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Reaching for the MDGs: South Africa's accelerated response to mother-to-child transmission of HIV

Reaching for the MDGs: South Africa's accelerated response to mother-to-child transmission of HIV. 20 July 2010 Kedar Mate 1,2 , Gugu Ngubane 3 , Pierre Barker 1,4 1 Institute for Healthcare Improvement 2 Weill Cornell Medical College 3 National Department of Health, South Africa

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Reaching for the MDGs: South Africa's accelerated response to mother-to-child transmission of HIV

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  1. Reaching for the MDGs: South Africa's accelerated response to mother-to-child transmission of HIV 20 July 2010 Kedar Mate1,2, Gugu Ngubane3, Pierre Barker1,4 1Institute for Healthcare Improvement 2Weill Cornell Medical College 3National Department of Health, South Africa 4University of North Carolina at Chapel Hill

  2. PMTCT Systems Gaps in SA In 2007, 20.6% MTCT rate or 64,000 babies infected with HIV in SA

  3. National Target • National DOH sets target to reduce MTCT rate to <5% by 2011 • Prevent 50,000 annual HIV infections amongst newborns • In 2009, DOH commissioned the PMTCT “Accelerated Plan” • Quality Improvement to improve clinical services • Social mobilization to improve demand • 6 Districts selected to start programme

  4. Launch National Partners Collaborative: Using QI approaches to rapidly scale up PMTCT Nationwide National government target: Using QI to improve delivery of PMTCT services Common Aim Shared knowledge Common QI and data framework Joint ownership NGO 5 NGO 1 Design, convening and training partner (IHI) NGO 4 NGO 2 NGO 3

  5. Launch National Partners Collaborative: Using QI approaches to rapidly scale up PMTCT Nationwide National government target: Using QI to improve delivery of PMTCT services Distr office Distr office NGO 5 NGO 1 Design, convening and training partner (IHI) NGO 4 NGO 2 Distr office Distr office NGO 3 Distr office

  6. Results of Partners Collaborative: PMTCT “Accelerated” Plan Within 9 months…. QI training for…. 115 District Office staff, 473 facility-level staff 88 NGO staff Supporting… 9 districts 161 facilities Using…. Shared understanding of systems obstacles Common QI methods Simplified indicator set Active Districts

  7. Ulundi, Zululand: KZNImproving VCT coverage in the ANC Gap in HIV testing Before Aplan Aplan

  8. Maluti-a-Phofung: Free State Aplan Aplan

  9. Aggregate Results Across All Facilities

  10. Launch National Partners Collaborative: Using QI approaches to rapidly scale up PMTCT Nationwide National government target: Using QI to improve delivery of PMTCT services Distr office Distr office NGO 5 NGO 1 Design, convening and training partner (IHI) NGO 4 NGO 2 Distr office Distr office NGO 3 Distr office

  11. Sustaining Change: District & Provinces replicate the QI mentorship Distr office Distr office National government target: Using QI to improve delivery of PMTCT services Distr office Distr office Distr office

  12. Thank you • IHI Colleagues: Pierre Barker, Michele Youngelson, Nicholas Leydon, Brandon Bennett, Nupur Mehta • Department of Health: Yogan Pillay, Gugu Ngubane, Precious Robinson, Provincial Coordinators and Partners • DFID & HLSP: Myles Ritchie, Kevin Bellis, Claire Dobson, Norma James • UKZN/20,000+: Jennifer Reddy, Wendy Mphatswe, Hloli Ngidi, Nigel Rollins kmate@ihi.org For more on Quality Improvement and HIV/PMTCT: Workshop (WEWS14) on Wednesday 2:30 MiniRoom 4

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