Comparison of Coaching Strategies for Improvement Collaboratives in Ugandan HIV/AIDS Health Centres

HCI has been implementing centrally organized collaborative improvement, with coaching provided by technical experts outside the MOH hierarchy, in 113 sites in Uganda to improve health care for patients with HIV/AIDS since 2006. In 2008, HCI introduced a district-based coaching strategy using MOH district management structures, as an alternative to centrally organized coaching, to facilitate sustainability of the approach and encourage its institutionalization and greater country ownership in the Ugandan health system.This study’s goal was to measure the relative efficiency and effectiveness of the two strategies in achieving improvements in process indicators.

The study found that there were mostly very small improvements in quality indicators for both district and central strategy sites but these were generally not associated quality improvement team performance (QITP). There were some differences in QITP in four of 13 team indicators but no difference in improvements between district and central strategy sites. The district strategy was about 1/5th the cost of the Central strategy cost and therefore significantly more efficient. We therefore recommend the MOH use the district rather than the central strategy for more widespread interventions.

The final study report can be found here.

Report Author(s): 
Bosiak B, Broughton E, Kyayse AM
ASSIST publication: 
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