Integrating palliative care with HIV care in two Ugandan districts using a collaborative quality improvement approach

The initiative was supported by the American people through the United States Agency for International Development (USAID) and its Health Care Improvement Project (HCI), with funding from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). The collaborative improvement approach involved integrating pain management, securing palliative care specialist knowledge and leadership, and logistics and management of morphine. The intervention also included the development of job aids, strengthening capacity for provision of palliative care across the facility health care team, and community-health facility linkages. The goal was to improve access to pain medicines through networking and referral. Initial assessments identified pain as a significant challenge for patients suffering from HIV and AIDS in the two districts. The collaborative improvement approach led to the expansion of availability of chronic care for HIV, with a significant increase in the number of patients receiving pain management. The initiative also resulted in the strengthening of capacity for provision of palliative care across the facility health care team, with improved community-health facility linkages and access to pain medicines. The results of the initiative were evaluated through various indicators, including the identification and documentation of pain, expansion of availability of chronic care for HIV, job aids, strengthening capacity for provision of palliative care, community-health facility linkages, and improving access to pain medicines. The evaluation revealed a significant increase in the number of patients receiving pain management, with a corresponding decrease in the number of patients experiencing pain. The initiative faced several challenges, including the availability of drugs, patient care, district leadership, and community leadership. However, the collaborative improvement approach helped to address these challenges, resulting in improved access to pain medicines and strengthened capacity for provision of palliative care. The conclusions of the initiative highlight the importance of integrating palliative care with HIV care in Uganda. The collaborative improvement approach was effective in improving access to pain medicines and strengthening capacity for provision of palliative care. The initiative also demonstrated the need for continued support and resources to sustain the gains made and to address the ongoing challenges faced by the health care system in Uganda. The initiative was supported by a range of stakeholders, including the district quality improvement teams, the quality improvement teams in the 13 health facilities that participated in the palliative care improvement collaborative, and the Palliative Care Association of Uganda. The initiative also received funding from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the United States Agency for International Development (USAID). The results of the initiative have implications for the broader health care system in Uganda, highlighting the need for continued investment in palliative care and HIV care. The collaborative improvement approach used in the initiative provides a model for other districts and health facilities to follow, with the potential to improve access to pain medicines and strengthen capacity for provision of palliative care across the country.