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 network 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 each other 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 26 people from six countries: Côte d’Ivoire, Eswatini, Mozambique, Uganda, Zambia, and Zimbabwe
- Dr. Bill Reidy (CQUIN Senior SI Specialist) is the technical lead, supported by Ms. Andrea Schaaf (ICAP SI Specialist)
- The CoP had 10 online meetings/calls and two in-person meetings in CQUIN’s most recent project year
- In its first year, the CoP developed an M&E framework, which was subsequently adopted for use 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.
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.
- In 2018-2019, 14 CoP members from Eswatini, Malawi, Uganda, and Zimbabwe worked to develop a P@HR screening tool, with support from Dr. Joanne Mantell from Columbia University and Dr. Herve Kambale from the Eswatini Ministry of Health
- In 2020, CQUIN partnered with CHAI and Unitaid to convene a multi-country workshop on DSD for advanced HIV disease
Recipients of Care / Community Engagement
Launched in 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.
- 19 people from all 11 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 Ms. Siphiwe Shongwe, CQUIN Clinical Advisor
- The CoP has had three virtual meetings and three in-person meetings
- The group has drafted a Community Engagement Framework, which was presented at the 3rd CQUIN Annual Meeting in November 2019
- In 2020, the group will develop an accompanying monitoring toolkit to enable stakeholders to assess the extent of Community Engagement in DSD-related policy, implementation, and evaluation
Quality and Quality Improvement
Launched in October 2018, the CoP had its first call in February 2019. Since then, it has focused on sharing updates on QI projects, co-creating DSD quality standards and indicators, and working to build QI-for-DSD capacity. 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.
- Initial participants included 40 people from 10 countries: Cote d’Ivoire, Eswatini, Kenya, Malawi, Mozambique, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe
- In 2021, the CoP will expand to include members from all network countries
- Mr. Martin Msukwa is the technical lead, supported by Ms. Phephile Dlamini
- The CoP’s first co-created product is the DSD Quality Standards tool; members are next going to develop quality indicators for DSD programs
Launched in March 2019 following the CQUIN workshop in Lusaka, the CoP had its first call in June 2019. There has been great interest in continuing the discussions held in Lusaka and in 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, Dr. Cassia Wells, and Dr. Mohammed Mahdi are the technical leads, supported by Ms. Laura Block (CQUIN Project Officer)
- The CoP has had four virtual meetings
- The first co-created product was a “differentiated TB/HIV” framework, outlining issues related to TPT implementation in the context of less-intensive DSD models
- In 2020, the CoP will develop an accompanying 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, 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.
The primary objectives of the group include:
- Identifying priority gaps and challenges related to differentiated HIV/NCD services;
- Working together to co-create training, implementation, and monitoring tools;
- Exchanging best practices and resources;
- Providing ongoing feedback and technical support
Current CoP participants included stakeholders from 13 CQUIN network countries and global agencies/organizations including IAS, RTSL, EGPAF, and PATH. Dr. Herve N. Kambale, Dr. Miriam Rabkin, and Ms. Phephile Dlamini are the technical leads, supported by Ms. Laura Block.
- 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.