Using Small Tests of Change to Improve PMTCT Services in Northern Nigeria: Experiences From Implementation of a Continuous Quality Improvement and Breakthrough Series Program

Abstract

Health workers were receptive to CQI process. A compendium of "change ideas" compiled into a single change package can be used to improve health care delivery.

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

“…18 Data quality was reported to have improved in another setting. 27 Cotrimoxazole prophylaxis prescription to combat opportunistic infections in eligible individuals increased in one study from 31% to 99% at the provincial level and from 75% to 83% at the district level, whereas TB screening in this same study also increased from 15% to 100% at the provincial level and from 18% to 79% at the district level. 16…”

“…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. 3).…”

“…However, despite enthusiastic participation in the program by health care workers, there was no measurable increase in patient satisfaction. 27…”

Improving Retention in Care Among Pregnant Women and Mothers Living With HIV: Lessons From INSPIRE and Implications for Future WHO Guidance and Monitoring

“…11 Again, the study team invested enormous effort and commitment to support local health facility teams to learn and implement CQI and the Breakthrough Series methods. 12 Facility teams enthusiastically engaged in the CQI process and actively tested change ideas—more than 41 in total across the intervention sites. Weaknesses in the theory of change, insufficient time to properly implement the intervention, civil strife, and disruptions in the health system may all have contributed to the lack of impact on retention in care.…”

A 6-Country Collaborative Quality Improvement Initiative to Improve Nutrition and Decrease Mother-to-Child Transmission of HIV in Mother–Infant Pairs

“…Countries with the highest burden of HIV in Africa have shown significant improvement in coverage rates for antenatal prevention of mother-to-child transmission (PMTCT) treatment using quality improvement (QI) approaches together with policy and protocol changes. 1-4 Despite these advances, the protection of infants from postnatal HIV infection through breast milk and nutritional management of these infants remains a major issue in all high-burden countries, significantly impacting their survival. 5,6…”