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Use of Quality Improvement Methods to Increase Utilization of Health Services: A Case Study of VMMC Post-Operative Client Follow-up at Gulu Regional Referral Hospital Poster
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URC staff presented a poster called 'Using Quality Improvement Interventions to Improve Laboratory Services at Public Healthcare Facilities in Uganda' at the International Forum that took place in Gothenburg, Sweden on April 12-15, 2016.
Voluntary Medical Male Circumcision (VMMC) decreases risk of HIV transmission (Weiss et al., 2008a). Mathematical modeling indicates that in order to yield significant declines in HIV prevalence in sub-Saharan Africa, wide adoption of VMMC is necessary (Nagelkerke, Moses, de Vlas & Bailey, 2007). In 2010, the Ugandan Ministry of Health passed the National Policy on Safe Male Circumcision aiming to circumcise 80% (4.2 million) of all uncircumcised men of age 15-49 years by end of 2015. The policy stimulated wide scale-up of VMMC activities in the country, mainly offered as a package of health and HIV prevention interventions that include: health education, provider-initiated HIV testing and counseling (PITC), assessment and treatment for sexually-transmitted infections (STIs), age appropriate counseling on risk reduction, post-operative wound care, provision and promotion of condoms, and proactive linkage to HIV care and treatment services for HIV-positive men.
For Gulu Regional Referral Hospital, delivery of VMMC services has been supported by the USAID/Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN) project since April 2013. However, it was noted that the hospital was experiencing challenges in offering the comprehensive VMMC package. One major gap identified was low client return for post-operative follow-up at 48-hours which was only at 2% in April 2014. Follow-up at 48-hours is important for early detection and management of post-operative adverse events.