Health-care worker engagement in HIV-related quality improvement in Dar es Salaam, Tanzania

Maria E. Garcia; Michelle S. Li; Hellen Siril; Claudia Hawkins; Sylvia Kaaya; Shabbir Ismail; Guerino Chalamilla; Sarah Geoffrey Mdingi; Lisa R. Hirschhorn

doi:10.1093/intqhc/mzr006

Health-care worker engagement in HIV-related quality improvement in Dar es Salaam, Tanzania

Maria E. Garcia, Michelle S. Li, Hellen Siril, Claudia Hawkins, Sylvia Kaaya, Shabbir Ismail, Guerino Chalamilla, Sarah Geoffrey Mdingi, Lisa R. Hirschhorn^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Objective: To assess health-care worker (HCW) awareness, interest and engagement in quality improvement (QI) in HIV care sites in Tanzania. Design: Cross-sectional survey distributed in May 2009. Setting: Sixteen urban HIV care sites in Dar es Salaam, Tanzania, 1 year after the introduction of a quality management program. Participants: Two hundred seventy-nine HCWs (direct care, clinical support staff and management). Main Outcome Measures: HCW perceptions of care delivered, rates of engagement, knowledge and interest in QI. HCWidentified barriers to and facilitators of the delivery of quality HIV care. Results: Two hundred seventy-nine (73%) of 382 HCWs responded to the survey. Most (86%) felt able to meet clients' needs. HCW-identified facilitators of quality included: teamwork (88%), staff communication (79%), positive work environment (75%) and trainings (84%). Perceived barriers included: problems in patients' lives (73%) and too few staff or too high patient volumes (52%). Many HCWs knew about specific QI activities (52%) or had been asked for input on QI (63%), but fewer (40.5%) had participated in activities and only 20.1% were currently QI team members. Managers were more likely to report QI involvement than direct care or clinical support staff (P<0.01). No difference in QI involvement was seen based on patient load or site type. Conclusions: HCWs can provide important insights into barriers and facilitators of providing quality care and can be effectively engaged in QI activities. HCW participation in efforts to improve services will ensure that HIV/AIDS quality of care is achieved and maintained as countries strive for universal antiretroviral access.

Original language	English (US)
Article number	mzr006
Pages (from-to)	231-238
Number of pages	8
Journal	International Journal for Quality in Health Care
Volume	23
Issue number	3
DOIs	https://doi.org/10.1093/intqhc/mzr006
State	Published - Jun 2011

Funding

This research was supported by the Harvard University Center for AIDS Research (CFAR), an NIH funded program (P30AI060354) which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI and NCCAM. M.E.G. was supported by the National Institutes of Health Office of the Director, Fogarty International Center, Office of AIDS Research, National Cancer Center, NEI, NHLBI, NIDA, NIMH, NIAID, NIDCR, and NIH Office of Women’s Health and Research through the International Clinical Research Fellows Program at Vanderbilt University (R24TW007988) and the American Relief and Recovery Act.

Keywords

Health-care surveys
Health-care workers
Quality improvement

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/intqhc/mzr006

Cite this

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title = "Health-care worker engagement in HIV-related quality improvement in Dar es Salaam, Tanzania",

abstract = "Objective: To assess health-care worker (HCW) awareness, interest and engagement in quality improvement (QI) in HIV care sites in Tanzania. Design: Cross-sectional survey distributed in May 2009. Setting: Sixteen urban HIV care sites in Dar es Salaam, Tanzania, 1 year after the introduction of a quality management program. Participants: Two hundred seventy-nine HCWs (direct care, clinical support staff and management). Main Outcome Measures: HCW perceptions of care delivered, rates of engagement, knowledge and interest in QI. HCWidentified barriers to and facilitators of the delivery of quality HIV care. Results: Two hundred seventy-nine (73%) of 382 HCWs responded to the survey. Most (86%) felt able to meet clients' needs. HCW-identified facilitators of quality included: teamwork (88%), staff communication (79%), positive work environment (75%) and trainings (84%). Perceived barriers included: problems in patients' lives (73%) and too few staff or too high patient volumes (52%). Many HCWs knew about specific QI activities (52%) or had been asked for input on QI (63%), but fewer (40.5%) had participated in activities and only 20.1% were currently QI team members. Managers were more likely to report QI involvement than direct care or clinical support staff (P<0.01). No difference in QI involvement was seen based on patient load or site type. Conclusions: HCWs can provide important insights into barriers and facilitators of providing quality care and can be effectively engaged in QI activities. HCW participation in efforts to improve services will ensure that HIV/AIDS quality of care is achieved and maintained as countries strive for universal antiretroviral access.",

keywords = "Health-care surveys, Health-care workers, Quality improvement",

author = "Garcia, {Maria E.} and Li, {Michelle S.} and Hellen Siril and Claudia Hawkins and Sylvia Kaaya and Shabbir Ismail and Guerino Chalamilla and Mdingi, {Sarah Geoffrey} and Hirschhorn, {Lisa R.}",

note = "Funding Information: This research was supported by the Harvard University Center for AIDS Research (CFAR), an NIH funded program (P30AI060354) which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI and NCCAM. M.E.G. was supported by the National Institutes of Health Office of the Director, Fogarty International Center, Office of AIDS Research, National Cancer Center, NEI, NHLBI, NIDA, NIMH, NIAID, NIDCR, and NIH Office of Women{\textquoteright}s Health and Research through the International Clinical Research Fellows Program at Vanderbilt University (R24TW007988) and the American Relief and Recovery Act.",

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doi = "10.1093/intqhc/mzr006",

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T1 - Health-care worker engagement in HIV-related quality improvement in Dar es Salaam, Tanzania

AU - Garcia, Maria E.

AU - Li, Michelle S.

AU - Siril, Hellen

AU - Hawkins, Claudia

AU - Kaaya, Sylvia

AU - Ismail, Shabbir

AU - Chalamilla, Guerino

AU - Mdingi, Sarah Geoffrey

AU - Hirschhorn, Lisa R.

N1 - Funding Information: This research was supported by the Harvard University Center for AIDS Research (CFAR), an NIH funded program (P30AI060354) which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI and NCCAM. M.E.G. was supported by the National Institutes of Health Office of the Director, Fogarty International Center, Office of AIDS Research, National Cancer Center, NEI, NHLBI, NIDA, NIMH, NIAID, NIDCR, and NIH Office of Women’s Health and Research through the International Clinical Research Fellows Program at Vanderbilt University (R24TW007988) and the American Relief and Recovery Act.

PY - 2011/6

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N2 - Objective: To assess health-care worker (HCW) awareness, interest and engagement in quality improvement (QI) in HIV care sites in Tanzania. Design: Cross-sectional survey distributed in May 2009. Setting: Sixteen urban HIV care sites in Dar es Salaam, Tanzania, 1 year after the introduction of a quality management program. Participants: Two hundred seventy-nine HCWs (direct care, clinical support staff and management). Main Outcome Measures: HCW perceptions of care delivered, rates of engagement, knowledge and interest in QI. HCWidentified barriers to and facilitators of the delivery of quality HIV care. Results: Two hundred seventy-nine (73%) of 382 HCWs responded to the survey. Most (86%) felt able to meet clients' needs. HCW-identified facilitators of quality included: teamwork (88%), staff communication (79%), positive work environment (75%) and trainings (84%). Perceived barriers included: problems in patients' lives (73%) and too few staff or too high patient volumes (52%). Many HCWs knew about specific QI activities (52%) or had been asked for input on QI (63%), but fewer (40.5%) had participated in activities and only 20.1% were currently QI team members. Managers were more likely to report QI involvement than direct care or clinical support staff (P<0.01). No difference in QI involvement was seen based on patient load or site type. Conclusions: HCWs can provide important insights into barriers and facilitators of providing quality care and can be effectively engaged in QI activities. HCW participation in efforts to improve services will ensure that HIV/AIDS quality of care is achieved and maintained as countries strive for universal antiretroviral access.

AB - Objective: To assess health-care worker (HCW) awareness, interest and engagement in quality improvement (QI) in HIV care sites in Tanzania. Design: Cross-sectional survey distributed in May 2009. Setting: Sixteen urban HIV care sites in Dar es Salaam, Tanzania, 1 year after the introduction of a quality management program. Participants: Two hundred seventy-nine HCWs (direct care, clinical support staff and management). Main Outcome Measures: HCW perceptions of care delivered, rates of engagement, knowledge and interest in QI. HCWidentified barriers to and facilitators of the delivery of quality HIV care. Results: Two hundred seventy-nine (73%) of 382 HCWs responded to the survey. Most (86%) felt able to meet clients' needs. HCW-identified facilitators of quality included: teamwork (88%), staff communication (79%), positive work environment (75%) and trainings (84%). Perceived barriers included: problems in patients' lives (73%) and too few staff or too high patient volumes (52%). Many HCWs knew about specific QI activities (52%) or had been asked for input on QI (63%), but fewer (40.5%) had participated in activities and only 20.1% were currently QI team members. Managers were more likely to report QI involvement than direct care or clinical support staff (P<0.01). No difference in QI involvement was seen based on patient load or site type. Conclusions: HCWs can provide important insights into barriers and facilitators of providing quality care and can be effectively engaged in QI activities. HCW participation in efforts to improve services will ensure that HIV/AIDS quality of care is achieved and maintained as countries strive for universal antiretroviral access.

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Health-care worker engagement in HIV-related quality improvement in Dar es Salaam, Tanzania

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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