People of AMPATH: Douglas Momanyi, Clinical Officer

From the consultation room, Douglas Momanyi calls out to the next patient in line who walks in, takes a seat and places his card on the desk. It’s a normal day in Turbo Sub-County hospital where Douglas, a clinical officer (CO), has been working for the last nine years seeing clients every day. However, the model of care here is quite unique. The AMPATH Comprehensive Care Clinic (CCC) was once a clinic where only HIV care and testing was provided. Today, the same clinic serves all chronic diseases seen by the same pool of clinicians, minimizing the stigma related with a visit.

Clinical officer Douglas Momanyi completed the Advanced Practitioner Clinical Officer course and manages patients with chronic diseases including HIV, diabetes, hypertension, cardiac disease and mental illness.

“I manage clients with different chronic diseases including HIV, diabetes, hypertension, cardiac disease, and mental illnesses,” said Douglas, who chose to pursue a career in health care after he first took a sick relative to the health center and was impressed by the care they received.

 “Clinical officers play a significant role of providing primary care in lower level facilities in Kenya as frontline providers of acute and chronic disease care. They are therefore key to achieving primary health care and building referral services as part of universal health coverage,” said Dr. Jeremiah Laktabai, a family physician leading population health efforts within the AMPATH partnership.

In addition to the required three-year clinical medicine program, Douglas has received training and mentorship to provide chronic care and refer cases appropriately. Douglas is one of 16 clinical officers who recently completed a higher national diploma in chronic disease care and is awaiting graduation in December 2019. The Advanced Practitioner Clinical Officer (APCO) diploma course was started in 2016 in partnership with the Moi Teaching and Referral Hospital (MTRH) Training Institute and AMPATH. The 18-month program was developed to provide a specialization track for clinical officers in primary chronic disease care. AMPATH’s longtime partner and supporter, AbbVie Foundation, supported AMPATH’s first class of clinical officers, including Douglas, as part of its comprehensive funding to AMPATH and commitment to improve health care systems in underserved communities.

The program is delivered via teleconference which makes it easy for clinical officers in remote areas to attend classes. In addition to the advance practice training, the clinical officers continue to receive mentorship from physicians and psychiatrists and to see clients with them regularly.

There is ample evidence supporting the benefits of integration of care including lower cost and improved quality of care. In Turbo, the integration of care has been particularly lauded for reducing stigma that was initially related to accessing care in the CCC. Now, the next client entering Douglas’ office is not necessarily labeled as HIV positive.

“Next patient, please!”