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

using the care delivery value chain framework to direct quality improvement

Kevin P. Fiori, Jennifer Schechter, Monica Dey, Sandra Flavia Braganza, Joseph Rhatigan, Spero Houndenou, Christophe Gbeleou, Emmanuel Palerbo, Elfamozo Tchangani, Andrew Lopez, Emily Bensen, Lisa R. Hirschhorn

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)29-33
Number of pages5
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume28
DOIs
StatePublished - May 26 2016

Fingerprint

Togo
Western Africa
value chain
West Africa
Quality Improvement
HIV
Pediatrics
Acquired Immunodeficiency Syndrome
AIDS
Continuity of Patient Care
Quality of Health Care
Patient Care
Communication
Delivery of Health Care

Keywords

  • care delivery value chain
  • global healthcare delivery
  • implementation science
  • Pediatric HIV
  • Togo

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Social Psychology

Cite this

Closing the delivery gaps in pediatric HIV care in Togo, West Africa : using the care delivery value chain framework to direct quality improvement. / Fiori, Kevin P.; Schechter, Jennifer; Dey, Monica; Braganza, Sandra Flavia; Rhatigan, Joseph; Houndenou, Spero; Gbeleou, Christophe; Palerbo, Emmanuel; Tchangani, Elfamozo; Lopez, Andrew; Bensen, Emily; Hirschhorn, Lisa R.

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Vol. 28, 26.05.2016, p. 29-33.

Research output: Contribution to journalArticle

Fiori, Kevin P. ; Schechter, Jennifer ; Dey, Monica ; Braganza, Sandra Flavia ; Rhatigan, Joseph ; Houndenou, Spero ; Gbeleou, Christophe ; Palerbo, Emmanuel ; Tchangani, Elfamozo ; Lopez, Andrew ; Bensen, Emily ; Hirschhorn, Lisa R. / Closing the delivery gaps in pediatric HIV care in Togo, West Africa : using the care delivery value chain framework to direct quality improvement. In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2016 ; Vol. 28. pp. 29-33.
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