ISTI’s portfolio in the health/population/nutrition sector represents a spectrum of experience which has emphasized health and family planning services delivery, health sector financing, nutrition policy, micronutrients , surveillance and interventions, laboratory development, tropical disease control, AIDS/STD prevention and control, and rural and urban water and sanitation activities. ISTI has extensive experience in the critical management and support functions that underlie successful service delivery: information systems for monitoring and evaluation; comprehensive commodity logistics systems; and applied research, which include studies to determine the relative cost-effectiveness of selected interventions and intervention modes.
Malaria Prevention and Control Activities in Cambodia, USAID TASC 3 IQC (2007 – 2010): As a subcontractor to URC and in collaboration with the Cambodian Ministry of Health and private sector, ISTI is contributing technical assistance and support to improve the diagnosis and treatment of malaria, continue surveillance of anti-malarial resistance, and educate communities about malaria prevention, control and appropriate health-seeking behaviors. ISTI’s activities in targeted provinces in western Cambodia focus on: provision of pre/in-service training in laboratory diagnosis of malaria and implementation of quality assurance (QA) and quality control (QC) in routine diagnostic practice; development of effective strategies for the clinical management of malaria cases; development and dissemination of messages with emphasis on appropriate health seeking behaviors to prevent the development and spread of anti-malarial drug resistance; and collaboration with other malaria control implementation partners.
Environmental Health Indefinite Quantity Contract (EH IQC), USAID (2004 – 2009): As a subcontractor to CDM International, ISTI provides support to USAID’s Bureau for Global Health, Office of Health, Infectious Disease and Nutrition (USAID/GH/HIDN) in knowledge management activities in environmental health. ISTI has contributed to developing a knowledge management workplan for an EH website, established and maintained an EH Activity website for GH/HIDN, developed six original web-based products per year, and contributed on USAID’s behalf to global and regional knowledge management networks in environmental health. ISTI has also been providing support to keep the USAID external website’s environmental health pages up-to-date, including links to EH-related websites and key products.
Research Study of Disability, Rehabilitation and Poverty Reduction (2007-2008):ISTI is engaged in a global study of disability and rehabilitation for the World Bank in partnership with PADECO Ltd. of Japan, focused on country-level disability data, cost-effectiveness of medical rehabilitation interventions, and impact on poverty reduction. Emphasis will be on availability, accessibility, utilization, cost-effectiveness and the efficiency of medical rehabilitation. Special assessments are underway in 14 selected countries in Asia, Africa and Latin America to prepare a topical basis for the planned UN Conference on Disability and Rehabilitation in 2008.
USAID’s HSSP Project/Strengthening MCH/RH Services and the Zambian Health Systems (2004-2009): ISTI leads the technical assistance work on micronutrients, vitamin A, food fortification and other areas of nutrition under a subcontract from Abt Associates. This is achieved through provision of home office and field-based short-term technical assistance as well as Zambian management staff in the field office.
Population, Health and Nutrition Technical Assistance and Support Contract (TASC2 & 3), Worldwide (2003–2011): ISTI is subcontracted for two consecutive awards by the Emerging Markets Group, in this world-wide mechanism to support USAID in the reduction of maternal, infant and child mortality, HIV transmission and the threat of infectious diseases. ISTI has been designated the lead institution for the areas of nutrition, food security and infectious disease and will play a secondary role in health finance, health systems management, monitoring and evaluation. Furthermore, ISTI will conduct health and medical assessments programs to reduce and combat infectious diseases in developing countries. Recent Task Orders are as follows:
- Evaluation of the USAID REDSALUD Project, Dominican Republic (2004):Included: concentrating on high-priority services pertaining to reproductive, maternal and infant health and infectious diseases; coordinating with other donor agencies to avoid redundancies in activities related to public health reform; enhancing cross-sectoral coordination, including democracy and governability in particular; and supporting the creation of “think-tanks” capable of generating sufficient civil society support to create political consensus on the next stages of reform.
Decentralized Health Services Project II-Small Scale Technical Assistance (SSTA), Indonesia (2003): Building upon Project Preparation (PPTA) Activity for ADB-funded DHS-II Project to (i) identify the contribution of each local government to the project according to their fiscal capacity, (ii) list districts, provinces and cities that are willing to participate in the project and their commitment to allocate the required local funds for the project, (iii) help estimate investments in health care services for the poor and vulnerable groups; and (iv) conduct competency based training of health personnel in regional hospitals. Four domestic consultants, two specialists on health services development and two financial analysts are engaged in helping to mobilize the three additional provinces as DHS II partners.
Decentralized Health Services Project II-Project Preparatory Technical Assistance (PPTA), Indonesia (2002 – 2003): The design of the proposed ADB-funded DSH-II Project in Indonesia. A team of seven international health experts was deployed by ISTI to work in five provinces, later expanded to eight. Over 25 domestic experts and institutions collaborated with the international team to hold 500 participatory workshops and to (i) investigate issues in health sector development, including advocacy, health services reforms and investments, and poverty impact assessment; (ii) conduct an analysis of the social, political and economic environment of the project areas; and (iii) develop information and communication technologies (ICT) to facilitate decentralization process.
Decentralized Health Services Project, Indonesia (2000): ISTI conducted a review of the health care decentralization policy in Indonesia and prepared a corresponding needs assessment and implementation plan for the Asian Development Bank.
Micronutrient Operational Strategies and Technologies (MOST) Project, Worldwide (1998-2005): The MOST Project is a seven-year activity funded by the US Agency for International Development. With this project, ISTI provides global leadership in reducing micronutrient deficiencies among vulnerable groups in developing countries. The MOST Project assists USAID’s Population, Health and Nutrition Center, USAID Missions, governments, donor agencies, NGOs, PVOs, research entities and the private sector to implement expanded, more effective programs and policies to prevent and control micronutrient malnutrition, especially vitamin A deficiency, through supplementation, fortification and dietary diversification.
Maternal and Child Health Technical Assistance Services Contract (TASC), Worldwide (1998-2003): TASC was designed to assist USAID Missions and Bureaus to easily access high quality technical assistance and support for maternal health, child health, and nutrition activities. TASC was awarded to ISTI as one of four subcontractors of Clapp and Mayne, Inc. ISTI’s particular strengths in maternal and reproductive health, nutrition, particularly child and maternal nutrition, micronutrients, food assistance and technology, and health systems strengthening, including policy reform, health finance, and management, as well as its broad coverage of geographic regions complements the expertise and coverage of the other TASC partners.
Evaluation of the PANFAR Project, Peru (1998-1999): The PANFAR program is an integrated program implemented by the PL 480 Cooperating Agency, PRISMA, and the Ministry of Health of Peru, designed to serve nutritionally high- risk children and mothers to combat malnutrition. ISTI evaluated the program to determine if there has been any relationship between PANFAR’s food distribution activities and alleged forced sterilization of recipients of the food program. ISTI and its subcontractor, SASE, conducted sample surveys, focus group discussions, and interviews with key informants to collect the data necessary for the evaluation.
Family Health and Nutrition, Indonesia, (1998 – 2003): The purpose of this Asian Development Bank/Ministry of Health project is to develop an effective partnership between health service users, and health services providers in order to improve the health and nutritional status, while reducing the total fertility rate in five provinces: Jambi; Bengkulu; North Sumatra; South Kalimantan; and Central Kalimantan. The central technical team comprise of team leader/family health and nutrition expert and advisors on community mobilization, human resource development, and social marketing for family health.
Design of Results Package to Upgrade Reproductive Health in PHC Centers, Jordan (1998): ISTI designed a Results Package for USAID/Amman to strengthen the reproductive health program within the primary health care system of the government’s overall health program. A five-person team assessed the government’s health facilities and its staffing and training needs, and reviewed quality of care and quality assurance issues to produce a final report.
Center for International Health Information (CIHI), Worldwide (1985 – 2000): Developed by ISTI, the Center specialized in the analysis and presentation of health information for policy makers and program managers by maintaining the USAID Health Information System, a system that combines project/program information with data and narratives describing the health situation in developing countries. Having established a reputation for providing the best available information through the Annual Reports to the Congress on USAID’s Child Survival Program, the Center has diversified through the production of country health profiles, including one of the earliest series of profiles on the Commonwealth of Independent States, and other written and graphic forms of data presentation. The Center has emerged as a major source of health information throughout the international health community. ISTI served as the prime contractor through January 1994, and the major subcontractor through 2000.
Environmental Health Project (EHP) (1994 – 2004) and Water and Sanitation for Health (WASH) Project (1980 – 1994): Since 1980, ISTI has been a key partner in the consortium implementing the Environmental Health Project and its predecessor WASH Project. In both projects ISTI has been responsible for tropical disease prevention and control, information management, communication and dissemination, and for providing technical support in the design and evaluation of water, sanitation, environmental health and tropical disease control projects. To date, ISTI has carried out over 180 short-term assignments in these areas in all regions in the world. The current EHP-2 contract (1999-2004) focuses on the utilization of practical, cost-effective methods for the prevention of diarrhea, acute respiratory diseases, malaria and other environmentally related diseases to reduce childhood morbidity and mortality.
Vector Borne Disease Project, Nepal (1998 – 2003): Within the framework of EHP, ISTI is implementing a five-year project to strengthen the Vector Borne Disease Research and Training Center in Hetauda, Nepal, to enhance Nepal’s capabilities in the surveillance, diagnosis, prevention and control of malaria, kala azar and Japanese encephalitis. Through the field office in Katmandu, ISTI conducts training and research programs in medical entomology, laboratory diagnostics, vector-borne disease surveillance, risk mapping, data management and multi-disciplinary analysis. The last includes research and training on socio-behavioral, geographical and environmental as well as public health and medical assessment.
Family Planning and Health, Ghana (1992 – 1996): ISTI assisted the Ministry of Health in improving its laboratory structure in order to upgrade and expand diagnosis and testing for HIV/AIDS, and to strengthen AIDS prevalence monitoring for policy makers. ISTI’s resident advisor institutionalized a sustainable system of continuing education in laboratory technology, infection control, quality assurance/TQM, laboratory management, and preventive maintenance and repair. ISTI also supported the development of NGO and workplace-based programs linked to the Ghana Social Marketing Foundation.
Food Security and Nutrition Monitoring and Support, Worldwide (IMPACT) (1990 – 1997): This project promoted the integration of human food consumption and nutrition considerations in development policies and activities in the food, agriculture, health, and related sectors in developing countries worldwide. The project provided technical assistance and training to help developing countries acquire and maintain food security and nutrition monitoring systems; conduct nutritional assessments; conduct operations research to improve the availability, relevance, and quality of food and nutrition information; and build local capacity to maintain food security and nutrition monitoring systems.
Health and Nutrition Sustainability, Latin America and Caribbean (1990 – 1995): This project’s objective was to provide USAID with the tools necessary to support policy change in the health and nutrition sectors. ISTI provided technical assistance in health care financing throughout the region and developed a cutting-edge methodology for evaluating the cost-effectiveness of breast-feeding promotion and food security programs. ISTI also supported the development of breast-feeding and micronutrient teaching curricula for use in regional professional schools and guidelines for formulating nutrition policy in the LAC region.
Child Survival and Family Planning, Nepal (1990 – 1995): ISTI provided the project’s long-term family planning/training advisor to improve the quality and coverage of family planning, child health care, and selected malaria control services, including the management, organizational issues, and practices affecting the delivery of these services. ISTI supported a number of major project initiatives, including decentralization and the joining of public, private, and NGO resources.
Family Planning Logistics Management, Worldwide (1986 – 1995): ISTI staff developed, tested, and introduced computerized MIS into over 30 USAID-assisted countries worldwide and helped the Agency, host countries, and other donors to improve forecasting and procurement scheduling and to monitor distribution at national, regional and clinic levels. ISTI staff provided technical assistance to develop regional training centers for Francophone Africa, the Middle East (Morocco), and Latin America and the Caribbean (Colombia). ISTI also developed COCOPLAN, an innovative forecasting tool which facilitates the use of demographic data for developing projections.
Family Health Services, Nigeria (1991 – 1994): ISTI provided the Project Administrator and Deputy Project Administrator who were responsible for the overall coordination and management of this large, complex project implemented by four U.S.-based prime contractors, numerous subcontractors and a Nigerian staff of more than 150. ISTI supported planning and implementation of decentralized state- and zonal-based family planning programs and coordinated multiple USAID-funded inputs to strengthen these regional level programs.
Vitamin A for Health Field Support (VITAL), Worldwide (1989 – 1994): ISTI provided USAID missions and their counterpart host-country institutions with technical support to 1) assess the prevalence of vitamin A deficiency 2) pre pare policies and intervention strategies/programs to combat the problems identified, 3) monitor and evaluate program progress, 4) conduct operational research to improve strategies and interventions, and 5) gather and disseminate technical/programmatic data about vitamin A programs worldwide.
IQC for Health Finance, Health Communications, and Emerging Health Issues, Worldwide (1991 – 1993): ISTI provided short-term assistance to USAID’s Bureaus and Missions around the world in health systems policy development, financing, and management; health products and services financing and management; commercial and social marketing, and health communications; and emerging socioeconomic, demographic, epidemiological, and political issues affecting health profiles of developing countries.
Health-Sector Financing, Indonesia (1988 – 1993): This was USAID’s largest bilateral health-sector financing project improving the efficiency and cost recovery of existing health services in Indonesia. The project assisted the Ministry of Health in introducing structural changes and management and financial innovations in the health insurance, hospital, and pharmaceutical subsectors of the health care system. Changes effected through the project had a powerful impact on the entire health economy. Project activities served as a catalyst for a number of important government efforts to open up foreign investment in the hospital sector; allowed a variety of government institutions, including hospitals, to have greater fiscal autonomy and retain revenues; and deregulated the health marketplace, (e.g., first time legislation enabling private-sector entities to offer health insurance, including managed health care packages). Five expatriate advisors and 20 Indonesian health professionals, assisted by 12 support staff comprised this successful team effort, with substantive contributions from more than 25 short-term experts.
Family Health and Population, Senegal (1985 – 1993): ISTI’s 17-person team provided technical assistance to the Government of Senegal to expand the delivery of family health/planning services and improve its demographic data. Under the project there was a change in the country’s family planning environment. With the promulgation of a National Population Policy, the launching of a national family planning program and the creation of a comprehensive network of staffed and equipped facilities, the use of contraception increased markedly, particularly in the urban areas, accompanied by a decrease in total fertility. ISTI also assisted a variety of organizations in the non-governmental sector to plan and carry out family planning service activities.
Population Technical (POPTECH) Assistance, Worldwide (1984 – 1993): ISTI provided technical assistance to USAID Office of Population, regional Bureaus and Missions, collaborating public and private-sector institutions, and LDC governments. These services enabled USAID to further the planning, implementation, and evaluation of its global population and family planning efforts. ISTI provided services for over 270 USAID assignments in 45 countries.
Umbrella Organization: Private Voluntary Organization (PVO) Child Survival, Guatemala (1989 – 1992): This project provided funding, technical assistance, and some commodity support to selected Guatemalan PVOs working in child survival. ISTI provided long-term assistance in health training and medical/clinical support, as well as short- term assistance in development communications and health information systems, program management, planning and evaluation, maternal and child health, and family planning.
Supplementary Feeding Programs for Women and Children, Latin America and Caribbean (1990 – 1991): The results of this in-depth assessment of the current status of supplementary feeding programs for women and children in 15 countries in Latin America and the Caribbean, funded by the World Bank, were used by the Bank to identify and develop cost-effective nutrition interventions and projects as part of its human resources assistance and poverty alleviation strategies. ISTI conducted the assessment in collaboration with INCAP, the Nutrition Institute of Chile, and the National Institute of Nutrition in Mexico.
Faculties of Public Health, Indonesia (1986 – 1991): An ISTI resident advisor and short-term personnel provided technical assistance to the Government of Indonesia to strengthen five new Schools of Public Health and upgrade the public health curricula in allied medical schools. Specifically, ISTI assisted with the development of curricula and instructional materials, training of faculty and staff, formulation of research programs, and development of management and administrative systems.
Village Family Planning/Mother Child Welfare, Indonesia (1987 – 1990): The focus of the project was to improve the integrated service delivery system and to institutionalize the capability to conduct operations research in support of program and policy decisions. ISTI assisted the Indonesia National Family Planning Coordinating Board (BKKBN) and the Ministry of Health (MOH) in developing and implementing operations research to analyze the cost and cost-effectiveness of the service delivery system and to estimate the capacity for greater community involvement.
National Institute for Population Studies, Islamabad (1989-1991): A resident advisor and consultants from ISTI assisted the National Institute for Population Studies in carrying out demographic analyses, policy formulation and participant training. In 1991 ISTI staff and consultants also carried out an evaluation of the USAID family planning program in Pakistan and participated in designing a new USAID-funded project.