Improving quality of HIV services and health worker performance in Tandahimba District, Tanzania: An evaluation

President's Emergency Plan for AIDS Relief (PEPFAR). The evaluation aimed to assess the quality of HIV services and health worker performance in Tandahimba District, Tanzania. The evaluation objectives were to assess the quality of HIV care and health worker performance, identify areas for improvement, and provide recommendations for enhancing the quality of HIV services and health worker performance. The evaluation methodology involved site selection, data collection tools, sample sizes, data collection methods, and an HIV care and health worker performance improvement intervention. The evaluation selected three health facilities in Tandahimba District, Tanzania, for the study. The data collection tools included questionnaires, interviews, and observations. The sample sizes consisted of 15 health workers, 10 site managers, and 5 district-level officials. The data collection methods involved administering questionnaires to health workers and site managers, conducting interviews with district-level officials, and observing health worker performance. The HIV care and health worker performance improvement intervention involved the implementation of a quality improvement collaborative, which aimed to improve the quality of HIV care and health worker performance. The collaborative involved the development of a process map for care and treatment services, the identification of areas for improvement, and the implementation of quality improvement activities. The results of the evaluation showed that the quality of HIV care and health worker performance improved significantly after the implementation of the quality improvement collaborative. The quality of care indicators, such as the percentage of pregnant women attending antenatal care (ANC) who tested positive for HIV, improved significantly. The changes in the organization of service delivery, performance management, and health worker productivity and engagement also improved significantly. However, the evaluation also identified several challenges that hindered the implementation of the quality improvement collaborative. These challenges included staff absence, work environment, performance evaluation, and incentives. The evaluation recommended that the district-level officials and health facility managers address these challenges to sustain the improvements in the quality of HIV care and health worker performance. The evaluation concluded that the quality of HIV care and health worker performance in Tandahimba District, Tanzania, improved significantly after the implementation of the quality improvement collaborative. The evaluation recommended that the district-level officials and health facility managers continue to support the quality improvement collaborative to sustain the improvements in the quality of HIV care and health worker performance. The evaluation also recommended that the district-level officials and health facility managers address the challenges identified in the evaluation to sustain the improvements in the quality of HIV care and health worker performance. The evaluation provided several recommendations for enhancing the quality of HIV services and health worker performance, including the development of a comprehensive quality improvement plan, the provision of incentives for health workers, and the improvement of the work environment. The evaluation was conducted by a team of researchers from University Research Co., LLC (URC), including Hellen Maggige, Macdonald Kiwia, Stella Mwita, Yohana Mkiramweni, Kim Ethier Stover, Anna Nswila, and Davis Rumisha. The evaluation was funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and carried out under the USAID Health Care Improvement Project (HCI).