Addressing PMTCT Gaps through a Systematic Process Improvement (PI) Approach

Addressing PMTCT Gaps through a Systematic Process Improvement (PI) Approach

Authors: Shallo Dhaba, Oromia RHB; Brian Robie, CDC Atlanta; Tekeste Kebede, CDC Ethiopia; Solomon Wolde, Jhpiego Ethiopia Yassir Abduljewad, Jhpiego Ethiopia

Background and Description

Ethiopia’s PMTCT program serves only 5.6% of HIV-infected pregnant women

Process Improvement (PI) pilot project was designed and implemented in five zones of Oromia Region

25 participants attended a five-day PI course and developed eight projects

The Seven Steps of PIDefine ProcessDefine Process

MeasureProcess

Performance

MeasureProcess

Performance

Analyze Causes of Variation

Analyze Causes of Variation

Summary of Results

Within three months, six of the seven teams reported improvements, including increasing:

1) hospital deliveries of HIV-positive women from 59% to 85%; 2) the percentage of HIV-positive women having their CD4 counts tested from 42% to 90%; and 3) the percentage of pregnant women's partners tested for HIV from 13% to 51%.

Lessons Learned

Well-designed and systematically mentored PI projects can have significant outcomes in improving quality of services.

Close follow-up will be required to sustain the changes at the worksites and to see that successful new processes are cross-fertilized to other sites.