Elimination of mother-to-child transmission of HIV in South Africa: Rapid scale-up using quality improvement
Elimination of mother-to-child transmission of HIV in South Africa: Rapid scale-up using quality improvement
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DOI：
10.7196/samj.7605
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发表时间：
2014-03-01
期刊：
影响因子：
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通讯作者：
Sherman, G
中科院分区：
文献类型：
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作者：
Bhardwaj, S;Barron, P;Sherman, G
背景南非（SA）致力于实现到2015年消除艾滋病毒母婴传播（MTCT）的目标。为实现这一目标，必须使所有妇女普遍获得优质产前、分娩、分娩和产后服务。在过去十年中，预防母婴传播（PMTCT）计划已扩大到该国所有医疗机构。然而，在实现100%的覆盖率和获得该方案方面仍然存在挑战。我们描述了国家卫生部（NDoH）与合作伙伴合作开展的过程，以开发，实施和监测数据驱动的干预措施，以改善设施，地区，省和国家预防母婴传播相关的性能。2011年至2013年期间，国家卫生部制定并实施了一项干预措施，利用数据驱动的参与性进程了解设施一级的瓶颈，以优化预防母婴传播的实施，并在全国范围内扩大预防母婴传播的优先行动。2011 - 2013年三年期间，预防母婴传播级联的所有关键指标都有显著改善。直观仪表板和行动报告数据等简单的监测工具被成功地用于提高南澳大利亚州预防母婴传播方案的绩效。母婴传播呈明显下降趋势。在全国范围内实施地区一级的数据驱动的质量改进进程，以改进地方一级预防母婴传播方案的业绩，这是可行的。
Background. South Africa (SA) is committed to achieving the goal of eliminating mother-to-child transmission (MTCT) of HIV by 2015. To achieve this, universal coverage of quality antenatal, labour, delivery and postnatal services for all women has to be attained. Over the past decade, the prevention of mother-to-child transmission (PMTCT) programme has been scaled up to reach all healthcare facilities in the country. However, challenges persist in achieving 100% coverage and access to the programme.Objectives. We describe the process undertaken by the National Department of Health (NDoH), in collaboration with partners, to develop, implement and monitor a data-driven intervention to improve facility, district, provincial and national PMTCT-related performance.Methods. Between 2011 and 2013, the NDoH developed and implemented an intervention using data-driven participatory processes to understand facility-level bottlenecks to optimise PMTCT implementation and to scale up priority PMTCT actions nationally.Results. There was remarkable improvement across all key indicators in the PMTCT cascade over the 3 years 2011 - 2013. Simple monitoring tools such as a visual dashboard and data for action reports were successfully used to improve the performance of the PMTCT programme across SA. MTCT has shown a significant downward trend.Conclusions. It is feasible to implement district-level, data-driven quality improvement processes at a national scale to improve the performance of the PMTCT programme at the local level.