Continuous quality improvement (CQI) Institutionalization to reach 95:95:95 HIV targets: a multicountry experience from the Global South
JournalBMC Health Services Research
MetadataShow full item record
AbstractBackground: Scaling up continuous quality improvement (CQI) processes could be key in achieving the 95:95:95 cascade and global HIV targets. This paper describes the experiences and outcomes related to implementing CQI processes to help reach these targets, with particular focus on clinical and programmatic settings in 6 countries from the global south. Methods: The HIV program at the University of Maryland, Baltimore (UMB) implemented an adapted CQI model in Kenya, Tanzania, Botswana, Zambia, Nigeria and Rwanda that included the following steps: (1) analysing the problem to identify goals and objectives for improvement; (2) developing individual changes or 'change packages', (3) developing a monitoring system to measure improvements; and (4) implementing and measuring changes through continuous 'plan-do-study-act' (PDSA) cycles. We describe country-level experiences related to implementing this adaptive design, a collaborative learning and scale-up/sustainability model that addresses the 95:95:95 global HIV targets via a CQI learning network, and mechanisms for fostering communication and the sharing of ideas and results; we describe trends both before and after model implementation. Results: Our selected country-level experiences based on implementing our CQI approach resulted in an increased partner testing acceptance rate from 21.7 to 48.2 % in Rwanda, which resulted in an increase in the HIV testing yield from 2.1 to 6.3 %. In Botswana, the overall linkage to treatment improved from 63 to 94 %, while in Kenya, the viral load testing uptake among paediatric and adolescent patients improved from 65 to 96 %, and the viral load suppression improved from 53 to 88 %. Conclusions: Adopting CQI processes is a useful approach for accelerating progress towards the attainment of the global 95:95:95 HIV targets. This paper also highlights the value of institutionalizing CQI processes and building the capacity of Ministry of Health (MoH) personnel in sub-Saharan Africa for the effective quality improvement of HIV programs and subsequent sustainability efforts.
Rights/Terms© 2021. The Author(s).
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/16224
- The impact of continuous quality improvement on coverage of antenatal HIV care tests in rural South Africa: Results of a stepped-wedge cluster-randomised controlled implementation trial.
- Authors: Yapa HM, De Neve JW, Chetty T, Herbst C, Post FA, Jiamsakul A, Geldsetzer P, Harling G, Dhlomo-Mphatswe W, Moshabela M, Matthews P, Ogbuoji O, Tanser F, Gareta D, Herbst K, Pillay D, Wyke S, Bärnighausen T
- Issue date: 2020 Oct
- A Continuous Quality Improvement Intervention to Improve Antenatal HIV Care Testing in Rural South Africa: Evaluation of Implementation in a Real-World Setting.
- Authors: Yapa HM, Dhlomo-Mphatswe W, Moshabela M, De Neve JW, Herbst C, Jiamsakul A, Petoumenos K, Post FA, Pillay D, Bärnighausen T, Wyke S
- Issue date: 2022 May 1
- What do the Universal Test and Treat trials tell us about the path to HIV epidemic control?
- Authors: Havlir D, Lockman S, Ayles H, Larmarange J, Chamie G, Gaolathe T, Iwuji C, Fidler S, Kamya M, Floyd S, Moore J, Hayes R, Petersen M, Dabis F, (Universal Test, Treat Trials) UT3 Consortium.
- Issue date: 2020 Feb
- Tackling the hard problems: implementation experience and lessons learned in newborn health from the African Health Initiative.
- Authors: Magge H, Chilengi R, Jackson EF, Wagenaar BH, Kante AM, AHI PHIT Partnership Collaborative.
- Issue date: 2017 Dec 21
- Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa.
- Authors: Manzi A, Hirschhorn LR, Sherr K, Chirwa C, Baynes C, Awoonor-Williams JK, AHI PHIT Partnership Collaborative.
- Issue date: 2017 Dec 21