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CEE: Capacity and Expertise Expansion

Capacity Building and Field Interventions

Capacity building is a multidimensional process that enhances or adds value to existing resources to promote effective, efficient, and sustainable outcomes. Capacity building efforts at the MAAETC have been successful through interventions that foster connections among providers, across care settings, and throughout the healthcare system.

Given the complex epidemiological challenges in the region, capacity building has become increasingly critical and will remain a key focus. It requires collaboration among individuals, the funding agency, and the evaluation team to establish shared goals, assess technical assistance (TA) needs, and develop tailored strategies to ensure program success.

The MAAETC’s model includes capacity building at the individual clinician level, as well as within HIV-related organizations and agencies. Interventions may be short- or long-term, depending on the need. The MAAETC continues to lead in training initiatives that support task-shifting, a strategy to expand access to services traditionally provided only by physicians. With the growing shortage of primary care physicians—especially in rural and medically underserved areas—it is essential to equip other healthcare professionals with the appropriate skills to fill the gap.

Task-shifting, long practiced in low- and middle-income countries with significant success, has demonstrated that non-physician healthcare providers can deliver care of comparable quality and often with greater economic efficiency and sustainability.

CEE: Intervention in the Field

The MAAETC provides technical assistance across all Parts of the Ryan White HIV/AIDS Program, as well as to departments of health, FQHCs, community-based organizations (CBOs), faith-based organizations (FBOs), and others. Our efforts include participation in advisory committees, convening forums, supporting grant development, facilitating continuous quality improvement (CQI), and resolving complex policy and practice issues across the region.

Our activities are guided by ongoing collaboration with HRSA to further enhance these efforts. Our extensive community linkages and regular needs assessments ensure that TA is responsive to emerging issues. Follow-up data from previous interventions have been documented and published.

We continue to offer both onsite and distance-based TA to connect regional providers with clinical experts and the National Clinician Consultation Center (NCCC) to support capacity building. While the COVID-19 pandemic necessitated a shift to remote interventions, in-person support remains essential. We have implemented small-group, targeted interventions for clinicians, clinic staff, administrators, psychosocial support teams, navigators, and community health workers—tailored to the needs identified during our initial assessments.

Integrating Interventions into Practice

Integrating these capacity-building approaches into the field is essential for transforming HIV care delivery within a chronic care model. Small group interventions are particularly effective in supporting organizations and clinics to:

  • Change clinician practices, policies, and procedures

  • Improve patient recruitment and retention

  • Enhance support services and peer navigation

  • Increase community and consumer engagement

  • Strengthen overall care structures and systems

These field-based interventions are ongoing and include the provision of expert guidance, tools, materials, and resources to improve service delivery, expand access, optimize resource acquisition, and ensure compliance with care, treatment, prevention, and funding requirements. Activities may include:

  • Facilitated sessions

  • Community forums and meetings

  • Resource dissemination

  • Expert linkages

  • Report and document development

Capacity Building and Field Interventions

Capacity building is a multidimensional process that enhances or adds value to existing resources to promote effective, efficient, and sustainable outcomes. Capacity building efforts at the MAAETC have been successful through interventions that foster connections among providers, across care settings, and throughout the healthcare system.

Given the complex epidemiological challenges in the region, capacity building has become increasingly critical and will remain a key focus. It requires collaboration among individuals, the funding agency, and the evaluation team to establish shared goals, assess technical assistance (TA) needs, and develop tailored strategies to ensure program success.

The MAAETC’s model includes capacity building at the individual clinician level, as well as within HIV-related organizations and agencies. Interventions may be short- or long-term, depending on the need. The MAAETC continues to lead in training initiatives that support task-shifting, a strategy to expand access to services traditionally provided only by physicians. With the growing shortage of primary care physicians—especially in rural and medically underserved areas—it is essential to equip other healthcare professionals with the appropriate skills to fill the gap.

Task-shifting, long practiced in low- and middle-income countries with significant success, has demonstrated that non-physician healthcare providers can deliver care of comparable quality and often with greater economic efficiency and sustainability.

CEE: Intervention in the Field

The MAAETC provides technical assistance across all Parts of the Ryan White HIV/AIDS Program, as well as to departments of health, FQHCs, community-based organizations (CBOs), faith-based organizations (FBOs), and others. Our efforts include participation in advisory committees, convening forums, supporting grant development, facilitating continuous quality improvement (CQI), and resolving complex policy and practice issues across the region.

Our activities are guided by ongoing collaboration with HRSA to further enhance these efforts. Our extensive community linkages and regular needs assessments ensure that TA is responsive to emerging issues. Follow-up data from previous interventions have been documented and published.

We continue to offer both onsite and distance-based TA to connect regional providers with clinical experts and the National Clinician Consultation Center (NCCC) to support capacity building. While the COVID-19 pandemic necessitated a shift to remote interventions, in-person support remains essential. We have implemented small-group, targeted interventions for clinicians, clinic staff, administrators, psychosocial support teams, navigators, and community health workers—tailored to the needs identified during our initial assessments.

Integrating Interventions into Practice

Integrating these capacity-building approaches into the field is essential for transforming HIV care delivery within a chronic care model. Small group interventions are particularly effective in supporting organizations and clinics to:

  • Change clinician practices, policies, and procedures

  • Improve patient recruitment and retention

  • Enhance support services and peer navigation

  • Increase community and consumer engagement

  • Strengthen overall care structures and systems

These field-based interventions are ongoing and include the provision of expert guidance, tools, materials, and resources to improve service delivery, expand access, optimize resource acquisition, and ensure compliance with care, treatment, prevention, and funding requirements. Activities may include:

  • Facilitated sessions

  • Community forums and meetings

  • Resource dissemination

  • Expert linkages

  • Report and document development