Communities of Practice
CQUIN Communities of Practice (CoP) bring network member countries together for joint learning and co-creation of resources that advance differentiated service delivery
National DSD Coordinators
Launched in April 2017, this CoP meets regularly to facilitate the exchange of information, best practices, and tools amongst national differentiated service delivery (DSD) coordinators. The CoP provides a platform for the CQUIN Project Director to provide technical support and mentorship to the DSD Coordinators; exchange and review of tools and resources; peer-to-peer feedback; CQUIN-related updates; and planning for upcoming meetings.
- Participants include 20 people from 21 countries.
- Dr. Peter Preko (CQUIN Project Director) is the technical lead, supported by Ms. Phephile Dlamini (Project Operations Coordinator)
- The CoP has monthly virtual meetings to update members on DSD implementation within the network.
- The platform facilitates the swift exchange of policy documents, SOPs, and data collection tools used in DSD among the network countries.
M&E of DSD
Launched in August 2017, the CoP reflects the ongoing high interest amongst CQUIN country teams in the need to adapt routine monitoring and evaluation (M&E) systems to accommodate DSD models and to develop tools and resources for ad hoc data collection related to DSD.
- Participants include more than 40 individuals from nine countries including Côte d’Ivoire, DRC, Eswatini, Kenya, Liberia, Mozambique, Uganda, Zambia, and Zimbabwe.
- Dr. Bill Reidy (CQUIN Deputy Director for Strategic Information) is the technical lead, supported by Dr. Karam Sachathep (ICAP Senior SI Manager).
- The CoP meets quarterly or more frequently as needed.
- In its first year, the CoP developed an M&E framework, which was subsequently used to inform M&E of DSD strategies in at least six countries: Côte d’Ivoire, Eswatini, Malawi, Uganda, Zambia, and Zimbabwe.
- In 2019, the CoP worked to develop a toolkit for DSD performance reviews in order to facilitate the ad hoc data collection needed to assess DSD coverage and quality in many countries.
- More recently, the CoP has met to share and discuss experiences related to topics such as M&E adaptations under COVID-19, assessing provider and recipient of care satisfaction, and the use of national electronic medical records systems for M&E of DSD.
DSD for Advanced HIV Disease
Differentiated service delivery (DSD) for people with advanced HIV disease and those at high risk of HIV disease progression (P@HR) has been an important theme within the CQUIN network. Network participants selected it as a priority at the CQUIN Launch Meeting, and early network activities included hosting an all-network meeting on DSD for P@HR in Harare, the development of a Call to Action for differentiated treatment models for patients with advanced disease and those who are at high risk of progression and development of a screening tool for use by frontline health workers.
- Dr. Maureen Syowai, is the technical lead, supported by Ms. Christine Mburu (Project Operations Coordinator)
- In 2018-2019, 14 CoP members from Eswatini, Malawi, Uganda, and Zimbabwe worked to develop a P@HR screening tool.
- In 2020, CQUIN partnered with CHAI and Unitaid to convene a multi-country workshop on DSD for advanced HIV disease.
- The AHD CoP steering committee was launched in 2020 comprising 10 members drawn from 7 countries.
- In 2021-22, the CoP co-created a capability maturity model dashboard for AHD to enable countries to self-stage the maturity of their AHD systems.
- The dashboard has been used for self-staging by 11 countries to date: Cote d’Ivoire, Eswatini, Ethiopia, Kenya, Malawi, Mozambique, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia.
- The CoP will host a satellite session on strengthening health systems to support AHD service delivery at the AIDS2022 conference in July 2022.
Community Engagement in DSD Programs
Launched in November 2018, the Community Engagement technical working group ensures that the voices of people living with HIV and recipients of care are central to the CQUIN network. The CoP supports the engagement of representatives of national and regional networks of people living with HIV in all CQUIN activities. For this CoP, all network countries should be represented by a Recipient of Care nominated by the respective national networks of people living with HIV.
- Representatives from 20 of the 21 network countries are currently participating in the CoP. They include representatives of national and regional networks of people living with HIV
- Ms. Solange Baptiste and Dr. Bactrin Killingo from ITPC are the technical leads, supported by Dr. Rudo Kuwengwa, CQUIN Regional Advisor
- The group drafted a Community Engagement Framework, which was presented at the 3rd CQUIN Annual Meeting in November 2019.
- In 2020-2021, the CoP developed and piloted an accompanying monitoring toolkit to enable stakeholders to assess the extent of Community Engagement in DSD-related policy, implementation, and evaluation.
- Initial results from the CE Assessment Toolkit were presented at CQUIN’s 5th annual meeting here.
Quality and Quality Improvement for DSD
Launched in October 2018, the CoP focuses on building capacity for DSD-specific quality management, including the development of DSD-specific quality standards, indicators, and quality assurance (QA) tools, and exchanging resources to support quality improvement (QI) of DSD programs. The CoP enables network countries to contribute towards the scale-up of high-quality DSD programs by exchanging best practices related to DSD quality management; identifying opportunities to co-create resources, and working to strengthen networks of practitioners and policymakers to promote ongoing cross-country learning.
- 19 countries are actively engaged in the CoP
- Mr. Martin Msukwa, CQUIN Regional Advisor, is the technical lead, supported by Ms. Gillian Dougherty, Senior QI Advisor at ICAP New York, and Ms. Phephile Dlamini, Project Operations Coordinator from ICAP in Eswatini.
- In June 2019, CQUIN hosted an all-network workshop on DSD Quality and QI, and the network continues to explore each of the three elements of the classic “Juran Triad” as they relate to DSD – quality planning, quality assurance, and quality improvement.
- In 2020, the community of practice reacted to the lack of global and national quality standards for DSD by co-creating a DSD quality standards framework for less-intensive DART models; the English version is here and the French version is here.
- In 2021, the CQUIN Quality and QI Community of practice has developed and piloted quality standards for DART models toolkit in three countries. The tool is intended to serve as a generic and adaptable resource for stakeholders to assess and improve DART quality. The development and piloting processes are described here.
- In 2022, CQUIN will host an all-network meeting on DSD-specific quality management, support each member country to develop DSD-related quality management action plans, refine the Quality domain in CQUIN’s capability maturity model dashboard, and support an expanding portfolio of DSD-for-QI training initiatives.
Differentiated TB/HIV Services
Launched in March 2019 following the CQUIN workshop in Lusaka, the CoP has focused on supporting the integration of TB intensive case finding and TB preventive treatment (TPT) into less-intensive DSD models.
- Participants include 49 people from the 11 network countries and global agencies/organizations including OGAC, CDC, and WHO.
- Dr. Andrea Howard and Dr. Greet Vandebriel are the technical leads, supported by Ms. Christine Mburu (Project Operations Coordinator), ICAP in Kenya.
- The first co-created product was a “differentiated TB/HIV” framework and toolkit, designed to guide the integration of TPT into less-intensive DSD models.
Differentiated HIV & NCD Services
Since the CQUIN launch meeting in March 2017, network participants have identified the need for efficient and integrated approaches to provide people living with both HIV and non-communicable diseases (NCDs) with holistic and integrated services. In response, CQUIN supports a stream of work related to differentiated service delivery for people with HIV and NCDs. The “Differentiated HIV & NCDs” community of practice (CoP) has supported webinars, satellite sessions, meeting breakout sessions, and virtual south-to-south exchanges between CQUIN countries in partnership with network country ministries of health, recipients of care, and partners including the Differentiated Service Delivery project of the International AIDS Society, Resolve to Save Lives, Beckman Colter, PATH, the NCD Alliance, and others.
The CoP also works collaboratively with CQUIN network countries to implement and scale-up integrated HIV/NCD services, exchanging best practices and models of care, identifying opportunities to co-create resources, and working to strengthen networks of practitioners and policymakers to promote ongoing cross-country learning.
- Current CoP participants included stakeholders from 13 CQUIN network countries and global agencies/organizations including the International AIDS Society (IAS), Resolve to Save Lives (RTSL), the EGPAF, PATH, and the NCD Alliance.
- Herve N. Kambale and Dr. Miriam Rabkin are the technical leads, supported by Ms. Phephile Dlamini, Project Operations Coordinator in Eswatini.
- CQUIN DSD & NCD Integration Community of Practice Meeting – June 2022
- Focus on the Person: Integration of HIV and Non-Communicable Disease (NCD) Services, A presentation by Wafaa El Sadr, Global Director, ICAP at Columbia University, ICASA 2019
- DSD for People Living with HIV and NCDs, A presentation by Dr. Hervé N. Kambale, Consultant, ICAP at Columbia University, CQUIN 4th Annual meeting 2020
- CQUIN HIV/NCD webinar
- Ehrenkranz P, Grimsrud A, Holmes CB, Preko P, Rabkin M. Expanding the Vision for Differentiated Service Delivery: A Call for More Inclusive and Truly Patient-centered Care for People Living with HIV. J Acquir Immun Defic Syndr 2021 Feb 1;86(2):147-152. doi: 10.1097/QAI.0000000000002549. PMID 33136818.
- Rabkin M, de Pinho H, Michaels-Strasser S, Naitore D, Rawat A, Topp SM. Strengthening the Health Workforce to Support Integration of HIV and Non-communicable Disease Services in sub-Saharan Africa. AIDS 2018;32:S47-S54. doi: 10.1097/QAD.0000000000001895. PMID: 29952790
- Duffy M, Ojikutu B, Andrian S, Sohng E, Minior T, Hirschhorn LR. Non-communicable Diseases and HIV Care and Treatment: Models of Integrated Service Delivery. Trop Med Int Health. 2017 Aug;22(8):926-937. doi: 10.1111/tmi.12901. Epub 2017 Jun 19. PMID: 28544500.
- Letebo M, Shiferaw F. Adapting HIV Patient and Program Monitoring Tools for Chronic Non-communicable Diseases in Ethiopia. Global Health. 2016 Jun 2;12(1):26. doi: 10.1186/s12992-016-0163-y. PMID: 27255329; PMCID: PMC4890485.
- Ameh S. Evaluation of an Integrated HIV and Hypertension Management Model in Rural South Africa: A Mixed Methods Approach. Global Health Action. 2020 Dec 31;13(1):1750216. doi: 10.1080/16549716.2020.1750216. PMID: 32316885; PMCID: PMC7191904.