Country Approach: Rwanda
A group discussion during CQI training in Rubavu District in June 2018.
Ciheb has been supporting Rwanda Biomedical Center’s (RBC) HIV division in response to the needs for capacity building in CQI. As part of this support, Ciheb has integrated CQI into HIV clinical mentorship guidelines and standard operating procedures by integrating CQI HIV quality indicators to be reported by all district health facilities. In collaboration with the Centers for Disease Control and Prevention, Ministry of Health, and RBC, the team has showcased their efforts to establish CQI teams to drive improvement in Rwanda, specifically for increasing index HIV testing.
CQI Digital Platform
Ciheb’s CQI work in other countries led to the development of a CQI digital platform in Tanzania. This CQI digital platform has now been adapted to Rwanda under the PEPFAR-funded Imakaza project, and Ciheb is now strengthening CQI in 111 health facilities. There are more than 50 ongoing CQI initiatives from health facilities. The methodology implemented for CQI in Rwanda includes initial site visits, mentorship and support, follow-up visits, and peer learning and experiential learning sessions.
In Kigali, under funding from UNICEF, Ciheb works with RBC in supporting 18 facilities on CQI projects, including family testing for children 2-14 years old born to mothers with HIV at non-HIV clinic spaces. CQI projects will support the establishment of mentor mothers and HIV-exposed infant champions that have shown tremendous success. A toolkit to support the disclosure of HIV status for the pediatric and adolescent population will also be developed for healthcare worker training.
Currently, 12 facilities have functional CQI teams and are implementing multiple improvement projects, and efforts are underway to ensure the sustainability of CQI initiatives. The focus of these efforts has been on supporting the RBC to scale up CQI activities across all high-volume sites, and to utilize the CQI digital app to monitor district hospital-based clinical mentorship indicators and ensure targets for mentorship and support are met.