The continuous quality improvement (CQI) approach was introduced on a pilot basis to 30 sites across Uganda. This approach identified barriers in achieving national standards for voluntary medical male circumcision (VMMC), identified possible solutions to overcome these barriers, and carried out improvement plans to test these changes while collecting performance data to objectively measure whether they had bridged gaps.
Teams used a 53-indicator quality assessment tool adapted by the Ministry of Health and based on the WHO VMMC Quality Toolkit as a management tool to measure progress across seven standards areas. Teams also measured client-level indicators through self-assessment of client records. Within one year of the start of the improvement efforts, the 30 sites achieved large improvements in compliance with the VMMC standards.
PEPFAR and USAID supported the work through the Applying Science to Strengthen and Improve Systems Project and ten different implementing partners across Uganda.
Read more about the improvements in the quality of voluntary medical male circumcision and the methods used on the PLOS ONE website.