Empowering Frontline Health Care Providers to Communicate Improvement Results

Joseph Kundy

Quality Improvement Adviser, Tanzania, USAID ASSIST Project/URC

In June 2015, USAID ASSIST supported the Ministry of Health and Social Welfare (MOHSW) of Tanzania to conduct the first National Forum on Improving Pediatric and Youth AIDS Services. The forum brought together various stakeholders working in health sector to share knowledge and experiences in improving pediatric HIV and AIDS services. The forum was mainly intended to bring frontline health care providers to share how they managed to apply quality improvement techniques to attain particular results. 

Frontline Health Care Provider Speaking at Tanzania National Forum on Pediatric Aids

A frontline health care provider from Lugarawa Mission Hospital in Njombe region, presenting during the first National Forum on Improving Pediatric and Youth AIDS Services in Dar es Salaam, Tanzania. Photo: Delphina Ntangeki. 

In contrast to most people’s expectations, the frontline health care providers made great presentations. They even managed to respond fluently to the questions directed to them during discussion sessions. In some of their presentations frontline health care providers explained how they applied the 'Plan Do Study Act (PDSA) Cycle’ to improve pediatric HIV/AIDS care. They also explained why quality improvement is also the frontline health worker’s job. They tested changes to improve pediatric uptake of HIV testing among children; improve provider initiated testing and counseling for children less than 15 years; improved access to HIV Early Infant Diagnosis (HEID); increased ART uptake among under 15 years; reduced attrition among HIV infected children under 15 years enrolled into ART services; improved HIV testing for admitted children; and improved provision of timely dried blood spot (DBS) results to caregivers of HIV exposed children. In all these endeavors, the frontline health care providers strived to maintain local context to the solutions applied to bridge the performance gap.

What the frontline health care providers presented made participants even those who have not visited facilities to believe hearing from a ‘horse’s mouth’ on what is happening in the field as regards application of quality improvement strategies to address various performance  gaps in pediatric ART along the continuum of care. The forum also provided participants the opportunity to realize the potentials of frontline health workers in improving quality of health services in addition to their normal roles of providing health care.  

“We were doing exactly what we agreed to do during coaching visits… and your assistance in the design of changes that would improve HIV testing among admitted children in our pediatric ward. You can see the results we presented today,” said Urambo District hospital quality improvement team leader to ASSIST staff after his presentation on “Improving integration of PITC implementation for children less than 15 years: Experiences from Tabora region.” 

It is inspiring to see how the people working in difficult circumstances who we sometimes overlook come forward and present the incredible results of their work with great confidence. 

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