The global burden of illness due to chronic conditions is currently estimated to be 60% and is expected to reach 80% in the next two decades. Nevertheless, health care systems worldwide continue to focus primarily on acute illness care & QPI is playing a leadership role in redesigning care processes to address the increasing global burden of illness due to chronic conditions. HIV/AIDS is a major chronic condition affecting large numbers of patients in Africa. Through the USAID  Health Care Improvement Project, URC embarked on improving care for people with HIV/AIDS by redesigning HIV/AIDS care systems. Key features include encouraging patient involvement in managing their illnesses, broad family and community support systems bringing care as close to home as possible, use of peer support groups, and support from health facilities to foster the functioning of all these structures.

Bridging Quality Gaps: A Framework for Improving Retention and Care for Patients on Antiretroviral Therapy

Challenge

Though HCI, URC developed a framework for quantifying, analyzing, and bridging gaps in quality of care that affect the health outcomes of patients on antiretroviral therapy (ART). The framework defines three key gaps in quality ART care that separate current levels of care from quality services: the coverage gap; the retention gap, and the wellness gap. By systematically monitoring these three gaps, providers are able to work with patients to develop and test solutions to bridge them.  

 
Results

• In Tanzania, the number of patients on ART more than doubled between May 2009 and February 2010. By understanding the causes of the gaps and testing to making changes to close them, the gaps in coverage, retention, and wellness are closing.
• We are testing the ART model in Nicaragua, Uganda, and Tanzania to develop locally appropriate strategies.
• HCI is launching a virtual community of practice for providers as a forum to ask questions, discuss barriers, and share success stories.