A New Jersey nurse practitioner fights HIV in Africa

Deborah Winters, NP, used skills she learned in the United States to help create the Ethiopia HIV/ART Nurse Specialist (HANS) Training Program Evaluation.

Global Rounds Podcast: Enter Title Here!
Global Rounds Podcast: Enter Title Here!

Debbie Winters is a nurse practitioner (NP) from New Jersey, who specializes in HIV care. She spends half her time working as a clinician in New Jersey and the other half working for the International Training and Education Center for Health (I-TECH) at the University of Washington, in Seattle.

I-TECH is a global health organization that works with local government agencies in Africa, Haiti, and India to support the development of a skilled health work force, and health delivery systems. In Africa, I-TECH works to improve effectiveness and sustainability in HIV and tuberculosis treatment.

Debbie does remarkable work and has had quite an amazing journey. In January 2014, I met her in South Africa at an HIV training course, where she was co-teaching with an African colleague. I recently had the opportunity to talk with her about her work, her journey with I-TECH, and her mission.

So how did a NP from New Jersey end up working in Africa? It all started when Debbie received a call from a colleague 15 years ago, asking if she'd like to go to Ethiopia. She accepted and was tasked with finding and learning about nurses who were working with HIV/AIDS patients.

This turned out to be a harder mission than Debbie imagined. She and her colleague took buses all over Ethiopia in search of these scarce clinicians. Ethiopia has a severe shortage of health care personnel — there are 21 nurses and three physicians for every 100,000 people, according to WHO.

Debbie did eventually find the nurses they were looking for and learned that much-needed HIV medications were not even available. Much work needed to be done, but the trip was eventually a success. The American and Ethiopian nurses collaborated to create the Ethiopia HIV/ART Nurse Specialist (HANS) Training Program Evaluation, a three-week intensive program to educate nurses about HIV treatment.

One fundamental aspect of the HANS Training Program Evaluation is that Debbie worked with nurses both before and after they complete the clinical training program. This allowed her to get a sense of what their learning deficits were before the program, address these deficits during training, and determine how well the nurses adopted new knowledge by reassessing them after training.

The program was so successful that it was not only expanded throughout Ethiopia, but it was also implemented in Zambia, Uganda, and Namibia. One of the major successes is that once nurses finish the training program, they become mentors themselves and train others. Creating a sustainable model, and working with local people, is a major goal of I-TECH. 

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