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TvT Associates Begins a New Chapter

Supporting evidence-based decision-making and improving health programs and interventions has been the focus of TvT Associates since the firm was founded in 1981 by Mary Tondreau, a development economist, and the late David van Tijn, an operations research pioneer. During their 1970s Peace Corps service in the South Pacific, Tondreau and van Tijn came to understand the profound impact of health on the entire development process. For over two decades, TvT has provided technical assistance and advisory services to programs covering the spectrum of developing country health issues, including maternal and child health, child survival, nutrition, infectious diseases, family planning and reproductive health, and HIV/AIDS.

In January of this year, TvT was acquired by Social & Scientific Systems, Inc. (SSS) - an integration of TvT's expertise in international health program planning, design and evaluation with SSS' broad base of experience supporting public health research. "This is a very exciting time for us," said Tondreau, president of the new TvT Global Health and Development Strategies division. "As a division of SSS, we have enhanced resources which translate into a broader range of services and products to offer our clients."

SSS analyzes public health data and provides research support services for clients in the U.S. Department of Health and Human Services and various state health care agencies. Much of the firm's work focuses on HIV/AIDS research. Founded in 1978, SSS has approximately 340 employees (including TvT Global Health and Development Strategies) and expects 2002 revenues to approach $70 million.

TvT expands SSS' capabilities by providing program planning and evaluation, policy analysis, and other technical assistance for international development programs. Recently, TvT worked intensively with the U.S. Agency for International Development (USAID) Office of Health, Infectious Diseases and Nutrition, to design the new Health Research for Children, Mothers and Families activity. This activity will address the health problems of a significant portion of the population in developing countries by helping to bridge the gap between the development of new health interventions and their introduction into practice. "The gap between research discovery, product and intervention development, and the introduction of these innovations into practice has caused major delay in the scaling up of many life-saving health research advances," observed Tondreau.

TvT also is facilitating and managing an interagency steering group composed of representatives from USAID, the Pan American Health Organization, the Micronutrient Initiative and the World Bank. The steering group is tasked with developing a document of technical guidance for the prevention and control of anemia worldwide.

Over the past decade, an increasing proportion of TvT's work has been in the field of HIV/AIDS. TvT uses state-of-the-art methodologies to evaluate outcomes and impacts of HIV/AIDS prevention and care programs, and guides clients in systematically using this information to improve program design and implementation. Increasingly, strategies reflect a comprehensive, multisectoral approach to the epidemic and to health in general.

Under the USAID-funded Synergy Project, TvT has developed a programming framework and methodology to systematically manage the complex process of assessment, planning, design, implementation monitoring, and evaluation (APDIME) of HIV/AIDS programs in an integrated and participatory manner. The APDIME Framework forms the backbone of several TvT/Synergy Project services.

The Synergy APDIME Toolkit was developed in collaboration with the University of Washington Center for Health Education and Research to support technical specialists and managers of HIV/AIDS programs in the developing world. This comprehensive electronic resource allows users to work with the stages and steps of the APDIME programming cycle as an index for locating information and tools that pertain to their immediate needs. Each step contains a brief summary of the process or method and provides links to relevant tools within the Synergy website, as well as on other websites. The Toolkit provides a window through which the user can view authoritative reports and syntheses of program outcomes, successes and failures. It contains links to checklists, budget templates, survey instruments, research findings, and worksheets, as well as a searchable database of Toolkit resources. Initial pilot-test feedback from developing country program managers at the 2002 XIV International AIDS Conference in Barcelona, Spain, indicates that users find the APDIME methodology to be useful and highly adaptable to other health and development challenges.

Capacity development is key to sustained program improvement. In August 2002, TvT and the University of Washington conducted the second annual Essentials of HIV/AIDS Program Planning course in Seattle, WA. Thirty-five individuals from 24 countries participated in the 5-day course, which is built around the APDIME Framework. Participants came away with a renewed commitment to ensuring stakeholder involvement in program planning and greater emphasis on using data for decision-making at each stage of the program cycle.

As the HIV pandemic grows, the complexity of effectively managing and coordinating appropriate responses to reduce HIV transmission also increases. TvT is helping USAID to describe and track its diverse HIV/AIDS activities as an integrated portfolio through a web-enabled programmatic database. This database enables standardized and comparable reporting by more than 40 cooperating agencies implementing USAID-funded activities worldwide. The programmatic database enables USAID to quickly describe the distribution of activities by agency, region, county, target group and type of intervention, and promotes learning from program experience in multiple countries and regions.

As a division of SSS, TvT has been able to work collaboratively with other SSS divisions - most notably the Computer Systems and Data Analysis (CSDA) division, which has provided assistance in the development of the APDIME Toolkit and the programmatic database. CSDA supports public health researchers and policy makers through statistical programming, data analysis, database development and maintenance, survey support, microsimulation modeling, system design and development, and Internet database applications. Another internal collaboration that offers intriguing possibilities is with SSS' Biomedical Research Support division, which supports three HIV/AIDS clinical trials networks funded by the National Institutes of Health. These networks are currently establishing new international clinical trials sites. According to Mary Frances leMat, president and CEO of SSS, "We are very interested in building a bridge from research into practice. With the addition of TvT and its program focus, we can explore and model how to link the two worlds."

SSS' website at http://www.s-3.com contains more information about the company.

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