JuoWi's Post

The collective approach that I have chosen is the preventing mother-to-child transmission (PMTCT) program in Rwanda, Sub-Saharan desert, implemented by the Rwanda health care system and USAID. Some of the challenges they faced are shortage of staff, lack of infrastructure and space, and poor provider motivation and burnout.

The organizations involved are USAID, Byumba Health Center, World Health Center (WHO), Rwanda Ministry of Health, the U.S. government and Rwandan Division of Health Care Services. USAID started the project with the Rwanda health care system. Byumba Health Center provided all the test results. WHO published that the quality improvement collaborative approach has had an impact on the providers as well as the patients by enhancing provider understanding of quality of care and targets. Rwanda Ministry of Health and the U.S. government together implemented a collaborative approach to improve antiretroviral treatment service delivery. Lastly, the Rwandan Division of Health Care Services institutionalized the approach as part of its national quality improvement strategy.

In my opinion, their approach is effective, efficient and sustainable. It is effective because through meetings and sharing of best practices with the QA teams, the sites reorganized their services to implement same-day testing and results, resulting in an increase of women receiving test results from 82 percent to 100 percent. Not only so, since their intervention in certain communities, the percentage of women receiving Nevirapine (NVP) increased from approximately 60 percent to 90 percent, and more than 10 sites have been providing NVP to 100 percent of eligible women for many months. All these were done in a very short period of time. Thus proving their efficiency. They are sustainable is because this project is started since year 2004, and until now, it is still working. This shows that it is very sustainable. This project has been following MDG 5 on child mortality rate. Till date, they have been following closely on their goals.

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