1. AMERICAN INTERNATIONAL HEALTH ALLIANCE We do development differently

2. PRESENTATION OUTLINE  AIHA Background & Overview  Our Partnership Model  Our Support to Clinical Associates Programs and Profession in South Africa  Conclusion & Next Steps

4. AIHA’S MISSION STATEMENT AIHA’s mission is to help resource-constrained communities and nations make positive, holistic, and sustainable changes that improve health outcomes.

5. WHAT WE DO TO IMPROVE HEALTH OUTCOMES 1.Collaborate with host country governments to identify local needs, implement responsive programs, and ensure long-term sustainability 2.Strengthen health systems by establishing new cadres and developing health workforces to fill critical human resource gaps 3.Build capacity among local institutions and organizations to improve the quality of care AIHA achieves this through our unique partnership model.

6. Educational Institutions Professional Associations National Authorities Regulatory Bodies Health Needs Health Services and Outcomes OUR APPROACH TO HEALTHCARE WORKFORCE DEVELOPMENT

7. KEY ELEMENTS OF OUR MODEL  Peer-to-peer relationships built through institution-to-institution partnerships  Emphasis on professional exchanges and mentoring  Voluntary contributions and leveraging of resources  Non-prescriptive but rigorous approach to process  Demand driven with high levels of recipient investment and ownership

8.  Launched health systems strengthening programming in South Africa in 2005  Partnerships to date: Brits Hospital / Foundation for Professional Development (2005 - 2007) Foundation for Professional Development / University of California - San Francisco School of Nursing (2007 - 2010) University of the Free State, Centre for Health Systems Research and Development / State University of New York Downstate Medical Center (2007 - 2010); CDC-funded Public Health Evaluation as a result of partnership Volunteer Healthcare Corps - South Africa Preceptors Initiative (2007 - 2010) Walter Sisulu University / University of Colorado - Denver (2010 - Present) University of Witwatersrand / Emory University School of Medicine (2010 - Present) University of Pretoria / Arcadia University (2011 - Present) Nelson Mandela Metropolitan University / St. Louis College of Pharmacy (2013 - Present) AIHA’S WORK IN SOUTH AFRICA

9. NEW CADRE DEVELOPMENT Critical shortages, poor distribution, lack of retention and performance gaps of human resources for health hinder the delivery of quality healthcare. Countries like South Africa are increasing the training and deployment of new health care workers to meet the needs of their health system, particularly in high HIV burdened, rural and underserved areas. In South Africa, the Twinning Center supports two new cadres: Medical: Clinical Associates (equivalent to Physician Assistants) Pharmacy: Pharmacy Technician

10. CLINICAL ASSOCIATES AIHA supports three twinning partnerships with:  Walter Sisulu University (Eastern Cape) & University of Colorado at Denver (2010 – present)  University of the Witwatersrand (Gauteng) & Emory University (Atlanta) (2010 – present)  University of Pretoria (Gauteng) & Arcadia University (Pennsylvania) (2011 – present)

11. CLINICAL ASSOCIATES  AIHA support for the Clinical Associates Profession Clinical Associates Forum Association strengthening for the Professional Association of Clinical Associates in South Africa (PACASA) Digital Integration and mHealth Platforms for training National Examination Workshop (Certification, Standards) Advocacy for integration into health workforce, awareness raising Support for impact research and data collection (graduate tracking, service delivery impact)

12. SELECTED ACCOMPLISHMENTS  Establishment of the Clinical Associates National Exam  Increased awareness of the Clinical Associates profession  Establishment of the Professional Association of Clinical Associates in South Africa (PACASA)  Placement of physician assistant volunteers (VHC) to mentor faculty and assist in teaching  Digital Integration of Clinical Associate Studies (DICAS) at Wits  Data collection on HIV/AIDS-related service delivery provided by Clinical Associates  Collaboration with governmental, advocacy, health stakeholders

13. CLINICAL ASSOCIATES Total Graduates By Year

14. WHERE ARE THEY NOW? Where Clinical Associates who graduated in 2010-2014 are currently working:

15. FUTURE CLINICAL ASSOCIATES Clinical Associate Student Enrollment by University and Year (through 2015 intake)

16. CONCLUSIONS & NEXT STEPS  AIHA has more than 23 years of experience helping countries develop locally- driven, locally-owned, and locally-sustainable health system capacity, including a decade of experience in South Africa  We look forward to continuing to work together with NDOH, provincial DOH, HPCSA, CDC, universities and other stakeholders to ensure the sustainable success of the Clinical Associates programs and profession  We hope this is the first of many conversations about how we can effectively collaborate to ensure that Clinical Associates support South Africa’s goal of healthcare for all and an AIDS-free generation