A quality improvement model for the rapid scale-up of a program to prevent mother-to-child HIV transmission in South Africa

作者：Mate Kedar S^*; Ngubane Gugu; Barker Pierre M

来源：International Journal for Quality in Health Care, 2013, 25(4): 373-380.

DOI：10.1093/intqhc/mzt039

• PMTCT
• HIV
• scale-up
• implementation
• South Africa

In South Africa (SA), non-governmental organizations (NGOs) have a major role in the provision of health services, but they often compete for funding and influence rather than collaborate. The National Department of Health (NDOH) sought to coordinate existing non-governmental organizations (NGOs) to optimize the prevention of mother-to-child HIV transmission (PMTCT) at scale.
We describe how a group of NGO and government partners were brought together to jointly develop the Accelerated Plan (A-Plan) to improve PMTCT services at health-care facilities in SA. The A-Plan used four main principles of large-scale change to align the network of NGO partners and NDOH: setting targets and improving data, simplifying processes and facilitating local execution, building networks and enabling coordination.
In the first 6 months of the project, six NGO partners were engaged and the program reached 161 facilities. The program spontaneously spread from five planned subdistricts to nine subdistricts and produced a package of tested interventions to assist in scale-up of the PMTCT program elsewhere.
Districts reported high levels of provider engagement in the initiative. In the 6-month project period, a total of 676 health-care workers and managers were trained in quality improvement methods and tools. Coverage of seven key processes in the PMTCT program was tracked on a monthly basis within each subdistrict.
We found that a network model for the A-plan could successfully recruit key stakeholders into a strong partnership leading to rapid scale-up of a life-saving public health intervention.

• 出版日期2013-9