Are Service-Delivery NGOs Building State Capacity in the Global South? Experiences from HIV/Aids Programmes in Rural Uganda

Author(s):  
Badru Bukenya
2018 ◽  
Vol 31 (4) ◽  
pp. 327-336
Author(s):  
Kevin Peter Fiori ◽  
Jennifer Schechter ◽  
Sesso Christophe Gbeleou ◽  
Sandra Braganza ◽  
Joseph Rhatigan ◽  
...  

Purpose The purpose of this paper is to describe the authors’ experience operationalizing the care delivery value chain (CDVC) as a management and continuous quality improvement (QI) approach to strengthen HIV/AIDS services provided in Northern Togo through addressing gaps across a care continuum. Design/methodology/approach The authors led a series of discussions to develop a CDVC specific to existing HIV/AIDS services in Northern Togo. Using the CDVC framework, 28 specific gaps in service delivery were identified and integrated into a strategic QI plan. Findings At 12 months, 92 percent of delivery gaps had demonstrated improvement. The CDVC framework proved to be valuable in the following ways. First, it facilitated the first comprehensive mapping of HIV/AIDS services in the Kara region of Togo. Second, it enabled the identification of gaps or insufficiencies in the currently available services across the full continuum of care. Third, it catalyzed the creation of a strategic QI plan based on identified gaps. Research limitations/implications This case description is the authors’ experience in one setting and should not be considered comparative in nature. Furthermore, the approach described may not be applicable to all initiatives and/or organizations. As described, the lack of sophisticated and comprehensive data collection systems limited the authors’ ability to collect reliable data on some of the QI initiatives planned. Practical implications The operationalization of the CDVC framework is an effective approach to drive continuous QI. Originality/value Through the operationalization of the CDVC, the authors developed a new approach for assessing existing services, identifying gaps in service delivery and directing continuous QI initiatives in a strategic manner.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254476
Author(s):  
Muhammad Ahmed Abdullah ◽  
Babar Tasneem Shaikh ◽  
Haider Ghazanfar

Background Pakistan’s National AIDS Control Program has registered 44,000 HIV/AIDS patients to date, but the actual number of cases have been estimated to be as high as 150,000–170,000. The health care system has a very important role to play in this equation and must be reformed to improve the health care services in Pakistan, with regards to HIV/AIDS. Methods It was a qualitative research employing a phenomenological approach. The principal researcher visited nine public and private health care facilities and conducted 19 key informant interviews with people working for providing preventive and curative services, in addition to the observations made on the site. Results Pakistan’s health system has a limited capacity to address the HIV spread in the country, with its current resources. There is an obvious scarcity of resources at the preventive, diagnostic and curative level. However, menace can be curtailed through measures taken at the service delivery level by checking the unsafe needles practices, unclean surgical procedures and an unregulated and untrained private health workforce which are dangerous potentials routes of transmission of the virus to the general population. Healthcare establishments carry the chances of nosocomial infections including HIV/AIDS. Poverty, illiteracy and stigma associated with the disease is compounding the overall situation. Conclusion Improved accessibility to service delivery with a greater focus on prevention would be imperative to address the threat of HIV/AIDS in Pakistan. A health systems approach would help in identifying gaps at both strategic and operational levels, and concurrently find and implement solutions.


2009 ◽  
Author(s):  
Pamela Valera ◽  
Nicole Dennis ◽  
Patrick Wilson

PLoS ONE ◽  
2018 ◽  
Vol 13 (5) ◽  
pp. e0194305 ◽  
Author(s):  
Sergio Bautista-Arredondo ◽  
M. Arantxa Colchero ◽  
Ogbonna O. Amanze ◽  
Gina La Hera-Fuentes ◽  
Omar Silverman-Retana ◽  
...  

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