USAID ASSIST Project Semi-Annual Performance Monitoring Report FY18

University Research Co., LLC (URC) and its partners have completed 5.5 years of implementation of the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project.

Improving PMTCT in Kenya

In 2013, the USAID Applying Science to strengthen and Improve Systems (ASSIST) project supported the National AIDS and STI Control Program (NASCOP) to launch the Partnership for HIV Free Survival (PHFS) initiative in Kenya to apply quality improvement (QI) to drive the national elimination of mother to child transmission of HIV (eMTCT) strategic plan 2012-2015.

National Psychosocial Support Guidelines for Orphans and Vulnerable Children in Kenya

These guidelines were developed for use by front line child service providers to streamline psychosocial support services for children. The guidelines provide guidance for supporting caregivers, general guidance for children of all ages, and specific guidance by age range: 0-5, 6-13, and 14-18. An implementation framework is also included.

Improving Care for Orphans and Vulnerable Children and Families: Experiences from implementation in Kenya

This is a compilation of products created with support from the USAID Applying Science to Strengthen and Improve Systems project (ASSIST) in Kenya based on the experience of applying quality improvement methods to improve quality of services for orphans and vulnerable children. This project was implemented between 2013 to September 2017.

Khunyangu Sub County Hospital Spread Rational Use of ACTs at Bumala B, in Western Kenya

Khunyangu Sub-County Hospital is one of the seven high volume hospitals in Busia County, in Western Kenya. It started implementing quality improvement (QI) in June 2014 when the USAID Applying Science to Strengthen and Improve Systems (ASSIST) project introduced its work in Busia County. The hospital experienced Artemesinin Combination Therapy (ACT) stock outs due to irrational dispensing of Artemether-Lumefantrine (ALs). There were no stocks of ACTs in March 2014 prompting a sub county redistribution in April 2014.

Improving Uptake of Intermittent Preventive Therapy in Pregnancy (IPTp) at Rachuonyo Sub County Hospital in Homa Bay County

The use of Sulfadoxine Pyrimethamine (SP), commonly known as fansider in pregnant women without malaria has been shown to provide requisite protection against the disease in malaria endemic regions. A dose of SP is given to women at 16 weeks’ gestation, four weeks apart as a directly observed therapy during antenatal clinic (ANC). Greater therapeutic benefits are realized with more intermittent preventive treatment in pregnancy (IPTp) doses. In Kenya, momentum is gaining towards pregnant women receiving three or more doses of IPTp.

Improving Malaria Case Management through Accuracy and Completeness of Data

Facilities in three high malaria burden counties (Siaya, Busia and Kakamega) formed Work Improvement Teams (WITs) in October 2015 to improve malaria case management data quality and reporting. They reviewed their malaria source documents in comparison with the reported DHIS data and identified gaps. The WITs developed a number of changes to test, which included: data quality audits, data validation, continuing medical education (CME), and on-the-job training on proper documentation. Through these efforts, within 5 months, 50% of their reported data in DHIS was accurate.

Improving screening and management of malaria in pregnancy during first Antenatal Clinic Visit at Rongo Sub-County Hospital, Migori, Kenya

Rongo Sub-County Hospital formed a work improvement team (WIT) in November 2016 to improve malaria case management. They reviewed their malaria data to look for gaps for the first time and quickly saw that pregnant women were not routinely getting screened for malaria at their first antenatal care (ANC) visit which was compounded by poor documentation for those who were screened.

Improving Quantification of Parasitaemia on Confirmed Malaria Blood Smears at Matungu Sub County in Kakamega County

The USAID Applying Science to Strengthen and Improve Systems project (ASSIST) has been supporting quality improvement (QI) with a focus on improving malaria case management in Kakamega County since June 2014. In February 2016, Matungu Sub County Hospital (MSCH) formed a work improvement team with the goal of improving malaria testing of suspected malaria cases through quality improvement. Rapid improvement was achieved with this initial work that they began looking for new areas to work on.

Improving Documentation of Malaria Suspects at Shiamakhubu Health Centre Outpatient Department in Kakamega County

During a clinical encounter of a suspected malaria patient in Kenya, it takes the triad of the clinician serving the patient, the morbidity tally sheet, and outpatient register to correctly capture the patient as a malaria suspect. Complete and accurate documentation of suspected malaria enables clinicians and malaria programs to determine testing rates, workload and thus planning and resource allocation.