Improving Coverage in the HIV Continuum of Care Response: Tested Changes and Guidance from Uganda
Since April 2013, ASSIST worked with the MOH and implementing partners in Uganda through applying improvement methods to implement the HIV continuum of response (COR) across 41 districts. The HIV COR collaborative uses a model that illustrates the flow of clients within a health facility and highlights the major gaps within the HIV continuum of response for health facilities to address. This change package addresses the first two gaps of linkage and coverage. The change ideas shared in this change package are a compilation of actions taken by health facility quality improvement teams that contributed to the improvement in the coverage of HIV care and treatment services for HIV-positive clients in the supported facilities. These change ideas were successfully implemented in 25 out of the initial 50 HIV COR health facilities where ASSIST was providing technical support to improve the quality of HIV care services using a quality improvement approach. These changes are a product of the innovative efforts of the health facility level staff together with the support of improvement coaches. The package highlights the five key improvement areas under HIV COR coverage and how these were implemented, namely:
1) HIV testing and counselling/identification of HIV-positives,
2) Linkage to care,
3) Enrolment into care,
4) ART eligibility assessment, and
5) Initiation on ART.
This change package provides detail on how changes were tested so that other facilities could replicate this work.