VMMC CQI webinar 1Feb2017 FINAL2 - usaidassist.org on the mother brochure because it has messages appropriate for children. ... Integrating CQI in the EIMC Pilot in Tanzania. CQI findings

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PEPFAR VMMC Webinar

VMMC Continuous Quality Improvement Results: What’s New in

Implementation, Research, and Tools?

Jackie Sallet, ModeratorFebruary 1, 2017

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Welcome

Jackie Sallet, MScDirector, AIDSFree

John Snow Inc.

USAID Applying Science to Strengthen and Improve Systems

Today’s presenters

• Emmanuel Njeuhmeli, USAID • Patrick Devos, CCP,

Mozambique • John Byabagambi, URC,

Uganda• Saidi Mkungume, Jhpiego,

Tanzania and Joseph Kundy, URC, Tanzania

• Lani Marquez, URC, USA

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Voluntary Medical Male CircumcisionSite Capacity, Site Utilization Tool

Emmanuel Njeuhmeli, MD, MPH, MBA

Senior Biomedicale Prevention Advisor

Office of HIV/AIDS, USAID Washington

February 1st, 2017

Definition of ‘Optimum’ is Variable…“It depends” Efficiency translates into program productivity

1. Efficient use of resources

2. Increased service volume

Safety & Quality always supersede

Efficiency & Volume

Clinical Techniques Faster/simple vs. slower/complex methods

Electrocautery vs. ligating sutures Alcohol-based gel vs. surgical scrub

between cases

Task Sharing Assignment of less-complex tasks to lower credentialed but highly trained

health care cadres Task Shifting Allowing

non-physicians to perform all aspect of MC surgery after training

and competency assessment

LogisticsBundled/disposable vs.

individual/reusable supplies Allocation of multiple surgical bays

to surgery team Patient scheduling/sector booking

Minor surgery vs. major operating theater

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Efficiency, Site Utilization Rate, Productivity and Productivity Index

• When resources are allocated, the next step is to ensure that these resources are being used efficiently

• Efficiency signifies a level of performance that describes a process that uses the lowest amount of inputs to create the greatest amount of outputs ~ “Investopedia”

• Site Utilization Rate is the ratio of the Daily VMMCs Done divided by the Daily Site Capacity

• VMMC site productivity is a measure of the efficiency of a VMMC site in converting inputs (staffs time, commodities, space….) into useful outputs (# men receiving quality services and circumcised)

• Productivity index in this analysis is computed by:

– Average daily # of VMMCs done minus Average daily optimum site capacity

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• Volume is function of

– # Surgical Beds

– # Surgeons (Nurse, Physician, Surgeon….)

– # Assistants (Nurse, Physician, Surgeon…)

• Quality of services function of

– # Additional nurses (client screening, client follow-up…)

– # Counsellors

– # Mobilisers

• VMMC Site capacity

– VMMC daily capacity

– VMMC annual capacity

VMMC Site Capacity (both volume & quality of services)

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VMMC Site Capacity in a Conventional Surgical Approach

1 surgeon

1 surgical bed

Conventional Approach

TEAM = 1 surgeon and 1 assistant

Patient time: 20 to 30 minutes

Surgeon time: 20 to 30 minutes

Number of MCs/hour: 2

Number of MCs/day: 10

1 assistant

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VMMC Site Capacity in a Modified Surgical Approach -Efficiency

Bay 1

Bay 2

Bay 3

Bay 4

Modified Approach

TEAM = 1 surgeon, 4 assistants, and 1 nurse

Patient time: 20 to 30 minutes

Surgeon time: 6 to 8 minutes

Number of MCs/hour: 8

Number of MCs/day: 40

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VMMC Site Efficiency & Productivity Comparison…It depends

Conventional Approach Per surgical team 10/day

50/week for 5 days a week 200/month for 4 weeks a month

2000/year for 10 months a year

Modified Approach Per surgical team 40/day

200/week for 5 days a week 800/month for 4 weeks a month 8000/year for 10

months a year

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Voluntary Medical Male Circumcision Supply – Demand Equation

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• Inputs

– # beds– # surgeons– # assistants

– # other nurses– # counsellors– # mobilizers

• Outputs– Daily current

capacity– Daily optimum

capacity

– Days of operation lost

– Annual current capacity

– Annual optimum capacity

• Outputs

– Site utilization rate

– Productivity index

• Inputs

– VMMC done

– Day of operation

– VMMC done by Age

– VMMC done by AE

– VMMC done by testing status

– HIV+ referred to care and treatment

• Outputs

– Achievement vs Target

– Daily VMMCs done

– Follow-up rate

– AE rate

– Uptake of testing

– HIV + rate

– Percent referred to care and treatment

VMMC Site Capacity & Site Utilization Tool

Site capacity Site performance Site utilization

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Mozambique Daily Current vs. Optimum VMMC Site Capacity

10 10 10

20

0 0

10 10 10 10

0

20

30 30 30

0 0

30 30 30

20

0

FY16

Current Optimum

30 30 30 30

0 0

30

20 20 20 20

30 30 30 30

0 0

30

20 20 20 20

FY17 Q1

Current Optimum

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Mozambique Annual Current vs Optimum VMMC Site Capacity

2,54

0

2,55

0

2,55

0

5,10

0

‐ ‐

2,55

0

2,55

0

1,05

0 2,54

0

‐

5,16

0

7,74

0

7,74

0

7,74

0

‐ ‐

7,74

0

7,74

0

7,74

0

5,16

0

‐

FY16

Current Optimum

2,13

0

2,10

0

2,10

0

2,13

0

‐ ‐

2,07

0

1,38

0

1,34

0

1,34

0

‐

7,74

0

7,74

0

7,74

0

7,74

0

‐ ‐

7,74

0

5,16

0

5,16

0

5,16

0

5,16

0

FY17 Q1

Current Optimum

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# of Additional Staff Needed for Optimum Operation

(1)(2)

(4)

(1)‐ ‐

(2)

(4) (4)

(2)

‐

(2)

(3)

(3)

(3)

‐ ‐

(3)

(3) (3)

(2)

‐

(1)

(2)

(2)

(2)

(4) (4)

‐ ‐ ‐

(1)

(4)

(3)

(3)

(3)

(4)

(4) (4)

(4)

(4)(3)

(3)(4)

(14)

(12)

(10)

(8)

(6)

(4)

(2)

-

FY16

Nurses Assistants

Mobilisers Counsellors

‐1

2 1

‐ ‐

2

‐ ‐ ‐

(2)(1)

‐

‐

‐

‐ ‐

‐

1 1 1

(1)

3 2

2

(1)‐ ‐

1

‐1

(1)‐

(1)(2) (2)

(3)

‐ ‐

(4) (4)(3)

(2)

(3)

(8)

(6)

(4)

(2)

-

2

4

6

FY17 Q1

Nurses Assistants

Mobilisers Counsellors

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Mozambique FY16 vs FY17 Q1 VMMC Site Utilization Rate

134%

72%

48%

74%

0%

0%

94%

40%

27%

57%

0%

236%

160%

167%

109%

0%

0%

102%

80%

71%

66%

0%

0% 50% 100% 150% 200% 250%

CS 1º MAIO II

CS MANICA I

CS GONDOLA SEDE I

HR CATANDICA

CS MACHAZE

CS MUSSORIZE

HP TETE

CS CHITIMA

CS MOATIZE

CS CHANGARE I

CS MUTARARA

FY17 FY16

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FY16 VMMC Productivity Index

1,640

(2,229)

(4,033)

(2,053)

‐

‐

(573)

(4,705)

(6,895)

(2,245)

‐

CS 1º MAIO II

CS MANICA I

CS GONDOLA SEDE I

HR CATANDICA

CS MACHAZE

CS MUSSORIZE

HP TETE

CS CHITIMA

CS MOATIZE

CS CHANGARE I

CS MUTARARA

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VMMCs Done in FY16 Q1 vs FY17 Q115

14

1529

885 14

00

0 0

1862

586 755

664

0

3,34

9

3,36

4

3,50

0

2,31

7

‐ ‐

2,10

2

1,66

6

1,43

2

883

‐

FY16 Q1 FY17 Q1

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FY17 Q1 VMMCs Done, Annual Target & Annual Site Capacity

3,349 3,364 3,500 2,317

‐ ‐

2,102 1,666 1,432 883 ‐

7,487

4,942

10,926

7,092

4,943

10,572

4,820 6,085

14,826

8,353

15,250

7,740 7,740 7,740 7,740

‐ ‐

7,740

5,160 5,160 5,160 5,160

‐

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

VMMC Done VMMC Target Annual Site Capacity

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Effective Demand Creation & In-Service Communications Strategy

Group Education (Optional)

One‐on‐One MC/CT

Counseling

Pre‐Op Assessment

and Counseling

MC Procedure

Post‐Op Recovery and Counseling

Two‐Day Review and Counseling

Seven‐Day Review and Counseling

Demand Creation

Education on MC Process through

CounselingPromotion of Safe

Healing

Promotion of Sustained

Safer Sexual Behaviors

Going for MC Staying safe after MC

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VMMCs Done by Age Groups

10‐14'35%

15‐1961%

30+4%

FY17 Q1

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Voluntary Medical Male Circumcision Supply – Demand Equation

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THANK YOU

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Improving Quality of VMMC In-Service Communication in Mozambique

Presented by Patrick DevosHC3, JHCCP

Issues Identified in EQA and Assessment, Sept-Oct. 2015

Issues Identified EQASept 2015

AssessmentOct 2015

Lack of clear procedures for documentation, tracking of referrals, follow-ups

X X

Privacy concerns for group education, HIV testing, at some sites

X

Not meeting specific needs of younger clients (Parental informed consent not available for all clients; materials not geared toward younger boys)

X X

Partial protection of VMMC not adequately addressed at a few sites

X

Issues around materials (supply, use, need local language, placement)

X X

Post-op & follow-up counseling needs improvement X XLack of comprehensive training for counselors; need for refreshers X 28

Key Recommendations from the Assessment

• Immediate comprehensive training of counselors• All materials should be reviewed (latest guidance

included, needs of younger client, etc.)• Put system in place for tracking stock of materials• Brief refresher training for the providers on key post-op

messages and checklist• Improve signage for better visibility• Ensure that critical post-op care instructions is in fact

reaching parents/guardians

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WHAT WAS DONE TO ACT ON THE RECOMMENDATIONS?

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1. Immediate Comprehensive Training of Counselors

• Training in communication skills and interpersonal counselling and use of SBCC material, organized by JHU through the PACTO project in partnership with Jhpiego and guided by MOH

• Attend individual and group counselling sessions to verify the correct use of counselling material, the messages conveyed, how the session is conducted, and subsequent technical support

• During the site supervision visits, key messages about VMMC, HIV, and how to use the SBCC materials were reinforced

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2. All Materials Reviewed to Update Guidance, Meet Needs of Younger Clients

• The flipchart job aid was adapted for use with younger clients, reviewed by the MOH and awaiting approval for printing

• Guided counsellors to base younger clients’ post-operative recommendations on the mother brochure because it has messages appropriate for children.

• Translated the PEPFAR Counseling Guide into Portuguese, and reviewing the materials to incorporate key messages from the Guide

• SBCC material was reviewed and changes made to flipchart for adults to more explicitly discuss tetanus risk (however, its change needs approval from the MOH)

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3. Put in Place System for Tracking Stock of Materials

• Strengthened the system for materials reproduction, printing, and distribution

• Allocated 1 focal point and 1-2 community counsellors in each VMMC site to:– Maintain daily log of the SBCC materials distributed

– Regular checking of SBCC materials stored in the circumcision rooms

– Replenish SBCC materials in public places, general waiting rooms of health units, and VMMC units

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4. Brief Refresher Training for Providers on Key Post-op Messages, Checklist

• Training of VMMC unit team in interpersonal communication and counselling skills, VMMC, and HIV issues. The training was facilitated by the MOH site by site in Manica Province, and in Tete Province took place during the training of providers organized by AIDSFree and guided by the MOH

• Reinforced the need to use SBCC materials because they have key messages about postoperative care and that the providers should always use the post-operative brochure

• Check during the supervision visits the availability of this brochure in the VMMC unit and with the provider and verify the effectiveness of its use

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5. Improved Signage for Better Visibility

• Produced and placed in each VMMC site a panel that indicates the service with the contact of the respective unit, the hours of operation, and the contact of Alo Vida hot line number

• There were also signs indicating the service

• Produced Tear Drops and banners that reinforce the location of the service

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6. Ensure that Critical Post-op Care Instructions Are Reaching Parents/Guardians

• During the meetings with parents in the community and group counselling at the VMMC unit, post-op wound care is explained and discussed

• Use of the "mother caring“ brochure during community outreach meetings with parents and during group and individual counseling sessions

• Each parent / child receives the post-operative brochure, "mother's affection", where they have guidelines for wound treatment, where the dates of follow-up of wound treatment, and the telephone number of the circumcision unit are written

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EQA Findings in Sept. 2016

Tool G Findings: Pre-Op Group Education, Individual Counseling and MaterialsBest practices• Very well trained counselors • Use of TV to entertain clients while waiting (Tete Hospital)Strengths

• All sites have very well trained community mobilizers• Separate counselors for group and individual counselling to

reduce waiting time (1⁰ de Maio)• Messages are reinforced at every point of care (Tete

Hospital)

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Issues Needing Improvement Identified in EQA, Sept. 2016

• Some key HIV issues were not mentioned in counseling: HIV testing is optional, VMMC provides only partial protection, common modes of HIV transmission, other risk reduction steps

• Condom use not always demonstrated• Counselor did not correct misconceptions about HIV• Counselor did not encourage partner testing

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Joint Improvement Plan to Address Recommendations from EQA

1. Improve the technical quality of clinical staff2. Refer HIV+ and clients with STI and ensure the return

of the client to the VMMC services3. Improve information on VMMC in STI consultation

rooms

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THANK YOU!

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Integrating CQI in the EIMC Pilot in Tanzania

Saidi Mkungume, AIDSFree VMMC ProjectJhpiego, Tanzania

Joseph Kundy, USAID ASSIST Project URC, Tanzania

This presentation is made possible by the generous support of the American people through PEPFAR with USAID under the Cooperative Agreement Strengthening High Impact Interventions for an AIDS-free Generation, number AID-OAA-A-14-00046 and the USAID Applying

Science to Strengthen and Improve Systems (ASSIST) Cooperative Agreement Number AID-OAA-A-12-00101. The information provided does not necessarily reflect the views of USAID, PEPFAR, or the U.S. Government.

Presentation Outline

• Describe the motive behind the early infant male circumcision (EIMC) pilot in Iringa Region, Tanzania

• Outline key highlights from EIMC CQI tool development process

• Summarize key findings from field testing of the EIMC CQI tool

AIDSFree Multi-prong Sustainability Strategy

Prong 1Prong 1

Integrate VMMC service delivery into existing health

services

Integrate VMMC service delivery into existing health

services

Continue to build region and district capacity and

directly support regions on VMMC implementation

Continue to build region and district capacity and

directly support regions on VMMC implementation

Partner with and build capacity of CSOs within the

regions

Partner with and build capacity of CSOs within the

regions

Prong 2Prong 2

Focus on early adolescents

Annual campaigns/outreach

to "catch" clients turning 10 years of

age not already circumcised

Model of adolescent friendly services within VMMC

Focus on early adolescents

Annual campaigns/outreach

to "catch" clients turning 10 years of

age not already circumcised

Model of adolescent friendly services within VMMC

Prong 3Prong 3

Scale up integrated early infant male circumcision in

saturated regions

Scale up integrated early infant male circumcision in

saturated regions

EIMC Pilot Finalization and Report• Pilot was initially in 4 sites,

expanded to a total of 8 facilities in Iringa Region

• Pilot ran from April 2013 through April 2016**

• A concurrent study was conducted Piloting Early Infant Male Circumcision (EIMC) in Iringa, Tanzania: Views on Acceptability and Service Delivery Integration.

• MOH approved EIMC pilot and study report in April 2016

56

EIMC Service Delivery Model

RCH

Immunization

EIMC

Well-Baby

Post-partum

Family Planning

PMTCT

• EIMC services are integrated into the Reproductive Child Health (RCH) units at the health facilities

• MOH providers are trained on EIMC procedure and conduct during regular work hours

• Parents are offered HIV testing as part of the services

• Currently use Mogen clamp for the procedure

• Eligible infant males are full term, >2.5 kg and aged 24 hours to 60 days old 57

Rationale for Integrating CQI in EIMC Pilot

Support local teams to address program deficiencies along the

continuum of care

Support frontline health workers to monitor and

control quality

Increase access, timeliness, effectiveness, safety and efficiencies of services

Maximize potential of EIMC providers to achieve better outcomes for MNCH services

at RCH

Framework for CQI in EIMCContent of care

– Leadership, planning & sustainability – Management systems– Enabling environment for EIMC services– Communication and infant care– EIMC procedure– Monitoring & evaluation– Continuity of care/post-operative follow-

up visit– Infection prevention & control

Process of care– ANC– Delivery– Post-natal care– HIV counseling & testing– Immunization & well baby

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Steps for CQI Integration in EIMC Services

Steps Area Key Activities1 Create an

enabling environment

• Developed VMMC and EIMC National Guidelines, SOPs, M&E Tools and National Training Package for VMMC and EIMC with integrated CQI

2 CQI tool design

• Built consensus on steps for CQI integration with key stakeholders, reviewed tools/documents developed by Jhpiego, agreed on key EIMC standards areas and criteria

3 Site visits to pre-test tool

• Testing tool at 4 EIMC service delivery sites and revised based on findings

4 Stakeholder buy-in

• Development of the National EIMC CQI tool draft zero

5 Field testing • EIMC Trainers led the field testing of the tool; NACP, ASSIST, and AIDSFree observed and documented findings; field test findings presented to the VMMC/EIMC TWG

6 CQI finalization meeting

• Revised and finalized the tool based on comments from the field test

Findings: Field Test National CQI Tool Draft Zero-October 2016

Mgmt. Supp. Comm. Procedure Continuity M&E IPC Overall

Iringa Regional Hospital

50 67 75 100 83 69 74

Frelimo Hospital 40 50 75 100 92 60 70

TosamagangaHospital 40 83 80 100 100 83 53 77

>80% Good

50 - <80%Fair

<50%Poor

Not assessed

Lessons Learned During EIMC CQI Tool Development

• MOH is committed in accelerating efforts towards HIV-free generation including provision of EIMC services

• EIMC service delivery register was not capturing linkages between EIMC and other infant related services

• Existing Work Improvement Teams or Quality Improvement Teams at the facility level can be leveraged to integrate CQI for EIMC services in their plans.

• Providers basic neonatal skills are lacking; need to provide multiple refreshers on basic neonatal emergency skills

Acknowledgements• Alice Christensen, AIDSFree/ Jhpiego Tanzania• Davis Rumisha, USAID ASSIST Tanzania• Gissenge Lija, NACP/ MoHCDGEC Tanzania• Lani Marquez, USAID ASSIST Washington• Emmanuel Njeuhmeli, USAID Washington

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Progress in rolling out VMMC CQI: Country results and tools

to support EQA and CQI

Lani Marquez, MHSKnowledge Management Director

USAID ASSIST Project, URC


Key elements of VMMC CQI support

• Training in application of CQI approach to improve quality

• Regular site assessments to identify quality gaps and monitor progress

• Onsite coaching and mentorship to address site-specific gaps

• Peer-to-peer learning sessions on quarterly basis• MOH-led quarterly VMMC meetings for all

implementing partners to share experiences

6666


ASSIST VMMC CQI support in Uganda

• Ongoing “Above Site” support to MOH and IPs to improve VMMC quality in 90 sites in 36 of 118 districts, drawing on experience gained over the past three years

• Supporting the MOH in rolling out its tetanus toxoid vaccination policy, including:– Training staff on new guidelines for tetanus toxoid

vaccination and communication on tetanus toxoid vaccination during SMC

– Assessing sites’ readiness in integrating the intervention in SMC program

67


Uganda: Improvement in linkage to care of HIV-positive clients identified in VMMC

: Improving linkage of HIV positives, identified through SMC at 92 sites in Uganda (Oct 2015-Nov 2016).

Changes made by sites:1. Orientation of staff on documentation of linkage of HIV+ clients2. Physically escorting clients to ART clinics3. Phone calls to follow up on clients linked to external ART centers

Increasing the proportion of HIV-positives identified through VMMC who were linked to care at 92 sites (Oct 2015-Nov 2016)

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ASSIST VMMC CQI support in South Africa

• CQI support to 65 facilities in the 5 USAID priority provinces

• Support for development of CQI tools and building capacity of DOH Regional Training Center in VMMC CQI

• Institutionalize CQI by training the Quality Assurance Coordinators of the Department of Health at all levels

69


South Africa: VMMC CQI dashboards, July 2014-Sept 2016

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Baseline and re-assessment at 5-27 months for sites receiving two to five assessments (July 2014 – Sept 2016)


ASSIST VMMC CQI support in Malawi

• Support MOH in improving quality of VMMC in 19 districts (8 PEPFAR + 11 World Bank supported)

• Support QI teams in 19 high-volume sites (12 USAID, 5 DOD & 10 World Bank supported sites) to continuously improve the quality and safety of VMMC services at the site level

• EQA-CQI training for 30 USG, MOH, and IP staff in Blantyre in March 2017

• Support for EQA in Malawi in March 2017

71


Malawi: Improvement in 48-hour review of VMMC clients in 9 supported sites

95

75

90

47

88

58

85

94 91

75

84

74

93 9592

0

20

40

60

80

100

120

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

% of VMMC clients reviewed at 48 hours, 9 CQI-supported teams, Oct 2015-Dec 2016

% of clients who reported for 48 hour post-operative review/care for 9 Teams

1989 2077 2380 3116 2765 3973 4296 2512 1854

8487

13934

1616 1523 1756 8970

20000

Oct‐15 Nov‐15 Dec‐15 Jan‐16 Feb‐16 Mar‐16 Apr‐16 May‐16 Jun‐16 Jul‐16 Aug‐16 Sep‐16 Oct‐16 Nov‐16 Dec‐16

Total Number of circumcisions done as part of the minimum package of MC for HIV Prevention services in 9 teams

Changes tested by the various sites

-Emphasizing to clients in post-operative counseling to return at 48 hours- Making reminder phone calls to clients that have appointments-Making arrangements with nearest health centers for 48-hour post- operative for clients living far from VMMC site-Collecting the right addresses for clients-Using expert clients and mobilisers to track clients in communities-Having a separate register to track follow-up clients

72


ASSIST VMMC CQI support in Tanzania

• Support MOHCDGEC* and IPs to implement CQI for VMMC at static sites and selected outreaches in the priority districts: 26 councils in Iringa, Njombe, Mbeya, Songwe, Shinyanga, and Tabora regions

• CQI support for EIMC services in 16 sites in Iringa and EIMC sites in Njombe

• Support MOHCDGEC to revise VMMC and EIMC CQI tools and integrate into national quality improvement framework

*Ministry of Health, Community Development, Gender, Elderly and Children

73


Tanzania: Improved compliance to VMMC standards, 12 sites, Njombe Region

First five rows=priority council that have received more CQI support

74


ASSIST VMMC CQI support in Lesotho

• Building VMMC CQI capacity for MOH and IP staff and supporting CQI in 6 sites, with quarterly re-assessments

Surgical Prepex1 28% 74% 62% 92% 59% 90% 93% 90% 95% 76%2 23% 77% 63% 98% 83% 92% 97% 96% 97% 81%3 37% 79% 67% 68% 84% 96% 84% 98% 90% 78%4 49% 67% 75% 94% 79% 73% 86% 89% 57% 74%

5 51% 77% 83% 100% 91% 89% 91% 82% 83%6 55% 81% 78% 98% 89% 92% 91% 94% 93% 86%

Overall 40% 76% 71% 92% 81% 89% 90% 93% 86% 80%

Infrastructure, supplies,

equipment and environment

ProcedureInfection

prevention and control TotalSite

Leadership, Planning

and Sustainability

Management systems

Monitoring and

Evaluation

Registration,Group

education and IEC material

Individual counselling

and HIV testing

Major improvements observed in December coaching visits in all sites:• Sites holding regular meetings to discuss VMMC

issues and challenges. • Site staff doing root cause analysis• All key indicators are being collected• Most areas of IPC have been addressed

75


ASSIST VMMC CQI support in Namibia

• Support to 10 private practitioner sites on VMMC and 5 MOH sites on HTC, PMTCT/ART/TB-HIV care

• VMMC CQI baseline (Oct. 2016):

76


ASSIST VMMC CQI support in Mozambique and Swaziland

Mozambique:• Stakeholder workshop with MOH, USAID, and all IPs to

discuss roles and responsibilities for CQI • CQI support and quarterly reassessments• EQA/CQI training and support for EQA

Swaziland:• Capacitate the MOH VMMC program to provide

QA/QI/CQI oversight to implementing partners and support M&E of national VMMC program

77


Tool development and training

• Downloadable EQA mobile app - VMMC QualTM

• QA/QI training for USG, MOH, and IPs and supporting materials—next training in Malawi March 21-23

• CQI online toolkit coming soon

78

79

URC appreciates the contributions of the Ministries of Health, implementing partners, site teams, and USG staff

to these results. This work is made possible by the support of the American people through the USAID ASSIST

Project, managed by URC with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

For more information, please visit www.usaidassist.org/vmmc-cqi-resources or contact Dr.

Donna Jacobs, ASSIST VMMC Lead, [email protected]

81

Wrap-up and Final Remarks

Jackie Sallet, MScDirector, AIDSFree

John Snow Inc.


CQI Resources

• Resource page on the USAID ASSIST website with current tools: www.usaidassist.org/vmmc-cqi-resources

• Presentations from this webinar will be posted at: https://www.usaidassist.org/content/webinar-vmmc-continuous-quality-improvement-results

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Documents

VMMC CQI webinar 1Feb2017 FINAL2 - usaidassist.org on the mother brochure because it has messages appropriate for children. ... Integrating CQI in the EIMC Pilot in Tanzania. CQI findings