26 facilities in the Northern Region of Uganda are participating in the collaborative improvement effort implementing the ART Framework. This study aims to understand how best practices to improve HIV/AIDS care are modified and adapted as they are spread across and implemented at these various sites, which are free to choose which changes they wish to apply and to modify those changes to suit their needs. This study will identify best practices that are being spread throughout the facilities and gather details of the implementation of specific changes. Tentatively, the following three practices will be studied: 1) giving 2-3 months supply of ARVs to adherent patients to improve retention, 2) pre-packaging medicines to reduce waiting time and ultimately improve coverage and clinic efficiency, and 3) using a screening tool for detecting tuberculosis in HIV/AIDS patients to improve clinical outcomes. The study will look at best practices that are implemented by five or more of the 26 participating facilities in order to understand how that change is modified across different sites.

This technical report describes results achieved during the demonstration phase of an improvement collaborative implemented in Cote d’Ivoire by the USAID Health Care Improvement Project (HCI), the National Program for the Medical Management of People Living with HIV/AIDS (PNPEC), and the Ministry of Health and Public Hygiene in order to improve the quality of HIV services.

An initial evaluation of the quality of care and treatment for persons living with HIV (PLHIV) was conducted from July – August 2008 in 33 health care centers throughout Cote d’Ivoire in order to draw attention to the need for improvements among different components of care and treatment services. After the restitution of the results of the initial evaluation and the establishment of the elements of an improvement collaborative, 41 sites were selected to participate in the demonstration phase of the collaborative. Of these 41 sites, 34 provide prevention of mother to child transmission of HIV (PMTCT) services, and 38 provide anti-retroviral (ARV) treatment services.

En 2008, à la demande du Ministère de la santé, avec l’appui financier du PEPFAR, le Projet d’Amélioration des Soins de Santé de l’USAID (HCI) a été invité à assister le Programme National de Prise en Charge des personnes vivant avec le VIH (PNPEC) pour conduire une évaluation nationale de la qualité des soins dans le domaine du VIH en Côte d’Ivoire. HCI et les partenaires de mise en œuvre ont conduit une évaluation nationale de la qualité des soins et services offerts aux PVVIH. Sur la base de l’évaluation, un comité technique dirigé par le PNPEC avec l’appui technique d’URC a développé un paquet de changement pour améliorer la documentation, le suivi et la rétention des patients. Ce rapport décrit les résultats du collaboratif d’amélioration d’ARV/PTME.  

At the request of the Office of the Global AIDS Coordinator (OGAC), the United States Agency for International Development (USAID) and the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria (Global Fund), the USAID Health Care Improvement Project (HCI) developed an approach to yield meaningful information about the quality of HIV services for users at multiple levels of the health system. The approach proposes 16 quality criteria (QC) that were assessed through 25 existing indicators. The indicators were based on measures previously required or recommended by funders and other stakeholders, such as the Global Fund, PEPFAR, and the World Health Organization. This report presents the findings from a field test of the approach in five countries in three world regions: Africa, Eurasia, and Southeast Asia.

This presentation was given by Dr. Donna Jacobs, HCI Country Director for South Africa, at the 28th International Conference of the International Society for Quality in Health Care, Ltd. (ISQua), which took place in Hong Kong, China from September 14-17, 2011. The conference theme was, “Patient Safety: Sustaining the Global Momentum."

This short report describes assistance that the USAID Health Care Improvement Project (HCI) is providing to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and to the Office of the Global AIDS Coordinator (OGAC) to develop an approach that can be used to harmonize global reporting and improve the quality of HIV services and health outcomes. This study details HCI’s approach that employs 16 quality criteria for 5 HIV service delivery areas: testing and counseling, care and treatment, PMTCT, TB/HIV, and harm reduction. Field tests were conducted in five selected countries: 3 in Africa, 1 in Eurasia and 1 in Southeast Asia.