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Using Small Tests of Change to Improve PMTCT Services in Northern Nigeria: Experiences From Implementation of a Continuous Quality Improvement and Breakthrough Series Program.

dc.rights.licenseopenen_US
dc.contributor.authorOSIBO, Bamidele
dc.contributor.authorORONSAYE, Frank
dc.contributor.authorALO, Oluwafemi D
dc.contributor.authorPHILLIPS, Abimbola
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBECQUET, Renaud
dc.contributor.authorSHAFFER, Nathan
dc.contributor.authorOGIRIMA, Francis
dc.contributor.authorIMARHIAGBE, Collins
dc.contributor.authorAMEH, Bernice
dc.contributor.authorEZEBUKA, Obioma
dc.contributor.authorSODZI-TETTEY, Sodzi
dc.contributor.authorOBI, Adaobi
dc.contributor.authorAFOLABI, Olusegun T
dc.contributor.authorINEDU, Abutu
dc.contributor.authorANYAIKE, Chukwuma
dc.contributor.authorOYELEDUN, Bolanle
dc.date.accessioned2020-06-26T13:33:04Z
dc.date.available2020-06-26T13:33:04Z
dc.date.issued2017-06-01
dc.identifier.issn1944-7884en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/8227
dc.description.abstractEnContinuous Quality Improvement (CQI) is a process where health teams systematically collect and regularly reflect on local data to inform decisions and modify local practices and so improve delivery of services. We implemented a cluster randomized trial to examine the effects of CQI interventions on Prevention of Mother-to-Child Transmission (PMTCT) services. Here, we report our experiences and challenges establishing CQI in 2 high HIV prevalence states in northern Nigeria. Facility-based teams were trained to implement CQI activities, including structured assessments, developing change packages, and participation in periodic collaborative learning sessions. Locally evolved solutions (change ideas) were tested and measured using process data and intermediate process indicators were agreed including overall time spent accessing services, client satisfaction, and quality of data. Health workers actively participated in clinic activities and in the collaborative learning sessions. During the study, the mean difference in time spent accessing services during clinic visits increased by 40 minutes (SD = 93.4) in the control arm and decreased by 44 minutes (SD = 73.7) in the intervention arm. No significant difference was recorded in the mean client satisfaction assessment score by study arm. The quality of data was assessed using a standardized tool scored out of 100; compared with baseline data, quality at the end of study had improved at intervention sites by 6 points (95% CI: 2.0 to 10.1). Health workers were receptive to CQI process. A compendium of "change ideas" compiled into a single change package can be used to improve health care delivery.
dc.language.isoENen_US
dc.subjectAdult
dc.subjectAnti-HIV Agents
dc.subjectCluster Analysis
dc.subjectDelivery of Health Care
dc.subjectFemale
dc.subjectHIV Infections
dc.subjectHealth Personnel
dc.subjectHumans
dc.subjectInfant
dc.subjectInfant
dc.subjectNewborn
dc.subjectInfectious Disease Transmission
dc.subjectVertical
dc.subjectNigeria
dc.subjectPatient Compliance
dc.subjectPregnancy
dc.subjectPregnancy Complications
dc.subjectInfectious
dc.subjectProgram Development
dc.subjectProgram Evaluation
dc.subjectQuality Improvement
dc.titleUsing Small Tests of Change to Improve PMTCT Services in Northern Nigeria: Experiences From Implementation of a Continuous Quality Improvement and Breakthrough Series Program.
dc.title.alternativeJ Acquir Immune Defic Syndren_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1097/QAI.0000000000001369en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed28498186en_US
bordeaux.journalJournal of Acquired Immune Deficiency Syndromesen_US
bordeaux.pageS165-S172en_US
bordeaux.volume75 Suppl 2en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcepubmed
hal.identifierhal-02882266
hal.version1
hal.date.transferred2020-06-26T13:33:18Z
hal.exporttrue
workflow.import.sourcepubmed
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