H Manisha Yapa, Wendy Dhlomo-Mphatswe, Mosa Moshabela, Jan-Walter De Neve, Carina Herbst, Awachana Jiamsakul, Kathy Petoumenos, Frank A Post, Deenan Pillay, Till Bärnighausen, Sally Wyke
BACKGROUND: We evaluated continuous quality improvement (CQI) targeting antenatal HIV care quality in rural South Africa using a stepped-wedge cluster-randomised controlled trial (Management and Optimisation of Nutrition, Antenatal, Reproductive, Child health, MONARCH) and an embedded process evaluation. Here, we present results of the process evaluation examining determinants of CQI practice and 'normalisation.' METHODS: A team of CQI mentors supported public-sector health workers in seven primary care clinics to (1) identify root causes of poor HIV viral load (VL) monitoring among pregnant women living with HIV and repeat HIV testing among pregnant women not living with HIV, and (2) design and iteratively test their own solutions...
October 27, 2020: International Journal of Health Policy and Management