Improving Services for HIV-Exposed Infants in Zambia and Cameroon Using a Quality Improvement Collaborative Approach.

التفاصيل البيبلوغرافية
العنوان:	Improving Services for HIV-Exposed Infants in Zambia and Cameroon Using a Quality Improvement Collaborative Approach.
المؤلفون:	Dougherty G; ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA. gd2410@columbia.edu., Abena T; ICAP at Columbia University, Yaoundé, Cameroon., Abesselo JP; ICAP at Columbia University, Yaoundé, Cameroon., Banda JN; Ministry of Health, Lusaka, Zambia., Biyaga TP; Ministry of Health, Yaoundé, Cameroon., Boccanera R; Health Resources and Services Administration, Rockville, MD, USA., Boyd MA; Centers for Disease Control and Prevention, Lusaka, Zambia., Ebogo M; ICAP at Columbia University, Yaoundé, Cameroon., Hamomba L; Centers for Disease Control and Prevention, Lusaka, Zambia., Jed S; Health Resources and Services Administration, Rockville, MD, USA., Kakanou ZF; Ministry of Health, Yaoundé, Cameroon., Kasonde P; ICAP at Columbia University, Lusaka, Zambia., Kasonka SC; ICAP at Columbia University, Lusaka, Zambia., Lungwebungu R; Ministry of Health, Lusaka, Zambia., Madevu-Matson C; ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA., Mayer MM; Centers for Disease Control and Prevention, Yaoundé, Cameroon., Mwamba M; ICAP at Columbia University, Lusaka, Zambia., Panya M; ICAP at Columbia University, Dar es Salaam, Tanzania., Sakanda P; ICAP at Columbia University, Lusaka, Zambia., Tsiouris F; ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA., Walker L; ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA., Rabkin M; ICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA.
المصدر:	Global health, science and practice [Glob Health Sci Pract] 2021 Jun 30; Vol. 9 (2), pp. 399-411. Date of Electronic Publication: 2021 Jun 30 (Print Publication: 2021).
نوع المنشور:	Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
اللغة:	English
بيانات الدورية:	Publisher: U.S. Agency for International Development and Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs Country of Publication: United States NLM ID: 101624414 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 2169-575X (Electronic) Linking ISSN: 2169575X NLM ISO Abbreviation: Glob Health Sci Pract Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Baltimore, MD : U.S. Agency for International Development and Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, 2013-
مواضيع طبية MeSH:	HIV Infections/diagnosis , HIV Infections/drug therapy , Quality Improvement*, Cameroon ; Early Diagnosis ; Humans ; Infant ; Zambia
مستخلص:	Introduction: Early infant diagnosis (EID) and rapid antiretroviral therapy (ART) initiation are lifesaving interventions for HIV-infected infants. In Cameroon and Zambia, EID coverage for HIV-exposed infants (HEIs) is suboptimal and the time to ART initiation for infants infected with HIV often exceeds national standards despite numerous policy and training initiatives. Methods: ICAP at Columbia University supported the Cameroon and Zambia Ministries of Health (MOHs) and local partners to implement quality improvement collaboratives (QICs) to improve EID coverage and ART initiation at 17 health facilities (HFs) in Cameroon (March 2016 to June 2017) and 15 HFs in Zambia (March 2017 to June 2018). In each country, MOH led project design and site selection. MOH and ICAP provided quality improvement training and monthly supportive supervision, which enabled HF teams to conduct root cause analyses, design and implement contextually appropriate interventions, conduct rapid tests of change, analyze monthly progress, and convene at quarterly learning sessions to compare performance and share best practices. Results: In Cameroon, EID testing coverage improved from 57% (113/197 HEIs tested) during the 5-month baseline period to 80% (165/207) in the 5-month endline period. In Zambia, EID testing coverage improved from 77% (4,773/6,197) during the 12-month baseline period to 89% (2,144/2,420) during the 3-month endline period. In a comparison of the same baseline and endline periods, the return of positive test results to caregivers improved from 18% (36/196 caregivers notified) to 86% (182/211) in Cameroon and from 44% (94/214) to 79% (44/56) in Zambia. ART initiation improved from 44% (94/214 HIV-infected infants) to 80% (45/56) in Zambia; the numbers of HIV-infected infants in Cameroon were too small to detect meaningful differences. Conclusions: QICs improved coverage of timely EID and ART initiation in both countries. In addition to building quality improvement capacity and improving outcomes, the QICs resulted in a "change package" of successful initiatives that were disseminated within each country. (© Dougherty et al.)
References:	J Acquir Immune Defic Syndr. 2019 Aug 15;81(5):487-496. (PMID: 31149954) J Int AIDS Soc. 2014 Jun 11;17:18914. (PMID: 24925044) BMJ Qual Saf. 2014 Apr;23(4):290-8. (PMID: 24025320) J Acquir Immune Defic Syndr. 2015 Mar 1;68(3):e26-32. (PMID: 25469521) BMJ Qual Saf. 2011 Aug;20(8):658-65. (PMID: 21317182) BMJ. 2008 Jun 28;336(7659):1491-4. (PMID: 18577559) BMJ Qual Saf. 2011 Apr;20 Suppl 1:i36-40. (PMID: 21450768) Int J Qual Health Care. 2002 Dec;14 Suppl 1:89-95. (PMID: 12572792) BMJ Qual Saf. 2016 Mar;25(3):147-52. (PMID: 26700542) Lancet Glob Health. 2018 Nov;6(11):e1196-e1252. (PMID: 30196093) J Assoc Nurses AIDS Care. 2019 Nov-Dec;30(6):682-690. (PMID: 30817370) BMJ Qual Saf. 2014 Apr;23(4):265-7. (PMID: 24365606) Lancet Glob Health. 2016 Sep;4(9):e594-6. (PMID: 27539798) BMJ Qual Saf. 2011 Jan;20(1):46-51. (PMID: 21228075) Qual Saf Health Care. 2005 Apr;14(2):140-3. (PMID: 15805461) BMJ Qual Saf. 2017 Jul;26(7):572-577. (PMID: 27986900) Pan Afr Med J. 2013 Jun 21;15:65. (PMID: 24198870) Qual Saf Health Care. 2007 Feb;16(1):77-80. (PMID: 17301211) BMJ Qual Saf. 2016 May;25(5):345-54. (PMID: 26208537) J Assoc Nurses AIDS Care. 2018 Sep - Oct;29(5):785-794. (PMID: 29803605) Int J Qual Health Care. 2014 Apr;26(2):117-23. (PMID: 24481053) J Acquir Immune Defic Syndr. 2017 May 1;75 Suppl 1:S51-S58. (PMID: 28398997) J Acquir Immune Defic Syndr. 2015 Jan 1;68(1):62-72. (PMID: 25501345)
معلومات مُعتمدة:	1U1NHA285550100 United States PEPFAR PEPFAR
تواريخ الأحداث:	Date Created: 20210708 Date Completed: 20211117 Latest Revision: 20211117
رمز التحديث:	20240628
مُعرف محوري في PubMed:	PMC8324201
DOI:	10.9745/GHSP-D-20-00550
PMID:	34234027
قاعدة البيانات:	MEDLINE

Full Text Finder

الوصف
تدمد:	2169-575X
DOI:	10.9745/GHSP-D-20-00550