Improving Completeness and Accuracy of Data for Elimination of Mother-to-child Transmission of HIV: Tested Changes and Guidance from Uganda
Since April 2013, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project, together with other USAID and U.S.
Centers for Disease Control and Prevention (CDC) partners--Food and Nutrition Technical Assistance (FANTA), Strengthening Partnerships, Results and Innovations in Nutrition Globally (SPRING), and the AIDS Support Organisation (TASO)--have been supporting the Ministry of Health to implement the Partnership for HIV- Free Survival (PHFS) Initiative in 22 health facilities in six districts. The PHFS initiative supports the goal of 'elimination of new HIV infections among children by 2015 and keeping their mothers alive' through scaling up an effective campaign to protect exposed infants from HIV infection and provide optimal nutrition for these infants.
In Uganda, the PHFS initiative was rolled out using a quality improvement approach. Quality improvement (QI) teams were either formed or reconstituted. These QI teams have been supported through monthly coaching visits to identify gaps in care, prioritize areas for improvement, develop and test change ideas to address the gaps and implement these changes.
After approximately 10 months of work, representatives from the 22 teams gathered at a harvest meeting organized by USAID ASSIST in February 2014 to reflect on their results, discuss both the successful and unsuccessful changes and related evidence which had led to the results, and develop their "best advice" based on their experience that could guide other facility teams to improve care.
This change package for improving the completeness and accuracy of data in the main data sources for tracking mother-baby pairs--the exposed infants' diagnosis (EID) register, EID clinical charts, ART register, and the HIV/ART care card --is one of the products of the meeting. It is intended to provide other quality improvement teams that will be starting on improvement work in PHFS guidance on how to improve data accuracy and use, including the main changes that the 22 facilities found to be successful.
Teams may not necessarily replicate these change ideas; rather, they should adapt them to suit their clinics.