HIVQUAL Philosophy

HIVQUAL Philosophy


  • Ongoing quality improvement activities improve patient care
  • Performance measurement lays the foundation for quality improvement
  • Quality Management Programs support systematic implementation of quality improvement activities
  • Indicators to measure performance are based on national guidelines

The HIVQUAL approach to quality management emphasizes the development of systems and processes to support quality improvement activities involving clinic staff and consumers with support from program leadership. These structural features are designed to be sustainable even with staff turnover, organizational leadership changes, or political transitions.

HIVQUAL builds capacity to support clinical data collection and analysis at the clinic level, linking these activities to building systems that improve processes and outcomes of care.

Through this process, HIVQUAL facilitates the strengthening of systems for documentation, permitting monitoring of appropriateness of care, and development of capability for self-assessment.

An important goal of HIVQUAL International is to be integrated into the existing program of the Ministry of Health so that it is part of the National HIV/AIDS Program and other national quality improvement activities. Ideally, staff from the Ministry of Health lead the Project. Guidance and support are provided by the HIVQUAL Team and the in-country US government team through the local CDC-GAP office.

International TOT Information:
As part of HIVQUAL’s mission to build in-country capacity for quality improvement and quality management, HIVQUAL International is developing a Training-of Trainer (TOT) Program. This program will enhance its participants’ expertise in quality management and teach them the skills needed to conduct trainings for other HIV providers. The TOT program intends to help HIVQUAL International meet its goal of expanding quality improvement services by enlarging the pool of available trainers and building regional and national capacity for quality management within PEPFAR supported countries.

The program consists of a 3-5 day intensive meeting of TOT participants and TOT faculty, filled with interactive presentations on quality management topics, advice on how to conduct effective trainings and available resources to conduct effective quality improvement workshops. In-country representatives from the Ministry of Health, HIVQUAL and regional stakeholders play a pivotal role in coordinating and facilitating TOT activities, thus creating sustainability and national capacity. HIVQUAL International will work closely with the in-country faculty team to increase their capacity to manage and facilitate future TOT sessions without US-based facilitators.

For each TOT session, HIVQUAL International will enroll between 40-50 participants in the TOT program. The target audiences for TOT trainers are those individuals who are responsible for supporting QI initiatives and who have the capacity and ability to train others on quality improvement. Participants include representatives from Ministries of Health, regional, provincial and district health units, regional and national organizations, implementing partners and local providers.