Journal of the International Association of Providers of AIDS Care (Jun 2019)

Applying Quality Improvement Approaches to Reduce Mother-to-Child HIV Transmission and Improve Health and Nutrition Care in Five Countries: Lessons from the Partnership for HIV-Free Survival

  • Amy F. Stern MHS,
  • Anisa Ismail MPH,
  • Esther Karamagi MBChb, MSc,
  • Tamara Nsubuga-Nyombi BSc, MPHDC,
  • Stella Kasindi Mwita MD, MPH,
  • Monica M. Ngonyani MSc,
  • Kevin Kinyua MbCHb,
  • Prisca Muange MBChB, MPH, MSc,
  • Kelello L. M. Lerotholi MD,
  • Manone Rantekoa BScN, MPH,
  • Khotso G. Mahlalefa BSc,
  • Maureen Fatsani Tshabalala RNM, BBA, MPH,
  • Nigel Livesley MD, MPH

DOI
https://doi.org/10.1177/2325958219847458
Journal volume & issue
Vol. 18

Abstract

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The World Health Organization guidelines for treating pregnant HIV-positive women and preventing HIV transmission to infants now recommend lifelong antiretroviral treatment for pregnant and breastfeeding women. We applied quality improvement (QI) methods to support governments and facility staff to address service gaps in 5 countries under the Partnership for HIV-Free Survival (PHFS). We used 3 key strategies: break the complex problem of improving HIV-free survival into more easily implementable phases, support a national management team to oversee the project, and support facility-level staff to learn and apply QI methods to reducing mother-to-child transmission. The key results in each country were increases in data completeness and accuracy, increases in retention in care of mother–baby pairs (MBPs), increase in coverage of MBPs with appropriate services, and reduction in vertical transmission of HIV. The PHFS experience offers a model that other multicountry networks can adopt to improve service delivery and quality of care.