Amsterdam 2015
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| Abstract #2156 - Poster 2 | ||||
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Session: 59.24: Poster 2 (Poster) on Tuesday in Chaired by Authors: Presenting Author: Mr Matthias Wentzlaff-Eggebert - German Federal Centre for Health Education (BZgA), Germany |
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| Additional Authors: | ||||
| Aim: Integrating quality improvement into HIV prevention practice | ||||
| Method / Issue: Many factors influence the effectiveness of HIV prevention interventions with affected populations. Different local histories of the response to HIV as well as the economic, political, social and cultural conditions in each setting interact with system, organisational and individual capacities in complex ways. Unsatisfactory results are often difficult to explain: was it the wrong choice or scale of intervention, or a lack of implementation quality, or both? Integrating practical quality assurance and improvement (QA/QI) tools into HIV prevention practice maximises quality and generates explanatory insight. However, introducing QA/QI also highlights power differences and levels of collaboration between stakeholders such as the affected populations, donors, governments and non-government organisations. The Quality Action project (an EU co-funded Joint Action of member states) builds a network of skilled trainers/facilitators who then apply one or more of five practical QA/QI tools and also train and assist others. Methods include adult education, train-the-trainer and e-learning. The overall approach is based on the principles of self-determination, participation and self-reflection. | ||||
| Results / Comments: Quality Action succeeded in training more than 100 (target: 60) government and NGO participants from HIV prevention projects and programmes covering key affected populations in Europe. Preliminary evaluation results show that a majority was satisfied with the training, assessed their own gains in knowledge and skills to be high and proceeded to apply the tools. Around a third also trained or assisted others. The project improvements they report most often are: clearer goals and objectives, better structure and increased stakeholder involvement. | ||||
| Discussion: Despite their express concerns about the potential misuse of quality systems for funding allocation and control, more than half of the trainees are from NGOs. According to preliminary results, the practical focus of the two-part training boosted skills, confidence and networking. The organisers reflected on and adapted the process throughout, tailoring methods to the needs of participants. The importance of striking a workable balance between adherence to the requirements of evidence-based and validated QA/QI tools and responding to the substantial barriers and constraints faced by participants in using them is a key learning for the project. Participants encountered obstacles such as severe funding cuts, disinterest from superiors, lack of time and productivity pressures from funders, organisations and peers. Communicating the benefits of self-reflective quality improvement is a challenge. In response, participants created practicable local adaptations of the tools and processes and exchanged solutions within the network, assisted by the support structure of Quality Action. The overall high uptake of QA/QI tools Quality Acton achieved is enriched by additional reported benefits such as the (sometimes first ever) collaboration between government and non-government stakeholders and the involvement of target groups. The experience of Quality Action shows that it is possible to communicate the benefits and integrate the practice of QA/QI into complex prevention settings as long as system-inherent as well as local barriers and constraints are considered within a participative and flexible approach. | ||||
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