Publications by authors named "J Bardfield"
Background: There have been a range of quality improvement (QI) and quality assurance initiatives in low- and middle-income countries to improve antiretroviral therapy (ART) treatment outcomes for people living with HIV. To date, these initiatives have not been systematically assessed and little is known about how effective, cost-effective, or sustainable these strategies are in improving clinical outcomes.
Methods: We conducted a systematic review adhering to PRISMA guidelines (PROSPERO ID: CRD42017071848), searching PubMed, MEDLINE, Embase, Web of Science, and the Cochrane database of controlled trials for articles reporting on the effectiveness of QI and quality assurance initiatives in HIV programs in low- and middle-income countries in relation to ART uptake, retention in care, adherence, viral load suppression, mortality, and other outcomes including cost-effectiveness and long-term sustainability.
Objectives: To describe the HEALTHQUAL framework consisting of the following three components: performance measurement, quality improvement and the quality management program, representing an adaptive approach to building capacity in national quality management programs in low and middle-income countries.
Design: We present a case study from Namibia illustrating how this approach is adapted to country context.
Methods: HEALTHQUAL partners with Ministries of Health to build knowledge and expertise in modern improvement methods, including data collection, analysis and reporting, process analysis and the use of data to implement quality improvement projects that aim to improve systems and processes of care.
Objective: To demonstrate the effectiveness of quality improvement methods to monitor and improve administration of cotrimoxazole (CTX) prophylaxis to improve health outcomes among adults living with HIV/AIDS in low resource countries.
Design: Program evaluation.
Setting: HIV/AIDS health care facilities in Uganda, Mozambique, Namibia and Haiti.