Where We Work

Namibia

The Namibia Project for Retention of Patients on ART (NAMPROPA), was a quality improvement collaborative (November 2016 - February 2018) with the aim of improving retention, viral load monitoring and suppression, and hypertension screening and treatment among people living with HIV in Khomas, Zambezi, and Ohangwena regions of Namibia to reach the UNAIDS 90-90-90 targets for Namibia. NAMPROPA was led by Namibia's Ministry of Health and Social Services (MoHSS) with technical support from HEALTHQUAL.

Based on the successful implementation of NAMPROPA, the MoHSS with HEALTHQUAL has now initiated another QI Collaborative - NamLiVE (Namibia Linkage to Care, Viral load Suppression and Ending TB), which is aimed at improving linkage to care, viral load suppression and TB prevention therapy (TPT) among People Living with HIV and AIDS in Namibia.

Zimbabwe

The Ministry of Health and Child Care and HEALTHQUAL successfully concluded the ART4All Collaborative in September 2018, which was designed to accelerate "Treat All" for PLHIV across 27 sites in City of Harare, Chitungwiza and Epworth District in Mashonaland East in Zimbabwe. This innovative collaborative addressed a new model of treatment implementation to reach the 90-90-90 goals. Results of ART4All activities indicate improvements in time to initiation, including same day initiation, missed appointments, viral load monitoring, viral load turn-around time and viral load suppression. ART4All activities were associated with site-level improvements in HIV quality management capacity, particularly in the areas of local leadership support for QI, existence of functional QI committees, measurement for QI and data analysis for improvement, and execution of QI initiatives according to identified targets.

ART4All Background and Results

Nigeria

The All Kids Count (AKC) Collaborative was implemented between January 2017 and November 2017 in 37 primary and tertiary health facilities across Federal Capital Territory, Lagos and Nasarawa States, Nigeria. Beginning in December 2017, AKC activities have been scaled up to include high-volume pediatric ART sites across 7 states (Akwa Ibom, Benue, Cross River, FCT, Lagos, Nasarawa, and Rivers) and intensify improvement efforts around the second and third 90s.

Southeast Asia

The Southeast Asia Stigma Reduction QI Learning Network is designed to accelerate implementation of national- and facility-level HIV-related stigma & discrimination reduction activities in Cambodia, Lao PDR, Thailand, and Vietnam through routine measurement, quality improvement (QI) methods, and structured peer learning and exchange. This multi-country undertaking offers a unique opportunity to share learning in this field between four countries in Southeast.

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Malawi

HEALTHQUAL has launched a collaborative with 29 hospitals aimed at improving same-day ART initiation, viral load monitoring, VLS, and TPT uptake
among PLWH in Blantyre District, Malawi. The collaborative is conducted in direct collaboration with the Blantyre DHO in coordination with MaiKhanda. 

Haiti

In Haiti, HEALTHQUAL is working to enhance data systems to link improvement with performance and quality management, integrate PEPFAR SIMS results into routine planning, and establish a formal QI coaching certification program.

Papua New Guinea

In PNG, HEALTHQUAL provides TA to the national HIVQUAL program in the NDoH - and mentorship to the NDoH QI program officer, as well as supporting initiatives to strengthen the national QM infrastructure. A major accomplishment for the PNG national program has been the programming of the HIVQUAL indicators into the HIV Patient Database (HPDB). This work will now allow providers to produce HIVQUAL reports from the same database into which they enter their reporting data. Finalizing these indicators was a key step to finalizing the National HIVQUAL Framework. 

Vietnam

In Vietnam, HEALTHQUAL is supporting the national HIVQUAL program, which has expanded from 11 outpatient clinics (OPCs) in 5 provinces in 2012, to 172 OPCs in 30 provinces in 2015. As part of the quality management program, HIVQUAL established a national TWG with 30 QM steering committees, 30 provincial TWGs, and 172 quality groups in hospitals/medical centers. As part of the performance measurement program, the national program has integrated multiple data platforms to track, analyze, and report on performance measurement data across sites (e.g. HIVQUAL software, eClinica). HIVQUAL-VN has established a national coaching program with a gradual transfer of technical support to provinces. Coaching supports the provinces and the OPCs to monitor QI implementation and site-level support for data collection. In addition to site visits, coaching is conducted through monthly web-based technical assistance via the ZOOM platform.

Uganda

In Uganda, HEALTHQUAL and UCSF are supporting QI implementation through a partnership with the Makerere School of Public Health/METS Program. The focus for this project is on data use for improvement through peer exchange and building capacity within Uganda’s national improvement program to spread improvement learning and build a regional knowledge network.