An article in this week's PLoS Medicine by Younsook Lim (from Dartmouth Medical School, USA) and colleagues shows how the Rwanda Learning Collaborative on Child Health (RLC) sought to increase access to and the quality of prevention of mother-to-child transmission of HIV/AIDS (PMTCT) services in the Eastern Province of Rwanda using a learning collaborative model. The model, which uses peer-to-peer learning methods, allows for multiple improvement ideas to be simultaneously tested and evaluated.
Through this experience, the authors found that a learning collaborative approach is one method that can garner cooperation between nongovernmental organizations (NGOs) and governments to improve coordination of services and strengthen health systems. The learning collaboration also found that in Eastern Rwanda: comprehensive PMTCT care requires following mothers and infants longitudinally to ensure quality care is delivered; targeted disease-specific programs can be designed to have an impact on related non-targeted services to increase the health value delivered to families; and quality improvement methods can be effective tools for engaging local health workers and targeting investment of limited resources to maximize improvement of services.
The authors say: "As the influence of global health initiatives continues to grow, the architects of programs targeting specific diseases or areas of care can commit themselves to considering the impact their interventions can have on health systems and outcomes beyond their immediate focus." They also report that "quality improvement approaches could be employed as effective organizing tools under active government guidance with the cooperation of NGOs to target investment of resources and strengthen health systems."
Funding: Funding was provided by the Harvard Francois-Xavier Bagnoud Center for Health and Human Rights (http://www.harvardfxbcenter.org/). The funder played no role in the decision to submit the article or in its preparation.
Competing Interests: Agnes Binagwaho is on the Editorial Board of PLoS Medicine.
Citation: Lim Y, Kim JY, Rich M, Stulac S, Niyonzima JB, et al. (2010) Improving Prevention of Mother-to-Child Transmission of HIV Care and Related Services in Eastern Rwanda. PLoS Med 7(7): e1000302. doi:10.1371/ journal.pmed.1000302
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Younsook Lim, MD
Dartmouth Medical School
The Dartmouth Institute for Health Policy and Clinical Practice
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