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

2. 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)

3. 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

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

5. 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

6. 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

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