1. Scaling-up HIV Prevention Care and Antiretroviral Therapy at Primary Health Centers: A WHO/PEPFAR Collaboration Quality Management

2. Operations Manual: Quality Management Definition of Quality Healthcare “The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” IOM 2001

3. Operations Manual: Quality Management The Operations Manual section on Quality Management focuses on continuous quality improvement at PHC. The District Addendum contains information and tools for quality assessment by the district management team.

4. Operations Manual: Quality Management A combination of tools may be required to improve the quality of care given at each facility. For example, a centre may start with a readiness assessment and then with support from the district HIV coordinator outline a strengthening plan. After the program has been implemented, the health centre team should build a sustainable quality improvement plan to improve and maintain the quality of existing services.

5. Operations Manual: Quality Management Operations Manual covers: Differentiating the concept of quality improvement from quality assurance Developing and measuring indicators Plan-Do-Study-Act cycles Promoting a culture of QI

6. District Addendum: Quality Assessment The District Addendum covers: Essential program elements for integrated services Assessment of site readiness from scale- up to sustainability Supervisory site visits Record audits

7. District Addendum: Quality Assessment Current Tools Structured Observations of Patient-Provider Interactions Site readiness tools Adapted JSI site readiness tool Tanzania facility checklist SAM (service availability mapping) Supervisory visit tool District rapid appraisal TB-tool (DRAT) IMAI rapid assessment

8. Quality Management: Outstanding Technical Issues What essential elements of CQI are feasible at the primary health center? What tools exist for CQI at PHC level? Can other tools be adapted to PHC? Case studies? Examples?