November 27th -28th 2013 – The USAID SUSTAIN project recently facilitated a shared learning session for Senior Principal Nursing Officers (SPNOs) and HTC focal persons from 12 hospitals. The two-day meeting aimed at sharing experiences and lessons learned from scaling up HTC services for adults and children, using the Provider-Initiated Testing and Counselling (PITC) method at hospitals over the past 12 months, and promoting the adoption and institutionalization of successful practices. Over 50 health workers—including Senior Principal Nursing Officers and Out-patient Department (OPD) and laboratory in-charges— shared their best practices and discussed current challenges they face in providing of HTC services.
The shared learning session provided a platform for the hospital teams to interact and learn from each other’s best practices and replicate them across various service delivery units within each hospital. Some of the practices shared include:
- Updating the HTC registers on a daily basis,
- Clarifying staff roles, creating staff deployment charts at each service delivery unit and managing rotation of skilled staff in areas with gaps,
- Setting targets for each healthcare service delivery unit and for different staff shifts,
- Engaging all hospital staff in HTC activities, including clinicians at OPD units,
- Testing “bed to bed” in paediatric wards to assess all admitted children for HTC services, and consequently, providing the services to those who have not accessed them,
- Establishing internal supervision teams that visit HTC units on weekly basis and provide support,
- Conducting regular internal and external quality control for HIV tests,
- Improving teamwork of HTC teams for laboratory, records and data and supply chain management teams,
- Opening more HTC units at different service delivery units within each hospital and integrating HTC into healthcare facility events (i.e., diabetic, breastfeeding, immunization, facility weeks and World AIDS Days),
- Improving forecasting for HTC supplies, especially HTC test kits, by having HTC teams work in partnership with laboratory and stores staff to assess stock status on weekly and monthly basis to ensure appropriate ordering and prevent stock-outs, and
- Integrating quality improvement activities in HTC performance and rewarding and recognizing best performers during HTC monthly review meetings.
As part of the session, each hospital team selected at least three new best practices that they are going to implement moving forward. These will also form a basis for subsequent on-site support supervision and coaching by the SUSTAIN project team in 2014.
|Testimonies from selected participants:|
“The attitude of staff towards PITC has greatly improved. Our leaders are involved and we also feel satisfied in offering a much needed service,” said a nurse from Fort Portal RRH.
“We got ‘converted’ when you involved us and valued our input. Thank you, SUSTAIN, for acknowledging the efforts put in by nurses. We pledge to even work harder,” said the SPNO from Soroti RRH.
As a result of intensive support to hospitals to scale up and offer HTC services using the PITC approach, a 101.6% improvement in the number of clients who were tested for HIV 16 hospitals was documented from October 2012‒September 2013: 294,785 clients accessed HTC services, compared to 146,217 clients from October 2011‒September 2012.
“I am humbled by the performance that you have put up in the last 12 months. The performance this year (2013) more than doubled the performance in the previous year (2012),” said Dr. Nathan Tumwesigye, SUSTAIN project Chief of Party.
At the end of the meeting, the Moroto Regional Referral Hospital team received a trophy for emerging as the best performer in improving HTC service delivery coverage in 2013 (13,540 clients tested in 2013, compared to 5,548 clients in 2012).
“It’s been a real challenge for people to work in Moroto district. Even with our dilapidated buildings, we thank SUSTAIN for changing our hospital staff’s attitudes towards improving HTC services,” reported Helen Oluka, Senior Nursing Officer, Moroto RRH.
|Senior Nursing Officers in a discussion on how to set new hospital HTC targets for 2014||One of the participants takes part in a discussion during the learning session|
|Health workers from Moroto RRH celebrate after receiving the trophy from SUSTAIN project. Moroto was the best performing SUSTAIN-supported facility in provision of HTC services in 2013|
Written by; Rosemary Nasaba, HTC Program Advisor, Kellen Baguma, HTC Program Officer, Julian Natukunda, Communications Specialist with contributions from Jessica Ziegler, Knowledge Management Specialist at URC