Phase 1: Assessment (January 18-22, 2021)

1.      1.

Developed concept note including quality assessment parameters

2.      2.

Formed pediatric task force team

3.      3.

Audited baseline folder of 315 unsuppressed CLHIV

4.      4.

Identified gaps in ART care and treatment for CLHIV (including service delivery process gaps)

5.      5.

Developed individualized action plans to close identified gaps, assigning individuals responsible and establishing timelines

6.      6.

Developed monitoring indicators and plan to measure progress

7.      7.

Developed a communication channel for granular-level data review, gap analysis, and remedial action plan

Phase 2: Implementation (January 18-July 31, 2021)

1.      1.

Mentored facility- and community-level ART site managers on pediatric regimen optimization and dosing

2.      2.

Provided pediatric ARV, Tuberculosis preventive therapy, cotrimoxazole dosing charts for appropriate weight-based dosing by health care providers

3.      3.

Profiled pediatric ARV stock on hand to guide transition to age-appropriate regimen

4.      4.

Provided information, education, and communication (IEC) materials and cues for adherence counseling, adverse drug reaction monitoring

5.      5.

Activated callback of children in the cohort for optimal service provision

6.      6.

Activated home visits and return to the facility for CLHIV whose caregivers’ phone contacts were unavailable

7.      7.

Provided services to CLHIV based on case-by-case package of care plans made in phase 1 (e.g., correcting inappropriate regimen, screening for opportunistic infections, support for disclosure)

8.      8.

Incentivized high performance

Phase 3: Evaluation (January 18-July 31, 2021)

1.      1.

Pediatric task force teams provided update on individualized plan via virtual meetings with QI task force.

2.      2.

Compared patient-level updates with data from electronic medical records to ensure concurrence

3.      3.

Documented and shared what was learned