AMERICAN INTERNATIONAL
HEALTH ALLIANCE
We do development
differently
PRESENTATION OUTLINE
 AIHA Background & Overview
 Our Partnership Model
 Our Support to Clinical Associates Programs and Profession in South
Africa
 Conclusion & Next Steps
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.
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.
OUR APPROACH
TO HEALTHCARE
WORKFORCE
DEVELOPMENT
National
Authorities
Health Services and
Outcomes
Professional
Associations
Health Needs
Educational
Institutions
Regulatory
Bodies
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
AIHA’S WORK IN SOUTH AFRICA
 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)
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
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)
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)
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
CLINICAL ASSOCIATES
Total Graduates By Year
600
516
500
400
300
200
130
149
93
100
121
23
0
2010
2011
2012
2013
2014
TOTAL
WHERE ARE THEY NOW?
Where Clinical Associates who graduated in 2010-2014 are currently working:
NGOs, 25
Private, 1
Left the Profession,
14
Military Hospitals,
52
Government
Hospitals, 424
FUTURE CLINICAL ASSOCIATES
Clinical Associate Student Enrollment by University and Year
(through 2015 intake)
250
195
200
173
162
150
WSU
Wits
95
100
75
74
63
50
60
50
37
40
36
0
3rd year
2nd year
1st year
UP
Total
CONCLUSIONS & NEXT STEPS
 AIHA has more than 23 years of experience helping countries develop locallydriven, 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