Implementing quality improvement in tuberculosis programming: Lessons learned from the global HIV response

Daniel J Ikeda; Apollo Basenero; Joseph Murungu; Margareth Jasmin; Maureen Inimah; Bruce D Agins

doi:10.1016/j.jctube.2019.100116

Implementing quality improvement in tuberculosis programming: Lessons learned from the global HIV response

J Clin Tuberc Other Mycobact Dis. 2019 Aug 7:17:100116. doi: 10.1016/j.jctube.2019.100116. eCollection 2019 Dec.

Authors

Daniel J Ikeda¹, Apollo Basenero², Joseph Murungu³, Margareth Jasmin¹, Maureen Inimah⁴, Bruce D Agins^{1

5}

Affiliations

¹ HEALTHQUAL, Division of Global Epidemiology, Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.
² Ministry of Health and Social Services, Windhoek, Namibia.
³ HEALTHQUAL, Institute for Global Health Sciences, University of California, San Francisco, Harare, Zimbabwe.
⁴ National AIDS and STI Control Program, Nairobi, Kenya.
⁵ Institute for Implementation Science in Public Health, City University of New York, New York, NY, USA.

Abstract

The quality of care and treatment for tuberculosis (TB) is a major barrier in global efforts to end TB as a global health emergency. Despite a growing recognition of the need to measure, assure, and improve quality of TB services, implementation of quality improvement (QI) activities remains limited. Applying principles of systems thinking, continuous measurement, and root cause analysis, QI represents a proven approach for identifying and addressing performance gaps in healthcare delivery, with demonstrated success in low- and middle-income settings in the areas of HIV/AIDS, maternal, newborn, and child health, and infection control, among others. Drawing from lessons learned in the development of QI programming as part of the global response to HIV, we review key enablers to implementation that may assist NTPs in turning aspirations of high-quality service delivery into action. Under the umbrella of a formal quality management (QM) program, NTPs' attention to planning and coordination, commitment to tracking key processes of care, investment in QI capacity building, and integration of TB QI activities within efforts to advance universal health coverage provide a framework to sustainably implement QI activities.

Keywords: AIDS; HIV; Quality improvement; Tuberculosis.

Publication types

Editorial