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QAP and AIHA Pioneer Comprehensive System of Care for HIV/AIDS in Russia

QAP, in partnership with the American International Health Alliance (AIHA), in late 2004, initiated groundbreaking efforts in Russia to create sustainable systems of health services delivery for quality HIV/AIDS care and support. Development of a strategy to strengthen HIV/AIDS treatment services follows on the heels of QAP’s national-level spread of quality improvement (QI) methods to 23 territories of the Russian Federation (RF), completed in June 2004.

In collaboration with AIHA, QAP is using QI methods to design a model for a comprehensive system to provide care, treatment, and support for HIV-infected and AIDS patients. QAP brings to the program its technical experience and expertise in developing and implementing QI methodology and in using an improvement collaborative approach to rapidly introduce and scale up best practices and innovations. AIHA draws from its partnership model to facilitate exchanges, communication, and discussion between healthcare providers and institutions in the RF and the United States. In addition, the program strategy calls for teams from participating territories to exchange experiences—a key element of a collaborative effort which seeks to make each team familiar with the work of the others in order to learn from their successes and setbacks.

The integrated system of treatment, care, and support will address a need to provide, in addition to medical treatment, social and psychological support to HIV/AIDS patients and their families. The network will link communities, healthcare systems, social service institutions, non-government organizations, drug treatment facilities, and other relevant groups. Additionally, the program seeks to strengthen public/private partnerships by encouraging healthcare facilities to establish systems of referral with local non-government and community organizations. Cross-cutting issues such as TB/HIV co-infection will be addressed through involvement of facilities which specialize in the treatment of tuberculosis and providers at the primary healthcare level.

Pilot programs will be implemented at sites in Samara, Saratov, and Orenburg Oblasts and in St. Petersburg City, with plans to spread the improved model of care to other territories in the RF. Sites selected for pilot programs include a wide range of private and public facilities: clinics and dispensaries which deliver services for HIV/AIDS, tuberculosis, and sexually transmitted infections; drug treatment facilities; women’s clinics and maternity homes; primary care facilities; local non-government organizations; government social service organizations; and, in some cases, prison facilities. The program has established teams and trained them in QI and conducted analyses of the current system of care. In 2005, the program will focus on choosing priorities for improvement, conducting clinical and best practices trainings, organizing meetings in which teams exchange experiences and ideas, developing project indicators, and testing and implementing changes to the system.

QAP has worked in the Russian Federation since 1998, adapting and applying QI methodologies to the Russian healthcare system. Following successful pilot programs and scale-up of improved systems of care for maternal and child and primary healthcare, QAP began in 2002 a national level spread of improvement methods in priority healthcare areas. The Methodological Center for Quality at the Central Public Health Research Institute of the RF’s Ministry of Health worked closely with QAP to carry out and oversee the project.

For more on QAP’s activities in Russia, contact Katya Kuznetsova at kkuzetosova@urc-chs.com or Victor Boguslavsky at vboguslavsky@urc-chs.com.