The sustainability of the elimination of the mother-to-child HIV transmission (emtct) program in the Eastern Cape: quality improvement team's perception

[摘要] ENGLISH SUMMARY: Background: The sustainability of the elimination of the Mother to Child HIV transmission (eMTCT) programme has decreased worldwide. The President's Emergency Plan for AIDS Relief (PEPFAR), and other collaborators engaged in the eMTCT program are faced with challenges in the implementation of programs or interventions that can cause a threat to program sustainability. The eMTCT interventions are beneficial to patients and their families and can contribute towards improvement and sustainable health outcomes. Sustainability of these interventions following the departure of the partners remains a concern. The purpose of this study was to explore the quality improvement team`s perception of the sustainability of the eMTCT Quality Improvement Collaborative(QIC) program implemented in the Mnquma sub-district in the Eastern Cape Province of South Africa using a quality improvement collaborative approach.Methods: A qualitative research methodology with a descriptive exploratory design was utilized in order to explore and describe the quality improvement team perceptions on the sustainability of the eMTCT QIC program. A purposive sampling method was used during participant selection from the 14 health clinics where the eMTCT QIC program was implemented. Two focus group discussions were conducted, one with four and the other with nine participants and also three individual interviews. A semi structured interview guide was used for both focus group discussions and the individual interviews. The interviews were audio taped and transcribed. Colaizzi`s method was applied during the data analysis.Results: The four themes that emerged from the data analysis were: Appreciating the QIC design; Program empowerment; Community influences and Development challenges to program sustainability. The participants became more resourceful following a good understanding of the quality improvement collaborative program. Emerging innovativeness enabled the participants to be excited about the quality improvement model and take ownership of the process and progress made during and after implementation of the QIC program. However, there are still gaps in the care and access to the management of the eMTCT program that still needs to be addressed. The participants overall views were that the eMTCT QIC program will continue to 'holding the gains'. Conclusion: Planning for sustainability is very important from the beginning of any new intervention. Organisations must clarify what is going to be sustained. The involvement and collaboration from all stakeholders, especially community involvement, according to the researcher is vital for program sustainability. In conclusion, leadership buy-in, teamwork, communication and feedback, regular data management, staff support, motivation and acknowledgement may lead to continuous improvement.

[发布机构] Stellenbosch University