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Research & Evaluation Study Profiles

  • Cost-effectiveness of the improvement collaborative approach in the context of hospital-level maternity services in Kabul | Afghanistan | 2010

    In 2010, the HCI Project began supporting implementation of a demonstration collaborative in four public and three private hospitals in Kabul, which serve 3.5 million of the city’s 4 million residents. The goal of the intervention is to increase the quality of maternal care to reduce maternal and infant mortality and morbidity. This study is an economic analysis of the intervention from the perspectives of the MoPH, private hospitals and USAID (who funded the improvement work through the HCI project).

  • Cost-effectiveness of quality improvement in the context of EONC in two provinces – Kunduz and Balkh | Afghanistan | 2010

     In November 2009, the HCI Project began a Demonstration Collaborative in the northern Afghan provinces of Kunduz and Balkh (K&B). The goal of the intervention is to improve birth outcomes by reducing maternal and infant mortality and morbidity. There is significant interest in understanding the cost implications and the cost effectiveness of this approach along the continuum of care – from community, to health center, to hospital.

  • Assessment of quality of ART services in the private sector in Uganda | 2009

    Of Uganda’s 4639 health facilities, 2154 (46 %) are privately owned for profits (PFPs). Of these, 36 are accredited to provide care and treatment to people with HIV/AIDS. To learn more about the quality of HIV care in PFPs, Uganda’s Ministry of Health and USAID requested that HCI assess the quality of HIV and antiretroviral therapy (ART) care in Ugandan PFPs; 30 health facilities were chosen for assessment. The study sought 1500 patient records, 25 records for each cohort for each facility, but found only 327.

  • Program evaluation of TB-HIV interventions in Thai Binh Province, Vietnam | 2009

    This 18-month study aimed at increasing the quality and quantity of TB/HIV detection by implementing the TB testing corner at HIV C&T Center in Thai Binh city; conducting routine surveillance of HIV/TB detection and management at provincial and district health facilities and PPM activity; and organizing training on skill of TB/HIV detection and management for health staff of Thai Binh province. Key results include strengthening TB control network, treatment management, and training.

  • Intensified TB case finding in Swaziland | 2009

    The increasing number of cases of TB associated with HIV infection in Swaziland has greatly increased the demands on TB and HIV treatment programs. Swaziland has an estimated TB incidence of 1,155 cases per 100,000 population per year (nearly a six-fold increase compared to a 1990 level of 267), while the incidence among the infectious sputum smear positive cases tripled within the same period. To better inform the NTP on magnitude and risk factors, Women Together, SWANEPHA and HCI carried out intensified case finding that targeted PLWHIV and their households.

  • Spreading evidence-based maternal and newborn care practices and CQI in Ecuador | 2009
    The objective of this research is to study the strategies developed and implemented by the Ministry of Public Health in Ecuador (as part of the national initiative to decrease maternal and neonatal mortality) to spread improvements in maternal and neonatal care throughout the country. This situation presents the opportunity to study spread and to gain a better understanding of strategies for spread and the manner in which new sites uptake better care practices developed from improvement collaboratives. This study will specifically investigate four questions: 1)What processes wer
  • Institutionalization of EONC better care practices and QI in Niger | 2009

    Little research has been done to characterize/describe the level of institutionalization achieved at the end of formal improvement collaborative activities. This research study will provide information needed to develop and evaluate strategies to strengthen institutionalization once formal improvement collaborative activities have ended. The results of this research will help quality improvement programs in other countries by providing them with key information about how to strengthen institutionalization within the context of collaborative (or other QI approaches) implementation.

  • Accessibility of ART in St. Petersburg and Orenburg City, Russia

    This study investigated the barriers preventing people with HIV/AIDS from accessing specialized medical care, specifically ART, and developed recommendations to increase ART availability and treatment adherence in HIV-positive, hard-to-reach patient groups in St. Petersburg and Orenburg. Structured interviews were held with 551 PLWHA—including injection drug users, commercial sex workers, and PLWHA in self-registered groups—as well as with focus groups and subject experts.

  • Task-shifting in maternal and newborn care counseling: Evaluation of the quality and impact of counseling by skilled and unskilled health care workers in Zou/Collines, Benin

    This pre-post intervention trial evaluated the quality and impact of counseling by skilled and unskilled health care workers in government facilities in Zou/Collines, Benin. Baseline and endline data were collected on quality of counseling, maternal knowledge, and facility-based newborn care practices before and after the training and introduction of a pictorial set of counseling cards. Fourteen public health maternities were included in the study and randomly assigned to intervention (seven sites) and control (seven sites) groups.

  • Assessment of VCT, PMTCT, and HIV/AIDS care and treatment in Cote d'Ivoire

    This assessment of the quality of HIV/AIDS care and services (VCT, PMTCT, ARV) in Cote d’Ivoire was carried out by PNPEC, URC, district health teams, and key PEPFAR implementing partners. The assessment covered 41 sites countrywide and used a cohort approach in examining patient records for three cohorts: pre-ARV, ARV, and PMTCT. Other methods of data collection included interviewing head physicians and patients and evaluating laboratory procedures.