Increasing Accountability for the Reliability of Rapid HIV Test Results: Observations from Seven Facilities in Rungwe District Council, Tanzania
In Tanzania in 2015, the USAID ASSIST project in collaboration with the Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) and implementing partners (IPs) was tasked to support activities to improve the quality of HIV rapid testing at point-of-care testing sites in 27 PEPFAR scale-up saturation districts of the Tanzania mainland under the regional HIV rapid testing quality improvement initiative (RTQII).
In 2015, ASSIST supported the Regional Health Management Team (RHMT) of Dodoma Region and the Dodoma Municipal Council to conduct HIV testing services quality assessments and coach health workers in 16 facilities on HIV testing services (HTS) quality improvement (QI). In July-September 2016, ASSIST supported the MOHCDGEC to carry out a baseline quality audit in 485 rapid testing points in 204 health facilities in 22 of the PEPFAR scale-up saturation districts and subsequently was asked to support improvement activities for rapid HIV testing in three regions: Mbeya and Rungwe district councils in Mbeya Region, Arusha Region, and Nyamagana Municipal Council in Mwanza Region.
This technical report describes the HIV rapid testing QI support that ASSIST provided in Rungwe District Council, where the project supported the Rungwe Council Health Management Team (CHMT) and IPs to instigate improvement efforts in 22 rapid HIV testing points at seven health facilities. The rapid testing points, which are outside the traditional laboratory-based testing process, included point-of-care rapid HIV testing at prevention of mother-to-child transmission (PMTCT), voluntary counseling and testing, tuberculosis/HIV, and sexually transmitted diseases clinics.
During the course of this intervention, it was found that blending quality assurance, QI problem solving processes, use of a focal person, and engaging leadership in QI activities not only increases accountability for the reliability of the HIV rapid testing results, but also improves morale and commitment of HIV rapid testing providers and empowers them to take responsibility for improving the quality of services they provide. Through the QI methods and the use of focal persons, the HIV rapid testing providers are now able to improve quality of HIV rapid testing through daily review of their performance and identify areas for improvement.
This report includes tools used by teams including a list of roles and responsibilities of an HIV rapid testing focal person and a site monitoring checklist.