HIV retesting in pregnant women in South Africa: Outcomes of a quality improvement project targeting health systems’ weaknesses
Southern African Journal of HIV Medicine
| Field | Value | |
| Title | HIV retesting in pregnant women in South Africa: Outcomes of a quality improvement project targeting health systems’ weaknesses | |
| Creator | Golden, Lauren M. Fairlie, Lee Might, Freda Mojela, Stina Motsamai, Dorothy Motshepe, Suzan Manyame, Enoch Parker, Craig Rees, Helen Maimela, Gloria Chersich, Matthew F. | |
| Description | Introduction: South Africa is moving towards achieving elimination of mother-to-child transmission (eMTCT) but gaps remain in eMTCT programmes. Documenting successful outcomes of health systems interventions to address these gaps could encourage similar initiatives in the future.Methods: We describe the effectiveness of a Quality Improvement Project (QIP) to improve HIV retesting rates during pregnancy among women who had previously tested negative by redesigning the clinic process. Eight poorly-performing clinics were selected and compared with eight better-performing control clinics in a subdistrict in North West Province. Over nine months, root cause analysis and testing of change ideas using Plan-Do-Study-Act cycles were used to identify and refine interventions. Analysis of patient flow showed that women were referred for retesting following their nurse-driven antenatal visits, and many left without retesting as this would have further prolonged their visit. Processes were redesigned and standardised, where a counsellor was charged with retesting patients before antenatal consults. Staff were mentored on data collection and interpretation process. Quality improvement nurse advisors monitored indicators bi-weekly and adjusted interventions accordingly.Results: Retesting in intervention clinics rose from 36% in the three months pre-intervention to full coverage at month nine. At the end of the study, retesting in intervention clinics was 20% higher than in controls. Retesting also increased in the subdistrict overall.Conclusion: Service coverage and overall impact of HIV programmes can be raised through care-process analysis that optimises patient flow, supported by targeted QI interventions. These QI methodologies may be effective elsewhere for identifying new HIV infections in pregnant/breastfeeding women, and possibly in other services. | |
| Publisher | AOSIS | |
| Date | 2018-07-12 | |
| Identifier | 10.4102/sajhivmed.v19i1.784 | |
| Source | Southern African Journal of HIV Medicine; Vol 19, No 1 (2018); 3 pages 2078-6751 1608-9693 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/784/1213
https://sajhivmed.org.za/index.php/hivmed/article/view/784/1212
https://sajhivmed.org.za/index.php/hivmed/article/view/784/1214
https://sajhivmed.org.za/index.php/hivmed/article/view/784/1211
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