Improving coverage and completion rate of isoniazid preventive therapy among eligible HIV patients using quality improvement approaches: a case study of State Hospital, Ijebu Ode, Ogun State, Nigeria

Ogunsola, Olabanjo Okunlola; Ajayi, Oluseye Ayodele; Ojo, Omobola Y.; Adeyeye, Oluwatomisin; Akinro, Yewande; Oke, O.T.; Adurogbola, Adefolake Adebare; Olajide, Olalere

doi:10.11604/pamj.2019.34.193.19360

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…Shortage of INH, fear of INH resistance, lack of confidence in ruling out TB disease, lack of commitment among providers and hesitancy in accepting IPT among clients were among the barriers for IPT implementation documented in several other studies (Nyathi et al, 2019;Teklay et al, 2016;Wesen Denegetu and Lovely Dolamo, 2014). Improvement in recording and reporting in order to identify PLHIV who are eligible for IPT, health education to curb fear of (Teklay et al, 2016;Ogunsola et al, 2019;Legese et al, 2020) which could be applied in our setting as well.…”

Section: Discussionmentioning

confidence: 90%

Coverage of isoniazid preventive therapy among people living with HIV; A retrospective cohort study in Tanzania (2012-2016)

Maokola

Ngowi

Lawson

et al. 2021

International Journal of Infectious Diseases

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Background: Isoniazid Preventive Therapy (IPT) is a proven public health tool to reduce Tuberculosis (TB) among people living with HIV. However, its implementation in most countries is suboptimal. This retrospective study was conducted to determine the coverage and factors associated with IPT initiation to inform program scale up and improve quality of service in Tanzania and elsewhere. Methods: Retrospective cohort study design involving HIV clinics in

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Section: Discussionmentioning

confidence: 90%

Coverage of isoniazid preventive therapy among people living with HIV; A retrospective cohort study in Tanzania (2012-2016)

Maokola

Ngowi

Lawson

et al. 2021

International Journal of Infectious Diseases

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“…A national QI programme in Namibia improved IPT by 16 to 28% [33]. In comparison, a Nigerian study made a larger improvement in IPT (11% to 50%); however, their efforts were focused at one busy facility [34]. Both studies attribute this success to QI interventions building skills and confidence among clinic teams to make improvements.…”

Section: Discussionmentioning

confidence: 98%

Organizational contextual factors that predict success of a quality improvement collaborative approach to enhance integrated HIV-tuberculosis services: a sub-study of the Scaling up TB/HIV Integration trial

et al. 2021

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Background A quality improvement (QI) collaborative approach to enhancing integrated HIV-Tuberculosis (TB) services may be effective in scaling up and improving the quality of service delivery. Little is known of the role of organizational contextual factors (OCFs) in influencing the success of QI collaboratives. This study aims to determine which OCFs were associated with improvement in a QI collaborative intervention to enhance integrated HIV-TB services delivery. Methods This is a nested sub-study embedded in a cluster-randomized controlled trial. Sixteen nurse supervisors (clusters) overseeing 40 clinics were randomized (1:1) to receive QI training and mentorship, or standard of care support (SOC). In the QI arm, eight nurse supervisors and 20 clinics formed a “collaborative” which aimed to improve HIV-TB process indicators, namely HIV testing, TB screening, isoniazid preventive therapy (IPT) initiations, viral load testing, and antiretroviral therapy for TB patients. OCFs measured at baseline were physical infrastructure, key staff, flexibility of clinic hours, monitoring data for improvement (MDI), and leadership support. Surveys were administered to clinic staff at baseline and month 12 to assess perceptions of supportiveness of contexts for change, and clinic organization for delivering integrated HIV-TB services. Linear mixed modelling was used to test for associations between OCFs and HIV-TB process indicators. Results A total of 209 clinic staff participated in the study; 97 (46.4%) and 112 (53.6%) from QI and SOC arms, respectively. There were no differences between the QI and SOC arms scores achieved for physical infrastructure (78.9% vs 64.7%; p = 0.058), key staff (95.8 vs 92; p = 0.270), clinic hours (66.9 vs 65.5; p = 0.900), MDI (63.3 vs 65; p = 0.875, leadership support (46.0 vs 57.4; p = 0.265), and perceptions of supportiveness of contexts for change (76.2 vs 79.7; p = 0.128 and clinic organization for delivering integrated HIV-TB services (74.1 vs 80.1; p = 0.916). IPT initiation was the only indicator that was significantly improved in the parent study. MDI was a significantly associated with increasing IPT initiation rates [beta coefficient (β) = 0.004; p = 0.004]. Discussion MDI is a practice that should be fostered in public health facilities to increase the likelihood of success of future QI collaboratives to improve HIV-TB service delivery. Trial registration Clinicaltrials.gov, NCT02654613. Registered 01 June 2015.

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“… 25 In a Nigerian case study, situated at a single state-run hospital, IPT initiation improved by 39% (11% to 50%). 26 Interestingly, the Namibian study was at a national level and the Nigerian study was conducted at 1 facility. 25 , 26 Similar to the SUTHI study, the Nigerian study was more active in addressing issues of organization, process, management, and systems.…”

Section: Discussionmentioning

confidence: 99%

“… 26 Interestingly, the Namibian study was at a national level and the Nigerian study was conducted at 1 facility. 25 , 26 Similar to the SUTHI study, the Nigerian study was more active in addressing issues of organization, process, management, and systems. The authors surmise that root cause analysis and first-hand involvement of clinic staff in developing systems played a role in achieving improvement.…”

Section: Discussionmentioning

confidence: 99%

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A Quality Improvement Intervention to Inform Scale-Up of Integrated HIV-TB Services: Lessons Learned From KwaZulu-Natal, South Africa

Gengiah

Naidoo

Mlobeli

et al. 2021

Glob Health Sci Pract

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Improving coverage and completion rate of isoniazid preventive therapy among eligible HIV patients using quality improvement approaches: a case study of State Hospital, Ijebu Ode, Ogun State, Nigeria

Cited by 8 publications

References 7 publications

Coverage of isoniazid preventive therapy among people living with HIV; A retrospective cohort study in Tanzania (2012-2016)

Coverage of isoniazid preventive therapy among people living with HIV; A retrospective cohort study in Tanzania (2012-2016)

Organizational contextual factors that predict success of a quality improvement collaborative approach to enhance integrated HIV-tuberculosis services: a sub-study of the Scaling up TB/HIV Integration trial

A Quality Improvement Intervention to Inform Scale-Up of Integrated HIV-TB Services: Lessons Learned From KwaZulu-Natal, South Africa

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