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Soroti District Improvement Report

Improvement Report
Amodoi Martin | Eudu Samson

Topics: Antiretroviral therapy/ART/ARV, HIV/AIDS, Retention in care

Region and Country: Uganda

Organization: Ministry of Health of Uganda
The Report

Soroti District is located in the North Eastern part of Uganda.  The district care system is run according to Ministry of Health policy guidelines.  The health system ranges from health centre I up to health centre IV for the case of Soroti.  The district provides a variety of activities at the different levels.  These activities are both preventive and curative.  The system, however, faced quite a number of challenges that needed development of systems that would enable it to uphold some of the challenges.

The most significant problems noted in health facilities included inadequate support supervision, lack of team work, lack of proper documentation of the implemented activities, inadequate human resource, and non-availability of ART services. The Ministry of Health through the quality improvement section came in to bail the district from the said problems.


The following interventions were carried out.  The major objective was to improve on the quality of health services provided:

  • - District Health Team members were oriented on the principles of quality improvement.
  • - District Health Teams hold monthly meetings to review and plan quality improvement activities.
  • - Regular monthly coaching and support supervision to health centre IV's.
  • - Established site quality improvement teams in the two health centre IV's.
  • - Established a data collection system and documentation system.

The orientation of the District Health Team and the site teams on the principles of quality improvement helped in refocusing us to deliver the services as a team, not as individuals, and this to the greater extent addresses the issue of human resources and cultivated team spirits.

Regular supervision enabled the site teams to build confidence in what they are doing.  It also improveed in documentation of changes made and above all prepared the facilities for the implementation of antiretroviral therapy because they were able to identify and enroll the clients for ART.  Regular support supervision also enabled the facilities and the district to improve on the documentation of the implemented activities and above all data collection, analysis, utilization and dissemination.  Regular planning and review meetings helped in the identification of gaps and through the quality improvement process, solutions were thought out.

  • - Regular support supervision enables health teams to build confidence in their work and fosters team spirit.
  • - The facilities have taken up on their data collection and analysis/information sharing as the basis for planning
  • - Direct link between health workers and ART clients helps to monitor treatment outcomes.
  • - Improved relationship between health workers and clients upholds retention in ART.
  • - Improved collaboration among sections within health facilities i.e., lab, OPD, etc. is essential in health service delivery.
  • - Strengthened regular support supervision improves quality of work.

Message: Adoption of quality improvement principles, i.e., focusing on systems and processes, utilization of data for future planning and team work are crucial in the delivery of health services at all levels.  It is important to use quality improvement principles to address gaps identified.