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Overview
Team/Leadership
Program Organigram

Swaziland QI Resources

ACLN 2010 Proceedings

ACLN 2010 Intro to HIVQUAL in Swaziland

HIVQUAL-Swaziland: M&E and HIVQUAL

Patient Retention on ART in Swaziland

Swaziland: National Quality Program Integration of QA and QI

Swaziland Storyboard: Integration of ART services in Mankayane Hospital Wards

ACLN 2011 Proceedings

HEALTHQUAL International Update, May 2010

HEALTHQUAL International Update, October 2011

Swaziland Ministry of Health National Quality Assurance Program

Swaziland Overview

Background

The Quality Assurance program was introduced in October, 2006 by COHSASA in collaboration with SAHCD, and introduced to stakeholders in 2007 February. A multidisciplinary team was nominated and capacitated with 18 pilot clinics identified for program implementation. A baeline survey was conducted, with subsequent assessment visits conducted through March 2010. Four health facilities qualified for the final survey, with three accredited facilities and ongoing assessment. HIVQUAL was launched in 2009, with training for health care workers on QI concepts and methdology and development of national indicators.

The Swaziland National Quality Program for Health Care Services is fully integrated into the overall Ministry of Health organizational structure including:

Ministry of Health leadership- A Directorate of Quality
Departments and departmental leaders for quality
Regional quality assurance teams
Health care workers- Quality part of routine work
Patients – those whom we serve
Other key stakeholders

Demographic Data

Population: +1 million

HIV prevalence:

-19% general adult population

-26% among 15-49 years

-191,000 people living with HIV

-15,000 children <15 years of age

-50,000 enrolled in ART

TB/HIV prevalence: ~ 79% of TB patients have HIV
Other pertinent Demographics:
Year Program Began: 2009
Scope: Adult and pediatric HIV
Number of facilities: 32

National Quality Program Components

-Create a National Quality Strategic Plan

-Development and dissemination of standards of care

-Development of national performance measures based on standards

-Prepare and disseminate aggregate performance reports (benchmarking)

-Set priority areas such as Adherence standards, PMTCT, ART, TB, MNCH and Malaria.

-Develop, Support and Sustain Regional Quality Assurance teams

-Use standard assessment tools to identify gaps in quality at the national, regional and facility level

-Target resources to low performing facilities and regions

-Solicitation of input from key stakeholders

-Align and coordinate all donor-driven quality activities and resources

-Create a Department to implement the national plan

HIV/AIDS Epidemic:

Prevalence of 26%. Estimated incidence of 2.9%. “Generalized hyper-endemic HIV prevalence.” Highest prevalence among 25-29 years age group for women and 35-39 for men at 49% and 45% respectively. Estimate HIV population of 185,803 in 2009 and rise to 216,735 by 2015. Major mode of transmission is heterosexual contact.

High TB incidence compounds the impact of the HIV epidemic. 2006 Sentinal Surveillance Survey reported prevalence of HIV among TB patients up to 79.6%.

*Data from Monitoring the Declaration of the Commitment on HIV and AIDS (UNGASS). Swaziland Country Report, March 2010.

Team/Leadership