title: Assessing the quality of HIV/AIDS services at military health facilities in Zambia.
abstract: After rapidly scaling up HIV/AIDS-related health services, the Zambian Defence Force (ZDF) has become concerned with assuring their quality. This evaluation assesses provider performance at eight ZDF facilities based on direct observations of 191 antenatal care (ANC) consultations and 175 follow-up consultations for antiretroviral therapy (ART). In addition, 43 ZDF health providers were interviewed about the work environment and service quality. On-the-job performance varied widely: providers completed as few as 0% and as many as 100% of tasks associated with each performance standard. Overall scores averaged 66% (range: 47-93%) for ANC consultations and 60% (range: 37-100%) for ART consultations. Perceptions of the work environment were generally positive, but 57% of providers lack confidence in their clinical skills and 42% think staffing is insufficient. These findings, which point to the unique opportunities and challenges in the military setting, will be used to guide a quality improvement initiative.
authors: Jhpiego/USA, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore MD 21231, USA. ymkim@jhpiego.net
authors: Y M
authors: YM
authors: Kim
authors: J
authors: J
authors: Banda
authors: C
authors: C
authors: Hiner
authors: M
authors: M
authors: Tholandi
authors: E
authors: E
authors: Bazant
authors: S
authors: S
authors: Sarkar
authors: A S A
authors: AS
authors: Andrade
authors: C
authors: C
authors: Makwala
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D019538:Health Care Surveys; D006282:Health Personnel; D006772:Hospitals, Military / Q000592:standards*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D008427:Maternal Health Services / Q000592:standards; D058749:Military Facilities; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D015397:Program Evaluation; D011787:Quality of Health Care / Q000592:standards*; D016526:Workload; D015024:Zambia
chemical_list: D019380:Anti-HIV Agents
keywords: Africa; HIV/AIDS; PMTCT; SBM-R; antenatal care; antiretroviral therapy; health services; military; performance assessment; quality improvement; standards; work environment