Performance and trend for quality of service in a large HIV/AIDS treatment program in Nigeria
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AIDS Research and Therapy Open Access
REVIEW
Performance and trend for quality of service in a large HIV/AIDS treatment program in Nigeria Ahmad Aliyu1 , Samer El‑Kamary2, Jessica Brown2, Bruce Agins3, Nicaise Ndembi1,7*, Gambo Aliyu4, Jibreel Jumare4, Babatunde Adelekan5,6, Patrick Dakum1,4, Alash’le Abimiku1,4 and Manhattan Charurat4
Abstract Background: As antiretroviral therapy (ART) programs expand access, there is an increase in burden to a healthcare system. These results are reduced provider-patient contact time and poor programmatic and patient outcomes. Qual‑ ity management offers providers a standardized approach for addressing the appropriateness of care to be applied in resource-limited settings. This study aimed to determine the trend of performance on HIV/AIDS quality management indicators of health facilities providing ART over a period of 5 years. Methods: The annual performance scores of quality of care (QoC) indicators of 31 health facilities providing ART was extracted from a database covering a period of 5 years (from October 2008 to September 2012). The data are percent‑ ages that indicate scores of each health facility assessed based on compliance to National ART guidelines categorized into several indicator domains. A Chi square statistic for the trend, as well as test for departure from the trend line was determined. The p value associated with each indicator provides the significant level for testing an alternative hypothesis that the rate of change over the period considered for that indicator does not equal to zero. The slope of the regression line also gives the magnitude of the rate of change for each indicator by healthcare level across the review period. Results: Generally, performance trends showed improvement across most indicator domains. The highest improve‑ ment occurred for “3 month loss to follow-up” and “1 year no-visit”, with scores declining from 37 to 3%, and 42% to 12% respectively. However, there was a sharp decline in performance between 2010 and 2012 in weight monitoring of patients (p
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