Photo Vrushabh Shah, Senior Associate, Prevention at NASTAD

Improving Public Health Systems Through Learning and Development Programs


Article originally published on E-Learn Magazine on May 22, 2018 – Click here for the Spanish version

Generally, Individuals become more engaged when receiving development opportunities. Learning and Development programs (L&D) aim to improve employee performance by sharing knowledge and enhancing skills and play an important role in an organization’s talent management. With the implementation of an L&D program, individual performance can be aligned with organizational goals so that structures and processes can be enhanced and best practices disseminated.

Through Capacity Building Assistance (CBA) and technical assistance, the National Alliance of State and Territorial AIDS Directors (NASTAD) is strengthening both domestic and global governmental public health. For over 20 years, this leading non-profit organization has helped often-marginalized populations around the world by improving the performance of public health officials throughout the Americas, Africa and Asia. Technical assistance and L&D programs offered through online learning modalities currently play an important role in achieve this goal, while also promoting the effective use of public health systems.

L&D programs at NASTAD are focused on promoting HIV and hepatitis prevention. The organization develops the programs and disseminates best practices among health departments, enabling them to meet the needs of target populations and facilitate knowledge transfer among peers.

NASTAD works with local partners to help health departments and ministries around the world to find more cost-effective methods to improve outcomes—an approach that optimizes efficacy and provides online technical assistance platforms aimed for capacity building. To support partners, NASTAD leverages the experience of peer public health experts so that methods, tools and resources are adapted to the local context and progress can be rapidly achieved.

NASTAD relies on virtual learning tools to deliver its L&D programs. Not only are they effective and help with waste reduction, the online platform truly helps to strengthen public health as members learn, share expertise and work together to solve common problems. NASTAD leverages online learning methods and tools to enhance technical assistance and capacity building to achieve a highly cost-effective training.

Vrushabh Shah, NASTAD’s Prevention Team senior associate within the CBA program, notes that a digital learning environment makes L&D programs more intuitive and effective, with tools that engage learners and provide multiple ways to present content and facilitate interaction among peers.

“What had previously been done in a meeting, can now be done via a video conferencing solution such as Blackboard Collaborate. Professionals at health departments can log into Blackboard and find what they need within a couple of clicks,” Shah explains. “In addition, we also have webinars and different learning communities on Blackboard Learn, which allow us to share resources, have discussions, and enables learners to join multiple programs where they can get technical assistance in different areas, get resources, and have discussions with other peers—all through a digital learning environment.”

He also mentions that some of the resources are permanently kept in their digital learning environment so that users can quickly find what they need. “In terms of tools, for example, we keep a map on Blackboard created for health departments who want to learn how to implement practices in Data to Care, a public health strategy that aims to use HIV surveillance data to identify HIV-diagnosed individuals that are not currently in care, and link them to it,” says Shah.

Acting Globally

Digital tools are especially relevant in NASTAD’s Global Program, which works to build the organizational and human resources skills of counterparts across the world by using a peer-to-peer capacity building framework that helps local leadership plan, manage and evaluate programs. NASTAD Global leverages the expertise of U.S.-based public health practitioners and pairs them with international public health peers to enhance national health systems.

“Domestically, we work with the health departments. Within the global team, we work with local jurisdictions. We provide technical assistance and CBA from peers who are already on the ground or from experts who have already done the work, and make sure that they are connected to peers who benefit from that work they’ve done. In general, we do all of our technical assistance and capacity building through a peer-to-peer training model,” explains Shah.

Learning technology is a cost-effective strategy for providing technical assistance and capacity building abroad, as well as a more efficient way to assess gaps and deliver content. “We used to provide all the assistance in person or over the phone, but we noticed a lot of gaps and many things that just couldn’t be done,” says Shah. “This model has allowed us to provide personal assistance via virtual meetings, and as a result, it has definitely reduced time and costs. It has also offered us opportunities to explore new models to reduce learning barriers. If there is an operational or financial limitation in a health department, staff will benefit from high-quality online technical assistance and the fact that they don’t have to travel to get it.”

An Inclusive Approach

NASTAD provides assistance based on local jurisdictions and local government concerns. Most requests for technical assistance and CBA come from a system called CRIS (CBA Request Information System), a web-based application that enables Centers for Disease Control and Prevention (CDC) and healthcare organizations to request assistance.

NASTAD assesses needs, tracks progress and ensures organizations receive tools to continue communicating with the health department involved in the peer-to-peer training, so they have all the best evidence-based models and resources at their disposal.

“The most important aspect is making sure there are solid connections on the ground that the health department will be able to leverage. But we often hear from health departments that they just need a template or guideline, or that assistance is necessary to implement a certain kind of program,” says Shah.

NASTAD plays an important role in program implementation, which typically takes place in the following order: establish partnerships, assess needs, and define priorities. Subsequently, data and evidence are used to guide the program design, later transitioning it to the local government. This last phase is what defines the success of the program.

“We assess whether the goals were achieved based on how successfully the local jurisdiction was able to implement a program or a model of care. If they are using our technical assistance or that of another health department, that is good, but it doesn’t mean much if they are not able to move the dice forward. When we leave, they should be able to monitor, implement and design an intervention, with NASTAD getting information from the partner government agency through feedback sessions,” comments Shah.

The duration of training varies depending on its structure. Some training may last around six weeks, with weekly webinar sessions. Some may last for months. And some training may be ongoing, with a program based on resource sharing and featuring an undefined timeline. “It depends on what resources we are sharing with them, what interest they have in that specific topic area, and what their on-the-ground needs are.”

“I think there are many opportunities to use online learning in our programs, because staff under training are able to get engaged faster. It depends on what the needs are, but in general, having more options available benefits health departments, says Shah. “We’re able to find out what their needs are within their health department and post-check whether they like this system. So, we can make sure that what we’ve done is useful and important for them. As a result, we saw an improvement in our outcomes, because it keeps us focused on what they need so we direct our effort.”

Connecting People

NASTAD Global provides peer support to help local partners define needs, opportunities and outcomes. Facilitating the design, development, implementation, evaluation and institutionalization of initiatives, NASTAD Global improves access to care and supports treatment adherence.

Providing content is an important part of the programs. To achieve NASTAD’s goals, it is essential to have a well-structured communication plan and tools that enable the collaboration and interaction between peers to sustain enthusiasm over the long term. Stakeholders need to be aware of learning opportunities and create a culture in which learning is routine.

“The short-term benefits of this kind of program are the creation of immediate networking opportunities, capacity and education. In the long-term, we are able to better implement a health program or a public health intervention, because they have attempted with the models the other health departments have already utilized and learned from,” adds Shah.

Programs are implemented under the direction of a local partner, leveraging technical support through a peer-to-peer approach. Success is achieved when local governments take the lead role in design, implementation and long-term management of needs-based public health programs.

“This has been our model since our inception, and it is a very successful model because we found that people on the ground are a lot more concerned about how the other health departments are doing similar work,” comments Shah. “With online learning, we make sure we’re giving staff what they need in real time, and the concerns are heard in real time. We are catering based on these needs a lot faster than we would if we had meetings in person. It is a win-win for both sides.”

“We’ve been training people for over 20 years now. We have reached over 100,000 people throughout dozens of countries, including the 50 U.S. states and all U.S. territories. We see many health departments coming back for technical assistance, which means that they are benefiting from the training we’re offering, and this is very gratifying,” says Shah.

Where NASTAD Operates

NASTAD represents public health officials in all 50 U.S. states, District of Columbia, Puerto Rico, the U.S. Virgin Islands, seven local jurisdictions receiving direct funding from the Centers for Disease Control and Prevention (CDC), and the U.S. Pacific Island jurisdictions.

Local jurisdictions: Baltimore, Chicago, Los Angeles County, Houston, New York City, Philadelphia, and San Francisco.

U.S. Pacific Island jurisdictions: American Samoa, Guam, the Marshall Islands, the Federated States of Micronesia, Northern Mariana Islands, and Palau.

NASTAD also supports partner governments in Africa, the Central America region, and the Caribbean region.

Focus Countries: El Salvador, Ethiopia, Guatemala, Guyana, Haiti, Honduras, Mozambique, Nicaragua, Panama, South Africa, Trinidad & Tobago, Uganda

Former Countries: Bahamas, Barbados, Belize, Botswana, Costa Rica, Jamaica, Tanzania, Zambia


NASTAD’s Capacity Building Assistance Process in Five Steps

1. Build Partnerships:NASTAD members leverage public health experiences and knowledge to build and maintain strong peer-based relationships.

2. Assessment: Work with partners to assess needs based on public health models and competencies.

3. Development:Define scope of work with set deliverables. At this point, the capacity building begins with local staff and programs.

4. Implementation: Implement training and program along with partners and use monitoring and evaluation systems to adapt and improve outcomes.

5. Transition: Transition established projects, programs and innovations to the host country, providing additional supportive capacity building as needed to ensure efficacy and sustainability.


Peer-to-peer training allows organizations to identify gaps and skills, saving time and resources that can be used to provide cost-effective, engaging and efficient capacity building. With peer learning, professionals are more easily up to date on new trends and can feel more comfortable when asking questions.


Photos by: AFP – Tasos Katopodis