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USAID Health Care Improvement Project (HCI) | Cote d'Ivoire
With field support and PEPFAR funding, URC worked with the Ministry of Health's (MOH's) National Program of HIV/AIDS Case Management (PNPEC) and partners to carry out an improvement collaborative with 120 sites across the country. The collaborative aimed at improving the quality of HIV/AIDS services, including prevention of mother-to-child transmission of HIV (PMTCT), palliative care, and antiretroviral therapy (ART), as well as laboratory and pharmacy services. HCI also assisted the National Program for Orphans and Vulnerable Children (PN-OEV) and the Ministry of Women and Social Affairs to develop and pilot test quality standards for services offered to children affected by HIV/AIDS and their caregivers. In coordination with other stakeholders, the project also supported the development of outcome-based standards and indicators for peer education programs for HIV prevention.
HCI Cote d’Ivoire managed four PEPFAR projects in different technical domains:
- Antiretroviral therapy and the prevention of mother-to-child transmission of HIV (ART/PMTCT): Improve the quality of HIV care and treatment services. The project supported the National HIV Care Program (PNPEC).
- Orphans and vulnerable children (OVC): Improved the quality of programs for these children. The project provided technical assistance to the National Program for Orphans and Vulnerable Children and the Ministry of Women and Social Affairs.
- HIV prevention: Developed standards and indicators for peer education programs in prevention activities and integrate courses used for training peer educators. URC provided technical assistance to the Ministry of Health and the National Committee for the Fight against AIDS.
- Laboratory: Supported the laboratory accreditation program of the World Health Organization and the US Centers for Disease Control and Prevention in 25 labs. This effort was run in partnership with the MOH and the Center for Health Evaluation and Accreditation of Health Facilities in Africa.
- Supported PNPEC to conduct learning sessions and coaching visits to assist collaborative sites in improving (1) the documentation of care in medical records, (2) service integration, and (3) the retention of patients in care;
- Facilitated national workshops of government and implementing partner stakeholders to review and validate evidence-based standards for programs serving OVC;
- Supported local nongovernmental organizations (NGOs) in four regions to test draft OVC quality standards and make changes in the NGOs’ service delivery processes to achieve compliance with the standards;
- Rapidly assessed HIV prevention activities countrywide and supported a national mapping exercise to identify highly vulnerable populations;
- Supported the National QI Task Force for Prevention and Peer Education to develop standards and indicators for peer education programs in HIV prevention;
- Assisted sites in gathering evidence relating to standards and differences in program outcomes; and
- Worked with the WHO-AFRO Laboratory Accreditation Program to support 25 labs in achieving accreditation standards.
- The percentage of NGOs documenting their activities rose from 20% to 95%.
- Most (94%) NGOs have updated their OVC lists by removing duplicates and non-eligible children, reducing lists from over 20,000 children to less than 14,000; this change will enable better targeting of and support for the neediest children.
- Health care providers’ completion of key items in the medical records of ART patients improved from 13% in 2008 to 85% in 2010.
- ART patients lost to follow-up fell from 35% in 2008 to 16% in 2010.
- HIV testing of infants borne to HIV-positive women rose from 15% in 2009 to 77% in 2010.
- The national standard for peer education programs has been validated.
2008 to 2013
US Agency for International Development (USAID)
Elizabeth Glaser Pediatric AIDS Foundation
International Center for AIDS Care and Treatment Programs (ICAP)
Health Action International (HAI)
Family Health Development Organization
Johns Hopkins University (JHU) School of Public Health
National Agency for Rural Development Support (ANADER)
United Nations Population Fund (UNFPA)
Olive Leaf Foundation
Association of Volunteers in International Service (AVSI)
18 of 19 regions in the country