboratories.
Our partnership framework includes several sub grantees, service delivery facilities and the host governments. We have developed an efficient engagement structure that enhances their technical, programmatic and finance processes for program implementation, monitoring and evaluation through capacity building and mentoring.
These platforms include monthly reporting and feedback processes, quarterly review meetings, quarterly technical assistance and structured knowledge management sessions. Under the separate prime Awards, CCCRN has sub-granted organizations that includes Christian Health Association of Nigeria, Solina Health, Excellence and Friends Management Consult and several CBOs with distinct scope of work in focus states.
Technology Applications for Strategic Information,
Monitoring and Evaluation,
Quality Improvement.
Through its capacity building awards, CCCRN has established a web based platform to provide virtual capacity building opportunities for health care work force. It provides additional learning resource other than those covered in the conventional training sessions. A training database has also been developed to capture information on trainees and their capacity building efforts. In the future, this will be expanded to link trained health workers to facility GIS coordinates and will provide visual and enhanced information for health workforce distribution for decisions on recruitment, deployment or redeployment of trained health workers.
Vaccine Management,
Tuberculosis and Antiretroviral commodity Management,
Maturity Moadel Assessment,
Product and Supply Management Technical Working Group (PSM TWG),
Pharmacovigilance and Adverse Drug Reaction Reporting
Through funding from UNICEF, in collaboration with NPHCDA and other stakeholders, Centre for Clinical Care and Clinical Research (CCCRN) conducted an independent physical stock count and audit of vaccines and devices in all the functional Cold & Dry stores in Abia, Anambra, Ebonyi, Enugu and Imo states. The exercise was conducted in the Zonal cold store, State and Local Government Cold and dry stores (SCS) across the 5 states and 926 Health facilities. The activity included training of field enumerators and Cluster Supervisor on inventory management for cold chain commodities in accordance with the time lines stipulated by the National Logistics Working Group (NLWG).
The project provided evidence for forecasting requirements at National, Zonal, State LGA and Facility disaggregated by programmatic areas for 2020.
CCCRN played a pivotal role in the establishment of PSM TWG and Logistics Management Coordinating Unit (LMCU) in many states, focused on capacity building and increasing supply chain ownership by State governments.
CCCRN supported these states in development of PSM TWG and LMCU TOR, developing integrated monitoring and supportive supervisory visits (iMSVs) checklist and conducting iMSV in health facilities to ensure smooth implementation of supply chain activities; address supply chain bottle necks at the state level Program level and ensure commodity security in the States by facilitate inter-IP commodity transfers.
As a drive towards continuous improvement, the Pharmacy and Supply Chain Management Unit periodically performs end-to-end supply chain self-diagnosis of their operations using the Global Health Maturity Model Assessment Tool to assess supply chain needs. This is done in collaboration with Association for Supply Chain Management (ASCM) through funding from Bill and Melinda Gates Foundation.
This tool highlights the most problematic constraint or weakest link to achieving supply-chain goals. Therefore, focusing efforts on; and removing this weakest link is a fast and effective way to improve performance.
CCCRN places high importance on Pharmacovigilance by promoting regular screening of patients for adverse drug reactions (ADRs) and ensuring proper monitoring, management, documentation and reporting of all identified adverse drug reactions.
Clinicians, Pharmacy focal persons and adherence counsellors are routinely trained and mentored onsite on ADR screening, monitoring and reporting. We deployed ADR monitoring tools (adverse drug reaction screening forms and Pharmacovigilance yellow forms) across all supported facilities to ensure proper documentation of ADRs.
All newly initiated patients on ART or INH and patients transitioned to the new molecules (TLD, LPV/r pellets and ABC/3TC) are particularly monitored for ADRs.
To further to strengthen the process of monitoring of ADRs, CCCRN provide technical support and facilitates bimonthly Pharmacovigilance meeting in all the facilities.
HIV Testing and Counseling,
HIV Care and Treatment,
Orphans and Vulnerable Children’s(OVC) Program,
Tuberculosis Care
CCCRN has strengthened hospital and community structures to implement standardized testing protocols for HIV testing and counseling. Our approach bundles HIV tests with prevention packages and are culturally delivered with sensitivity that improves/encourages uptake, particularly for people at high risk of HIV infection and key populations.
CCCRN has counseled and tested over 10 million Nigerians through a mix of facility and community level testing services. Our collaboration with churches and congregational settings under the Healthy Beginning Initiatives Baby Shower project has resulted in an unprecedented acceptance for partner testing in PMTCT settings. CCCRN has provided testing services to hard to reach populations such as key populations, homeless persons and nomadic herdsmen. CCCRN applies quality assurance protocols that guarantee the integrity of testing and counseling services and results.
Applying the use of Dried Tube Samples for proficiency testing, all testing points are periodically assessed for proficiency and required corrective actions.
From 2010 till date, CCCRN has implemented large comprehensive HIV care and treatment projects (CDC/CHAN-CHARIS Project: 2010–2012; CDC/SEEDS project 2012-2017; CDC/APIN iCARES project: 2017-2022) in Plateau, Kano, Enugu, Ebonyi Imo and Benue States. These projects built strategic partnerships with Nigerian health institutions and communities in implementing and evaluating HIV/AIDS prevention, and care and treatment programs.
The project strengthened over 800 health facilities that include a mix of tertiary, secondary and primary health facilities and included government, private and faith-based institutions. Through these facilities, CCCRN provided comprehensive care and treatment services to over 100,000 HIV-infected patients and their family members.
Services are designed to be client focused and delivered to meet the needs of different sub populations including key populations and most at risk populations.
CCCRN has strengthened capacity of local community based organizations to provide comprehensive OVC services in six states (Imo, Ebonyi, Enugu, Cross River, Akwa Ibom and Benue State) to more than 380,000 orphans and vulnerable children and 54,000 households many of whom have been graduated from the program.
Through the USAID ICHSSA award, the program has recorded several notable success stories in household economic strengthening as a sustainable means of comprehensive OVC service delivery, collaboration with State and local government to deliver basic services and detect and respond to child rights violations; and Collaboration with ccommunities to promote child and family friendly, gender and HIV sensitive cultural norms and practices
CCCRN has developed and implemented innovative approaches to increase TB case detection among itinerant Fulani in Kwara and Niger State using community volunteers through a WHO TB REACH grant in 2014. The project screened 50,000 nomadic herdsmen for Tuberculosis and helped build community structures for sustainable screening and referral of active TB cases using modified clinical tools and mobile technology. The project utilized mHealth solutions for reportage, identification and care continuity. The innovations and capacity were transferred to the host government through the National TB program to ensure sustainability.
Through a sub award from KNCV, Center for Clinical Care and Clinical Research (CCCRN) has started implementing a 5 year USAID funded TB LON on April 2020, for TB control in Anambra, Delta and Imo States. The project will improve access to high quality person-centered, TB, DR-TB and TB/HIV services and reduce TB transmission through private sector partnership.
Grants Management Capacity
Research Capacity
Disease Surveillance and Notification
CCCRN has implemented clinical and operational research activities funded through CDC, NIH, Clinton Health Access Initiatives, GEANCO and other private streams. These include Adolescent Coordinated Transition study to Improve Health Outcomes among Nigerian HIV Youth, (NIH 1R01HD089871-01), Tuberculosis prevalence survey among HIV infected clients in South East Nigeria (CDC 5U2GGH00868-5), In-service Training Impact Evaluation study (I-TIE) to assess impact of in-service training on work practices in Nigeria (5U2GGH000916-04), Building and Strengthening Infection Control Strategies to Prevent Tuberculosis in Health facilities in South East Nigeria (CDC 5U2GGH00868-03) and Intervention for Sustained Testing and Retention (iSTAR) Among HIV-infected Patients (NIH 1R01HD087994-01), among others.
These studies have contributed to a better understanding of infectious disease burden and strategies to address them in resource limited settings.
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