1. MWENGE ESTATE CLINIC, KYENJOJO DISTRICT, UGANDA,EAST AFRICA.
RETENTION COLLABRATIVE IN HIV/AIDS CLIENTS.

2. AUTHORS NAME:
Mr. rusongoza david

3. QUALITY IMPROVEMENT INTERVENTIONS.
Patients were interviewed using a questionnaire which aimed at identifying reasons why patients fail to keep scheduled appointments.
Individual patients were interviewed.
Answers from respondents were recorded on blank space provided on questionnaire forms.
Clients were interviewed by a counselor.
Patients were finally requested to suggest any appropriate solutions to minimize failure to keep appointments.

4. IMPROVEMENT METHODS USED.
Improvement models and methodologies are used to identify, analyse,develop and test quality improvement procedures.

5. IMPROVEMENT TOPICS.
Improvement topics are based on retention of HIV patients currently enrolled at our site. The site has an active number of 700 HIV patients. 213 are on ARVs.

6. IDENTIFICATION OF RETENTION PROBLEM AT MWENGE ESTATE CLINIC.
In 2009 ,the site team collected baseline data on the number of HIV clients picking their pills(Arvs /cotrimoxazole tablets) each month. Basing on data collected, it was discovered that not every patient was able keep scheduled appointment. Only 86% of the patients were able to keep scheduled appointments.

7. QUALITY IMPROVEMENT INTERVENTIONS.
The following reasons were given by HIV/AIDS clients as the cause of failing to keep appointments:
Long distance from our Health unit
lack of transport.

8. Steps required to introduce or implement Group supply.
Patient should have a good track record on good adherence of 95% and above for the last three months.
Distance from Health unit should be 10km or more.
Clients to form a group of five to qualify for the supply.
Group should be registered at the health facility.

9. Patients interviews. Ten patients were interviewed.
Out of ten patients,7 patients said transport, 3 said long distance.
Among the patients interviewed, 8 proposed group supply and 2 proposed two months supply.

10. (5)Cumulative number of patients, Number of patients expected in care per month & actual patients in care receiving art per month.
2 months supply
12/2/2018

11. Barriers encountered:
Group supply members unable to contribute transport to the person supposed to pick drugs.
Some members unable to read and write this makes it difficult to pass new information to the rest of the team members.

12. Solutions to the barriers:
Patients unable to read and write: we put drugs together with a medical form in a polythene paper and seal for fear of mixing up different regimen and delivering wrong drug to patients in the group.

13. Lesson to learn.
In the management of chronic care illness, patients involvement is important in coming up with solutions to specific problems which patients face.
Introducing group supply narrowed the gap between expected and patients who kept appointments.

14. Remarks.
The above tested changes started on october,2009 and is on going.

15. Thank you,
David Rusongoza