Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111723

Raz Stevenson, MD, MPH¹, Stephen Kinoti, MD², Roderick Kisenge, MD, PhD², Mary Drake, RN, MPH³, Ya-Shin Lin, MPH², and Mandy Rose, MBBS, MPH, MRCP⁴. (1) University Research Co., LLC, Quality Assurance Project, PO Box 4513, Dar -es-Salaam, Tanzania, (2) The Quality Assurance Project, University Research Co/LLC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, 301 654 8338, skinoti@urc-chs.com, (3) Quality Assurance Project, University Research Co/LLC, 7200 Wisconsin Avenue, Bethesda, MD 20814, (4) The Quality Assurance Project, University Research Co /LLC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814

Few programs have scaled up pediatric HIV/AIDS care and treatment despite international commitment to providing access to this service. Scale-up may be achieved most rapidly by integrating pediatric HIV/AIDS programs into existing pediatric hospital based programs, which unfortunately often also need radical improvement.

In 2004, the Tanzanian Ministry of Health began an improvement collaborative in 7 referral hospitals with recently deployed HIV/AIDS treatment teams. While improving the quality of care for common conditions causing severe illness and death in children, the collaborative aimed to strengthen linkages between service entry points to improve the identification, testing, treatment and follow up of children with HIV/AIDS.

Baseline assessments on the quality of pediatric care found that although most facilities had most equipment, medicines and supplies for routine care, few patients were managed according to WHO guidelines, PMTCT coverage was low, and systematic follow up of babies born to HIV positive mothers and routine provision of cotrimoxazole did not occur.

An algorithm to identify and screen pediatric HIV patients was developed. The pediatric components of the national HIV/AIDS care and treatment curriculum and the HIV component of a WHO facility-based guideline were strengthened. Hospital teams were trained in the facility-based guidelines and the screening algorithm and systems were put in place to strengthen linkages with the outpatient-based HIV care and treatment teams. This paper will present findings and lessons learned from the collaborative and discuss the potential for scaling up.

Learning Objectives:

• List 5 common problems that affect the quality of pediatric HIV/AIDS care.
• Describe the key elements of the collaborative improvement approach and how this leads to rapid improvements in the quality of pediatric HIV/AIDS care

Keywords: HIV/AIDS, Pediatrics

Related Web page: www.qaproject.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.