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In Tanzania, Launch of a Quality Improvement Collaborative To Expand Pediatric HIV Testing

June 3, 2015

Tanzania has made significant strides in expanding HIV treatment to those in need, but like many countries, continues to face challenges in testing and treating children. Only 26 percent of eligible HIV-positive children have started antiretroviral treatment, and addressing this shortfall is a national priority. In May, ICAP, in partnership with Ministry of Health and Social Welfare (MOSHW), National AIDS Control Programme (NACP) and NGO partners brought together 24 health facilities to begin an innovative one-year effort to expand pediatric HIV testing.

With funding from the CDC through PEPFAR, ICAP is partnering with MOHSW, NACP and two local NGOs to improve pediatric provider-initiated testing and counseling (PITC) coverage using the quality improvement (QI) collaborative methodology to expand PITC services at 24 health facilities in the high-prevalence regions of Simiyu and Geita.

ICAP and partners held kick-off learning sessions in each region, with teams of health care workers from the target health facilities. The learning sessions included orientation to the project, refresher training on the NACP QI strategy, briefing on the QI collaborative methodology, and training on pediatric PITC best practices. In addition, teams identified two key aims: within one year, the collaborative will aim to increase the proportion of hospitalized children offered HIV testing to at least 80 percent, and will aim to increase the linkage of HIV-positive children from testing to enrollment in care and treatment to 90 percent or higher.

Using a variety of QI tools, teams will work to achieve a series of facility-level deliverables and meet quarterly to share progress and discuss challenges and successes with other collaborative members in the same region.

“Four team meetings in a year is an aggressive and unique QI approach,” said Gillian Dougherty, quality improvement technical advisor at ICAP. “But multiple meetings offer the greatest opportunity for teams to exchange data and change methods.”

“Peer pressure is a good motivator,” she added.

In addition to working with local partners and stakeholders to support the QI collaborative, ICAP will also provide technical support by disseminating successful PITC strategies and engaging NACP and PEPFAR to inform future strategic planning on pediatric HIV care and treatment.

“This collaborative is concerned with rapid-cycle change,” said Dougherty. “It’s an opportunity to reflect early on what isn’t working and get feedback from other facilities that have had success working towards the project aims.”

This QI collaborative is part of ICAP’s broad portfolio of short-term, targeted, global technical assistance projects aimed at increasing access to HIV prevention, care and treatment services and generating tools and resources to encourage health outcomes and sustainable impacts in PEPFAR focus countries.