The overall responsibilities of the HIV QI Program include:
- Development of policies guiding implementation of QI.
- Periodic review and updating of the QI framework and its indicators utilizing existing resources to redesign systems to achieve optimal patient outcomes.
- Capacity building, mentoring, and coaching county teams on QI activities.
- Monitoring and evaluation of national performance of key indicators.
The Kenya HIV Quality Improvement Framework (KHQIF), adopted from the Kenya Quality Model of Health (KQMH), was developed in 2014 to provide guidance within which HIV Quality Improvement will be implemented across the country. The KHQIF is accompanied by an operational manual that provides a detailed standard operating procedure and tools that are used in implementing the KHQIF.
Implementation of the National Quality Improvement Program in NASCOP started in 2008 with technical support from HEALTHQUAL-International. A National leadership group of key HIV stakeholders was convened to develop the first set of QI indicators and define the initial plan for prioritization and implementation. The group prioritized 3 regions and 15 facilities with the highest burden of HIV to start piloting the QI program in 2009. By 2011, the program expanded to 65 facilities through all regions. The National QM Team has since expanded to include broad representation from key stakeholders from Development Partners and MOH Directorates.
To date, QI Outcomes have been included in program updates using a CQI Dashboard in the Data Warehouse for EMR supported sites which interfaces with reporting to DHIS and provides access to performance measurement reports. In summary QI is everyone’s business in the spirit of programmatic efficiency and effectiveness, and being accountable for results.