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

Abstract

Supplemental Digital Content is Available in the Text.

Improving Utilization of HIV Viral Load Test Results Using a Quality Improvement Collaborative in Western Kenya

“…These results are consistent with other published reports of QI projects and QICs, which have shown success in enabling facility-level QI teams to design, test, and scale contextually appropriate interventions that improve the quality of health services ( Hargreaves et al, 2019 ; Schouten, Hulscher, van Everdingen, Huijsman, & Grol, 2008 ). As is typical for an QI project, there was no control group, so results at these 30 HFs cannot be compared with sites not participating in the QIC or generalized to other HF.…”

COVID-19 and the Gaping Wounds of South Africa’s Suboptimal Immunisation Coverage: An Implementation Research Imperative for Assessing and Addressing Missed Opportunities for Vaccination

“…This can involve a quality improvement (QI) intervention designed and implemented based on qualitative and quantitative assessment findings. QI approaches have been increasingly used in healthcare to improve health outcomes over the years [ 51 , 52 , 53 , 54 ]. The WHO defines QI as “a change in process in a health-care system, service, or supplier to increase the likelihood of optimal clinical quality of care measured by positive health outcomes for individuals and populations” [ 55 ].…”

Improving Services for HIV-Exposed Infants in Zambia and Cameroon Using a Quality Improvement Collaborative Approach

“…As with most QIC projects and time-series analyses, inferring causality between the intervention and the results in the current study is limited by the absence of a control or comparison group, and generalizability is limited by the nonrandom selection of HFs. 40 However, expert consensus suggests that randomized studies of QI project effectiveness are likely to be an inappropriate study method and that statistical process control FIGURE 3. Improvements in Early Testing, Timely Return of Test Results, and Antiretroviral Initiation From Baseline to Endline After Implementing a Quality Improvement Collaborative Approach, Cameroon and Zambia methods such as the use of run charts are the preferred approach to determining project success.…”