A Quality Improvement Approach to PMTCT programs in South Africa

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Presentation transcript:

A Quality Improvement Approach to PMTCT programs in South Africa Dr D Jacobs -Jokhan University Research Co.,LLC

The Quality Assurance Project / Health Care Improvement Project (QAP/HCI) This is one of 3 projects within University Research Co.,LLC (URC) working with the South African NDOH to strengthen and improve the implementation of and collaboration between HIV and AIDS programs and TB services. QAP/HCI supports 145 facilities in five provinces to improve quality of care in HIV and AIDS programs, of which 106 provide PMTCT for HIV + women. EC (24) KZN (23) Limpopo (12) Mpumalanga (36) NW (11)

How do we provide support for QI? Basis – focus on both content & process of care QA training Promote team work, integration of services and continuity of care Collect and analyze data at facility level with feedback (record audits & data from registers) Use data to identify problems Analyze problems and identify improvement interventions to address the quality gaps Continuous PDSA (plan, do, study, act) cycles

PMTCT: Proportion of HIV-exposed babies receiving NVP PMTCT: Proportion of HIV-exposed babies receiving NVP Compliance data (clinical staging & CD4 counts)

Lessons learnt Significant improvement in health outcomes in QAP/HCI-supported facilities. Importance of continuous monitoring and evaluation, capacity development of staff, integration of services and strengthening the continuum of care. Data analysis at all levels is critical Quality improvement initiatives replicable to other facilities / provinces

Recommendations Integration of services and strengthening the continuum of care plays a critical role. Supervision of HCW is a critical component of the program Follow up of training needs for facility & district staff Understanding of indicators & data utilization at facility & district levels – essential Improvement of data management system (DHIS) – vital for accurate recording and reporting of programmatic progress Feedback from program managers relates to better programmatic outcomes QI initiatives required for sustainability within programs

Acknowledgements URC QAP/HCI staff – National & provincial Department of Health – National, Provincial, district & facility staff USAID / PEPFAR