Closing the delivery gaps in pediatric HIV care in Togo, West Africa

Using the care delivery value chain framework to direct quality improvement

Bibliographic Data

ID19442829
AuthorsKevin P Fiori (0000-0003-1370-7366, Albert Einstein College of Medicine, corresponding author), Kevin Fiori, Jennifer Schechter (High Throughput Biology (United States)), Monica Dey (University of Kara), Sandra Braganza (0000-0002-8897-3370, Albert Einstein College of Medicine), Joseph Rhatigan (0000-0002-4516-7969, Brigham and Women's Hospital), Spero Houndenou (University of Kara), Christophe Gbeleou (University of Kara), Emmanuel Palerbo (University of Kara), Elfamozo Tchangani (University of Kara), Andrew Lopez (0000-0002-0918-151X, University of Kara), Emily Bensen (University of Kara), Lisa R Hirschhorn (0000-0002-4355-7437, Brigham and Women's Hospital)
Year2016
Volume28
Issuesup2
Pages29-33
Publication date2016-05-26
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2016.1176678
PMID27391996
OpenAlexW2473569961
LanguageEN
Citations received3
References cited1

Providing quality care for all children living with HIV/AIDS remains a global challenge and requires the development of new healthcare delivery strategies. The care delivery value chain (CDVC) is a framework that maps activities required to provide effective and responsive care for a patient with a particular disease across the continuum of care. By mapping activities along a value chain, the CDVC enables managers to better allocate resources, improve communication, and coordinate activities. We report on the successful application of the CDVC as a strategy to optimize care delivery and inform quality improvement (QI) efforts with the overall aim of improving care for Pediatric HIV patients in Togo, West Africa. Over the course of 12 months, 13 distinct QI activities in Pediatric HIV/AIDS care delivery were monitored, and 11 of those activities met or exceeded established targets. Examples included: increase in infants receiving routine polymerase chain reaction testing at 2 months (39-95%), increase in HIV exposed children receiving confirmatory HIV testing at 18 months (67-100%), and increase in patients receiving initial CD4 testing within 3 months of HIV diagnosis (67-100%). The CDVC was an effective approach for evaluating existing systems and prioritizing gaps in delivery for QI over the full cycle of Pediatric HIV/AIDS care in three specific ways: (1) facilitating the first comprehensive mapping of Pediatric HIV/AIDS services, (2) identifying gaps in available services, and (3) catalyzing the creation of a responsive QI plan. The CDVC provided a framework to drive meaningful, strategic action to improve Pediatric HIV care in Togo

Business · Economic growth · Family medicine · Health care · Quality management · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing · Pneumocystis jirovecii pneumonia detection and treatment · Marketing