Appendix G
Attributes of Governmental and Nongovernmental Organizational Models for the Potential Administration of the Global Health Service



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Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS Appendix G Attributes of Governmental and Nongovernmental Organizational Models for the Potential Administration of the Global Health Service

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Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS SAMPLING OF ORGANIZATIONAL MODEL ATTRIBUTES TABLE G-1 Governmental Organizational Models Government Agency Attributes CDC Epidemic Intelligence Service (EIS) http://www.cdc.gov/eis Headquartered at CDC, an agency of the Department of Health and Human Services (DHHS) and receives its budget and congressional oversight through DHHS. Employs qualified personnel for 2-year positions. International work can be part of a 2-year service, but service is never completely overseas. EIS officers are placed within CDC or a similar agency. Have 20 field programs to support international efforts. 130 current EIS officers that are placed according to the needs of a specific location. Epidemiologic investigations can be related to HIV/AIDS. CDC Global AIDS Program (GAP) http://www.cdc.gov/nchstp/od/gap/default.htm CDC is an agency of the DHHS and receives its budget and congressional oversight through DHHS. GAP works under the direction of the Office of the Global AIDS coordinator. Deploy and employ experienced staff for 2-year terms. Maintain offices abroad including support staff. Active in 25 countries including all PEPFAR countries. Programs include addressing opportunistic infections, TB, and other STIs. Focus on prevention and surveillance. Health Resources and Services Administration (HRSA) http://www.hrsa.gov HRSA is an agency of the DHHS and receives its budget and congressional oversight through DHHS. Programs were domestic until recently (intradepartmental delegation of authority from CDC) but it is unclear if they have the capacity to support volunteers overseas. One of their strategies is to provide support to developing countries to rapidly expand the pool of trained providers, managers, and allied health staff to improve HIV/AIDS, TB, and malaria services. In addition they

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Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS Government Agency Attributes conduct training activities to support human capacity; strengthen the capacity to collect data and monitor and evaluate data on health care services; and establish partnerships that support human resource capacity development. Indian Health Service (IHS) http://www.ihs.gov IHS is an agency of the DHHS and receives its budget and congressional oversight through DHHS. Provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 35 states. Recruit every discipline involved in providing health care, social, and environmental health services. Offer recruitment incentives such as loan repayment and scholarships to attract professionals. HIV/AIDS services may be included. National Health Service Corps (NHSC) http://nhsc.bhpr.hrsa.gov NHSC is part of the Health Resources and Services Administration which is an agency of the DHHS and receives its budget and congressional oversight through DHHS. Deploy highly skilled health professionals (placement limited to clinicians) to underserved areas in the United States for 2-3 years service. No international mandate or experience. Offer recruitment incentives such as loan repayment to attract professionals. Primary care provided by deployed clinicians could include HIV/AIDS care and treatment. Peace Corps www.peacecorps.gov The Peace Corps is an independent agency within the executive branch of the U.S. Government. The Peace Corps’ annual budget is determined each year by the congressional budget and appropriations process, and is part of the foreign operations budget. The Senate Foreign Relations Committee is charged with general oversight of the activities and programs of the Peace Corps, and the House Committee on International Relations serves a similar function.

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Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS Government Agency Attributes Recruit and deploy volunteers (nonsalaried) for 2-year service. Deploy skilled volunteers for specific assignments (usually 6 months) under Crisis Corps. Maintain at least one main office in every active country including support staff. Currently active in 72 countries, including all PEPFAR focus countries. 20 percent of the current 7,733 volunteers work on health and HIV/AIDS. United States Agency for International Development (USAID) http://www.usaid.gov USAID is an independent federal government agency that receives overall foreign policy guidance from the secretary of state. Employs skilled staff overseas. Works in all of the PEPFAR countries. Maintains offices in over 80 countries around the world including support staff. Works on HIV/AIDS issues under PEPFAR. Volunteers for Prosperity http://volunteersforprosperity.gov Is part of USA Freedom Corps. Supports international voluntary service but does not deploy. No capacity to support volunteers or overseas workers. Provides recognition to volunteers. Has about 200 for profit and nonprofit organizations on website. Supports U.S. development initiatives including PEPFAR.

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Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS TABLE G-2 Nongovernmental Organizational Models Nongovernment Agency Attributes American International Health Alliance (AIHA) http://www.aiha.com Focus on twinning and are recipients of Twinning Center award from HRSA. Participants in twinning projects include a variety of health professionals depending on the need of the international partner and the specific project. No experience with long term deployment of volunteers but plan to deploy volunteers linked to PEPFAR twinning projects for 3–6 months. Volunteers receive no compensation but do receive reimbursement for travel expenses. No experience in PEPFAR countries. Experience addressing HIV/AIDS through twinning partnerships. Catholic Medical Mission Board (CMMB) http://www.cmmb.org Focus on addressing immediate needs by providing care and building capacity through training. Places only experienced, licensed professionals. Volunteer service usually one year or more with limited available placements ranging from 1–6 months. Has a program that provides physicians traveling abroad with medical supplies. Experience in some, but not all PEPFAR countries. Addresses HIV/AIDS. Health Volunteers Overseas (HVO) http://www.hvousa.org Focus on training, not providing care. Service is usually 1 month but shorter assignments of 2 weeks are sometimes feasible as are longer assignments of 3–6 months. Supports over 60 projects in more than 25 countries. Deploys specific specialties of highly skilled professionals. Volunteers pay their own way, but HVO lists some funding opportunities on their website. Addresses HIV/AIDS.

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Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS Nongovernment Agency Attributes International Center for Equal Healthcare Access (ICEHA) http://www.iceha.org Focus on infectious diseases with an emphasis on HIV/AIDS. Deploy physicians and nurses to improve clinical skills of local health care providers by using a method of clinical mentoring and informal didactic training. Deploy physician assistants, and pharmacists to work as a team with volunteer physicians. Volunteer service is a minimum of 2 months, not usually long term. Of the PEPFAR countries, have experience in Côte d’Ivoire, Nigeria, and Vietnam. Volunteers do not provide care but only build local clinical expertise. Volunteers donate their time. Addresses HIV/AIDS. JHPIEGO http://www.jhpiego.org Focus on building capacity, promoting sound health policies, learning innovatively, developing networks, and promoting best practices. Hire local staff, third country nationals, expatriots, or consultants. Works in 37 countries, has offices in 14 countries including many of the PEPFAR focus countries. Addresses HIV/AIDS and close ties to Johns Hopkins University provide easy access to expertise from internationally known leaders in the field. UMCOR http://gbgm-umc.org/umcor Work in 88 countries, 20 of which have large projects. Deploys about 187,000 volunteers a year (both domestically and internationally) in teams of 10. Volunteers pay their own way. Deployments range from months to years. Qualifications vary with assignment. Some assignments may address HIV/AIDS.