From June 23–26, 2019, the HIV Coverage, Quality, and Impact Network (CQUIN) convened 165 experts in Nairobi, Kenya to address the issue of quality in differentiated service delivery (DSD). The hands-on workshop aimed to enable CQUIN member countries to define DSD quality standards, monitor and evaluate DSD quality, and implement contextually appropriate, DSD-specific quality improvement projects.
Participants included representatives from ministries of health, civil society, national networks of people living with HIV, academic institutions, and PEPFAR implementing partners from eleven CQUIN countries. The World Health Organization, UNAIDS, the Global Fund, the International Treatment Preparedness Coalition, and the Bill & Melinda Gates Foundation were also represented.
The meeting featured plenary sessions, breakout sessions, lunchtime discussions, and a tools lab to maximize south-to-south learning.
“Earlier this year in Uganda, we scaled up quality improvement across the country. Along the way, we have had some challenges, so listening to the Kenya presentation was an important opportunity for learning,” said Cordelia Katureebe, national coordinator for HIV care and treatment for the Uganda Ministry of Health.
The voices of recipients of care were central to all meeting sessions. “I participated in three sessions just now and in each I had a chance to provide inputs into specific, quality-related tools. This is very important—it makes me feel that I’m not just a person to receive services, but that I can contribute something,” said Mathew Kawogo, manager of community mobilization and engagement for the National Council of People Living with HIV/AIDS in Tanzania.
As the meeting adjourned, CQUIN network members looked forward to continuing their work via a recently launched CQUIN community of practice focused specifically on quality in the context of DSD. Through the community of practice, ten CQUIN member countries are jointly creating a quality standards framework for differentiated treatment models and exchanging best practices for DSD quality assurance.
“The Q in CQUIN stands for quality,” explained Miriam Rabkin, director for health systems strategies at ICAP. “The network is designed to support countries to scale up high-quality DSD, and this meeting enabled a deep dive into what quality DSD looks like, how to measure it, and how to continuously improve it. We’re excited about the progress that was shared, and about the joint work we have planned for the future.”
To learn more about the workshop content, click below:
- See Meeting Report
- Workshop concept note
- Workshop agenda
- Monday (June 24) presentations
- Tuesday (June 25) presentations
- Wednesday (June 26) presentations
- The Quality Imperative
Dr. Miriam Rabkin, Director of Health Systems Strategies, ICAP at Columbia University
- The CQUIN Learning Network
Dr. Peter Preko, CQUIN Director, ICAP at Columbia University
- A Big Picture View of Quality for HIV Services
Dr. Charles Holmes, Faculty Co-Director of the Center for Global Health and Quality, Georgetown University
Panel Presentations | Defining DSD Quality Standards: What Do We Mean When We Say “High-Quality” DSD?
- The CQUIN Community of Practice for Quality and DSD
Mr. Martin Msukwa, Regional Quality Improvement Advisor, ICAP at Columbia University
- Recipient of Care Preferences for DART Models in Harare, Zimbabwe: A Discrete Choice Experiment
Dr. Clorata Gwanzura, Differentiated Care Medical Officer: HIV Care and Treatment, Zimbabwe Ministry of Health and Child Care
- Mr. Nelson Otwoma, Executive Director, National Empowerment Network of People Living with HIV/AIDS, Kenya
Breakout Session | Country Teams Paired to Discuss DSD Quality Standards and Challenges
Panel Presentations | Measuring DSD Quality: How Do We Know If We’re Delivering High-Quality DSD?
- Eswatini’s DSD Quality Assessment Tool
Dr. Hervé Nzereka Kambale, DSD Technical Advisor, Eswatini National AIDS Programme
- Uganda’s Targeted DSD Support Supervision – March 2019
Dr. Josen Kiggundu, National Technical Advisor for DSD, Ministry of Health AIDS Control Program, Uganda
- Measuring and Addressing Stigma
Ms. Stella Kentutsi, Executive Director, National Forum of People Living with HIV/AIDS Networks in Uganda
- ITPC Community Treatment Monitoring in West Africa
Valentin Keipo, Monitoring, Evaluation, and Research Assistant, ITPC-West Africa
- Tonderai Mwareka, Program Officer, Zimbabwe National Network of People Living with HIV
- Using Quality Improvement to Enhance HIV Services
Mr. Ivan Teri, Program Optimization and Service Quality Improvement Advisor, Elizabeth Glaser Pediatric AIDS Foundation
Panel Discussion | Quality Improvement Case Studies
- Program Quality and Efficiency in DC Implementation
Ms. Maureen Inimah, QI Coordinator, National AIDS & STI Control Program, Kenya
- Using and Electronic Information System to Improve the Central Chronic Medicine Dispensing & Distribution Model In South Africa: Synchronized National Communication in Health
Dr. Marissa Courey, Epidemiologist, U.S. Centers for Disease Control and Prevention, South Africa
- Improving Quality of Adherence Clubs in Cape Town – The Club Audit and Club Champions Group
Ms. Aysha Ismail Smith, Sub District Pharmacist, Area Central, City of Cape Town
- Building a QI-for-DSD Learning Network in Zambia
Dr. Nancy Mutinta Zyongwe, Senior Advisor for QA/QI, Ministry of Health, Zambia
- Using QI Methods to Maximize DSD Impact and Efficiencies in Uganda
Dr. John B. Ddamulira, Lecturer, Makerere University School of Public Health
- Optimizing Viral Load Utilization in Malawi: Lessons from Balaka Viral Load Quality Improvement Initiative
Mr. Michael Odo, Technical Advisor, HIV Care and Treatment, Ministry of Health, Malawi
- Scaling Up Routine Viral Load Monitoring in Ethiopia: A Quality Improvement Collaborative
Dr. Berhanu Tekle, Senior QI Advisor, ICAP in Ethiopia
Parallel Breakout Sessions | Root Case Analysis of Priority Quality Challenges
- Achieving Quality DSD: Recipient of Care Perspective
Mr. Lawrence Khonyongwa, Executive Director, Malawi Network of People Living with HIV
Parallel Breakout Sessions | Achieving Quality for Specific DART Models
Breakout Session | Individual Country Team Strategies