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Short Reports

  • The USAID Health Care Improvement Project: A Global Resource for Improving Health Care | 2010

    The USAID Health Care Improvement Project (HCI) is a five-year Indefinite Quantity Contract issued in September 2007 by the United States Agency for International Development (USAID) to University Research Co., LLC (URC). The goal of the HCI Project is to achieve and document measurable improvements in the quality of health care and health workforce management in USAID-assisted countries.

  • The USAID Health Care Improvement Web Portal | 2010

    This short flyer describes the main sections and features of the Health Care Improvement Portal, the HCI Project's knowledge management web site, and how practitioners can contribute their own improvement experiences to the portal's Improvement Database.

  • Improving the Quality of HIV and AIDS Care and Related Services in Cote d'Ivoire | 2010

    This short report describes assistance that the USAID Health Care Improvement Project is providing to the National Program for HIV Care and Treatment (PNPEC) of the Ministry of Health, implementing partners, the National Program for Orphans and Vulnerable Children (PN-OEV) and the Ministry of the Family, Women and Social Affairs (MFFAS) in Cote d'Ivoire to apply improvement methods to improve the quality of antiretroviral therapy services, PMTCT, OVC programs, and peer prevention of HIV.  The report also highlights results from 41 sites that have been engaged in an impro

  • How to Obtain Technical Assistance through the USAID Health Care Improvement Contract | 2010

    This short document explains how USAID Missions, Strategic Element Groups, and Bureaus can obtain services in health care improvement through the Health Care Improvement (HCI) Indefinite Quantity Contract, either through obligation of funds through the existing global task order (HCI Task Order 3) or by issuing a new task order. 

  • PEPFAR | Care that Counts: Improving the Quality of Programs for Orphans and Vulnerable Children | 2010

    Lessons Lessons learned from OVC programs have revealed the need to improve service quality and to strengthen harmonization across partners around the questions: How can our programs make a measurable difference in children’s well-being? What are the essential actions that we all agree need to be part of a service to best to mitigate the impact of HIV/AIDS on children and families, in the pursuit of efficiency, effectiveness, equity, reach, and scale and sustainability?

  • The Framework for Engagement into HIV Care: A Tool for Strengthening the Health System's Response to the HIV/AIDS Epidemic in St. Petersburg, Russia | 2010
    Since 2004, teams of providers from the City AIDS Center, district polyclinics, TB facilities, and PLWH organizations in St. Petersburg, Russia, have worked together to analyze and improve the HIV/AIDS care system.
  • Collaboratives: A Feasible Improvement Strategy for Less Developed Countries | 2009

    The improvement collaborative approach, developed in the 1990s by the Institute for Healthcare Improvement (IHI), brings together practitioners from different health care organizations to work together to rapidly improve quality in a specific area of care. The Quality Assurance Project (QAP) and the follow-on Health Care Improvement Project (HCI), both funded by the United States Agency for International Development (USAID), adapted the core improvement mechanisms of collaboratives to the complex realities of developing countries.

  • Applying Quality Improvement Approaches to Human Resources for Health | 2009

    The USAID Health Care Improvement (HCI) Project supports countries in applying quality improvement methods to strengthen processes and outcomes of health care. Quality improvement (QI) involves mobilizing provider teams to: 1) identify problems affecting care quality and the changes that can be made to address them; 2) test interventions to find those that yield improvement; and 3) spread successful changes and best practices through shared learning and collaboration among multiple teams.

  • Decentralization of HIV Care in St. Petersburg, Russia | 2009

    To improve access to care and outcomes, the USAID-funded Quality Assurance Project (QAP) and Health Care Improvement Project (HCI) have worked since 2004 in a pilot district (Krasnogvardeisky) of St. Petersburg to develop and then scale up a model for the decentralized delivery of treatment, care and support services to PLWH using the improvement collaborative approach. QAP staff and participating providers first analyzed the system of care for PLWH.

  • HCI Techical Advisory Group meeting summary | 2009

    This short report summarizes the comments and recommendations made by the members of the HCI Technical Advisory Group at their meeting held May 18, 2009 at USAID. The meeting addresses five topic areas critical to fulfillment of the HCI statement of work: strengthening health systems, health workforce development, spread and institutionalization, quality improvement methods, and global learning/knowledge management.

    The full proceedings report is also available on this web site.

  • Quality Improvement for OVC Services: Changing Youth Participation from a "Token Voice" to a Key Actor | 2009

    This short report describes three guiding principles for involving children and adolescents in improving the quality of services they receive. These principles hold that service providers should: 1) focus on the needs and desires of those being served; 2) recognize that children are part of a larger entity—a family and/or community; and 3) do no harm.  The report also briefly describes experiences from Ethiopia and Tanzania with engaging children and guardians in QI teams.

  • Preventing postpartum hemorrhage: Why quality improvement matters | 2009

    The failure of many health services worldwide to deliver evidence-based prevention and treatment of postpartum hemorrhage (PPH) where and when women need care is a major quality problem for maternal health.  This HCI short report describes how quality improvement approaches can accelerate scale-up of a high-impact intervention to reduce PPH--active management of the third stage of labor.  The report describes how quality improvement efforts in Niger and Ecuador led to remarkable gains in national coverage of this life-saving intervention. 

  • Le project d'amelioration des soins de sante: Ressource de l'USAID | 2008

    Le Projet d’Amélioration des Soins de Santé (Health Care Improvement Project ou le Projet HCI) est un nouveau Contrat de Quantité Indéfinie, d’une durée de cinq ans et d’un montant de $150 million finance par l’USAID pour aider les pays à améliorer la qualité et l’impact des services de santé.

  • Improving Tuberculosis Control in Rural Bolivia | 2008

    In 2006, USAID/Bolivia asked the Quality Assurance Project (QAP) to work with its bilateral health project, Gestión y Calidad en Salud (GCS) and the National TB Control Program (NTP) of the Ministry of Health (MOH) to implement an improvement collaborative aimed at strengthening the TB program’s performance. A rapid assessment conducted by GCS and QAP in 38 public health facilities in Los Yungas in January 2007 found divergent cure rates (as low as 47%), abandonment rates of 21%, and no directly observed treatment.

  • Improving Pediatric Care in Nicaragua | 2008

    In 2003, the USAID-funded Quality Assurance Project (QAP), the Ministry of Health of Nicaragua, and UNICEF/Nicaragua started a Pediatric Hospital Improvement (PHI) Collaborative aimed at standardizing and improving the care of severely ill and malnourished children at secondary care hospitals. Six regional hospitals were selected to participate based on high case fatality rates and interest on the part of the staff to improve care processes: Bluefields, Chinandega, Estelí, Jinotega, Madriz, and Matagalpa.

  • Niger: Quality Improvement for Maternal-Newborn Health Services | 2008

    On average a Nigerien woman faces a 1 in 7 risk of dying from pregnancy complications over the course of her lifetime, one of the highest maternal mortality risks in the world. Post-partum hemorrhage (PPH) is the leading cause of maternal mortality in Niger followed by sepsis and eclampsia. For every maternal complication, there is a high rate of newborn death and morbidity.

  • Testing Service Standards and Developing Best Practices for Reaching Standards in OVC Programs | 2008

    Over the last year or so, several countries and programs have developed service standards for their OVC programs in order to improve the quality of services provided to children, and address the variation in, and lack of equity among, OVC service providers on what constitutes “an OVC served.” These draft standards are an important step in improving OVC programming and reflect current practice, common sense, and the collective wisdom of people involved in programs.

  • Using the Collaborative Approach to Improve Pediatric Hospital Care | 2008

    In 2003–2004, the USAID-funded Quality Assurance Project began supporting health ministries in Nicaragua, Niger, and Tanzania to improve the quality of care for hospitalized children through national Pediatric Hospital Care Improvement (PHI) Collaboratives. The PHI Collaboratives’ purpose was to adapt WHO guidelines for the management of childhood illness to local health care settings and conditions, support the application of the adapted guidelines, and then scale up the lessons learned and improvements.

  • Improving Access to HIV/AIDS Care and Patient Retention in Russia | 2008

    The USAID-funded Quality Assurance Project (QAP) began work in the Russian Federation in 1998, initially supporting the piloting and scale-up of improved systems of care for maternal and child and primary health care. In 2003, USAID asked QAP to apply quality improvement methods to improve treatment, care, and support for HIV-infected and AIDS patients. From 2004- 2006, QAP supported a demonstration collaborative on HIV/AIDS treatment, care and support involving sites in four cities in the oblasts of Samara, Saratov, and Orenburg, and St. Petersburg.

  • Integrating TB and HIV Services in the General Health Care System in Russia | 2008

    Assurance Project (QAP) began to work with federal and regional health authorities in the Russian Federation to apply the improvement collaborative approach to design a model system on HIV/AIDS treatment, care and support in pilot sites in four cities: St. Petersburg (one of 18 districts), Orenburg, Engels, and Togliatti. The aim of the demonstration collaborative was to develop a municipal model for delivery of integrated treatment, care and support services, including tuberculosis (TB) testing and treatment, to persons living with HIV/AIDS (PLWHA).

  • Quality Improvement in HIV/AIDS Care, Prevention of Mother-to-Child Transmission, and Related Services | 2008

    The Quality Assurance Project (QAP) and its successor project, the USAID Health Care Improvement Project (HCI), have reached a stage in quality improvement work in Tanzania that lessons can be derived and shared with others. Clearly, the commitment of the Government and its agencies, the Ministry of Health and Social Welfare and its departments, have made these successes possible, setting an example for others.