A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities

Kols, Adrienne; Kim, Young Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie C.

doi:10.1097/qad.0000000000000720

Cited by 4 publications

(5 citation statements)

References 10 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, significant and consistent increases in compliance with SBM-R standards were observed over time. Comparable results have been recorded in other studies [20]. …”

Section: Discussionsupporting

confidence: 90%

Monitoring maternal and newborn health outcomes in Bauchi State, Nigeria: an evaluation of a standards-based quality improvement intervention

Kabo

Otolorin²,

Williams³

et al. 2016

Int J Qual Health Care

View full text Add to dashboard Cite

ObjectiveThis study assessed the correlation between compliance with set performance standards and maternal and neonatal deaths in health facilities.DesignBaseline and three annual follow-up assessments were conducted, and each was followed by a quality improvement initiative using the Standards Based Management and Recognition (SBM-R) approach.SettingTwenty-three secondary health facilities of Bauchi state, Nigeria.ParticipantsHealth care workers and maternity unit patients.Main outcome measuresWe examined trends in: (i) achievement of SBM-R set performance standards based on annual assessment data, (ii) the use of maternal and newborn health (MNH) service delivery practices based on data from health facility registers and supportive supervision and (iii) MNH outcomes based on routine service statistics.ResultsAt the baseline assessment in 2010, the facilities achieved 4% of SBM-R standards for MNH, on average, and this increased to 86% in 2013. Over the same time period, the study measured an increase in the administration of uterotonic for active management of third stage of labor from 10% to 95% and a decline in the incidence of postpartum hemorrhage from 3.3% to 1.9%. Institutional neonatal mortality rate decreased from 9 to 2 deaths per 1000 live births, while the institutional maternal mortality ratio dropped from 4113 to 1317 deaths per 100 000 live births.ConclusionScaling up SBM-R for quality improvement has the potential to prevent maternal and neonatal deaths in Nigeria and similar settings.

show abstract

“…In this study, significant and consistent increases in compliance with SBM-R standards were observed over time. Comparable results have been recorded in other studies [20]. …”

Section: Discussionsupporting

confidence: 90%

Monitoring maternal and newborn health outcomes in Bauchi State, Nigeria: an evaluation of a standards-based quality improvement intervention

Kabo

Otolorin²,

Williams³

et al. 2016

Int J Qual Health Care

View full text Add to dashboard Cite

show abstract

“…We grouped approaches into 4 main categories with support from experts in the Quality of HIV Care Technical Working Group (Fig. 1): health systems approaches using QI methods (n = 20), 21,22,24–26,29–43 standard-based methods that use QI tools to improve performance gaps (n = 2), 17,23 campaigns that use QI methods (n = 1), 28 and QI learning networks including collaboratives (n = 6). 15,16,18–20,27 Initiatives were performed in 13 LMICs, including South Africa, 15,19,20,28 Vietnam, 16,35 Zambia, 17,23 Nigeria, 18,27 Uganda, 21,22,31,36,40 Mozambique, 21,22 Namibia, 21,22,29,34,42,43 Haiti, 21,22,24,32,36,41 Thailand, 25,26 Nicaragua, 33 Kenya, 38 Tanzania, 37 and Guyana, 34,39 (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The 2 citations that used standard-based methods only reported on acceptability of the intervention (2 published and 0 gray literature). 17,23 The studies initially sought to define performance criteria relevant to the context, before using outside support to measure pre-existing performance gaps (in relation to the new standards), which are subsequently addressed and reassessed. In both studies, the authors indicated that health care worker perceptions of their work environment were positively impacted by the intervention, whereas they declined in comparison sites.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Do Quality Improvement Initiatives Improve Outcomes for Patients in Antiretroviral Programs in Low- and Middle-Income Countries? A Systematic Review

Hargreaves

Rustage

Nellums

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

show abstract

“…The existing performance monitoring team at health facilities were instrumental in using the health facility data for weekly review and performance improvement. A similar intervention in Zambia helped staff identify weaknesses, develop interventions for improvement, mobilize resources, and strengthen support systems to improve ART and prevention of mother-to-child HIV transmission services [ 13 ]. In our intervention, major issues identified at the health facility and sub-city level were escalated to AACAHB for further attention.…”

Section: Discussionmentioning

confidence: 99%

Enhancing and promoting data management and systematic monitoring for an improved HIV/AIDS programs in Addis Ababa, Ethiopia

Habte

Zemenfeskudus

Endale

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

Background Ethiopia Population-based HIV Impact Assessment findings showed that in Addis Ababa, only 65.2% of people living with HIV (PLHIV) know their status. We present the enhanced HIV/AIDS data management and systematic monitoring experience in Addis Ababa City Administration Health Bureau (AACAHB). Methods AACAHB established a command-post with leadership and technical team members from the health bureau, 10 sub-city health offices, and non-governmental stakeholders. The command-post improved governance, standardized HIV program implementation, and established accountability mechanism. A web-based database was established at each health facility, sub-city, and AACAHB level. Performance was scored (green, ≥75%; yellow, 50–74%; red, < 50%). The command-post reviewed performance on weekly basis. A mentorship team provided a weekly site-level support at underperforming public and private health facilities. At facility level, quality of data on recording tools such as registers, and individual medical records were maintained through continued review, feedback mechanisms and regular consistency check of data. Percentage and 95% confidence interval were computed to compare the improvement in program performance over time. Results After 6 months of intervention period, the monthly New HIV case finding in 47 health facilities increased from 422 to 734 (1.7 times) and treatment initiation increased from 302 to 616 (2 times). After 6 months, the aggregate scoring for HIV testing at city level improved from yellow to green, HIV case finding improved from red to green, and treatment initiation improved from red to yellow. An increasing trend was noted in HIV positive case finding with statistically significant improvement from 43.4% [95% Confidence Interval: 40.23–46.59%] in May 2019 to 74.9% [95% Confidence Interval: 72.03–77.6%] in September 2019. Similarly, significant improvement was recorded for new HIV treatment from 30.9% [95% Confidence Interval: 28.01–33.94%] in May 2019 to 62.5% [95% Confidence Interval: 59.38–65.6%] in September 2019. Conclusions Regular data driven HIV program review was institutionalized at city, sub-city and health facility levels which further improved HIV program monitoring and performance. The performance of HIV case finding and treatment initiation improved significantly via using intensified monitoring, data driven performance review, targeted site-level support based on the gap, and standardized approaches.

show abstract

A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities

Abstract: A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

Cited by 4 publications

References 10 publications

Monitoring maternal and newborn health outcomes in Bauchi State, Nigeria: an evaluation of a standards-based quality improvement intervention

Monitoring maternal and newborn health outcomes in Bauchi State, Nigeria: an evaluation of a standards-based quality improvement intervention

Do Quality Improvement Initiatives Improve Outcomes for Patients in Antiretroviral Programs in Low- and Middle-Income Countries? A Systematic Review

Enhancing and promoting data management and systematic monitoring for an improved HIV/AIDS programs in Addis Ababa, Ethiopia

Contact Info

Product

Resources

About