The Malawi HIV Implementation Research Training Program (M-HIRST) introduced the developing discipline of Implementation Science(IS) to Malawi through its collaborative program between the University of Malawi College of Medicine (CoM) and University of North Carolina. Over the past 4 years, we have established a core group of Implementation Scientists (8 faculty, 3 PhD, 7 Master?s, 14 mentored grant awardees) providing a platform to launch new IS research, establish an IS thematic area within the CoM department of Public health and Family Medicine, and embed IS training into the recently launched Master?s in Global Health Implementation and the Research Support Centre. However, due to continued evolution of the Malawi HIV program, the need for implementation scientists has outpaced our development of faculty. For our renewal, all research will be guided by an annual scientific priorities workshops to ensure our goals are aligned with Ministry of Health Guidelines and the Malawi National Health Research Agenda. Key areas identified in the 2018 workshop included implementation strategies to achieve 90/90/90 targets, advanced HIV care, integration of NCD services in HIV care, and Integrated prevention strategies (VMMC, PrEP). Based on 2019 feedback, differentiated ART care and TB preventive therapy have emerged as priority topics. All planned training activities complement existing capacity building programs at our institutions to maximize impact. We will train additional faculty at CoM while expanding to include faculty at the Kamuzu College of Nursing (KCN). Our goals are to support an additional 4 PhD and 6 Master?s candidates, and engage 12 junior faculty at CoM, KCN, Ministry of Health and research partners through structured leadership training, career development grant writing, and protected research time. Our IS internship program will partner with PEPFAR implementing partners to place 12 trainees in mentored research environments to gain practical experience. Our iterative short course program is designed to train both new course faculty and trainees and will include advanced IS topics including mHealth, Economic Evaluation of Health Programs, Quality Improvement, Spatial Modeling for Health impact, and career development grant writing. Trainees participating in any part of our program can apply for mentored grants (up to 15 grants) to support their research. By the end of the award, we expect to have independently funded Malawian investigators capable of multidisciplinary research to lead the Malawi HIV treatment and prevention implementation science agenda and mentor the next generation of research scientists.
The Malawi HIV integrated treatment and prevention guidelines have recently adopted evidence- based interventions including Dolutegravir based antiretroviral therapy, Pre-Exposure prophylaxis and integrated service delivery but require implementation science research to bring the interventions to scale for maximum impact. The University of North Carolina (UNC), the University of Malawi, College of Medicine (COM), Kamuzu College of Nursing (KCN) and Ministry of Health (MOH) will build upon nearly two decades of experience in HIV training activities and institutional research capacity strengthening in Malawi to expand HIV implementation science skills among research-focused faculty at COM, KCN, MOH and partner affiliates. Our program will develop both investigators and strengthen systems in the COM and KCN to assist the Malawi government to conduct high quality implementation science.
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