Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA.
Int J Qual Health Care. 2013 Sep;25(4):373-80. doi: 10.1093/intqhc/mzt039. Epub 2013 May 24.
QUALITY PROBLEM AND ASSESSMENT: In South Africa (SA), non-governmental organizations (NGOs) have a major role in the provision of health services, but they often compete for funding and influence rather than collaborate. The National Department of Health (NDOH) sought to coordinate existing non-governmental organizations (NGOs) to optimize the prevention of mother-to-child HIV transmission (PMTCT) at scale.
We describe how a group of NGO and government partners were brought together to jointly develop the 'Accelerated Plan' (A-Plan) to improve PMTCT services at health-care facilities in SA. The A-Plan used four main principles of large-scale change to align the network of NGO partners and NDOH: setting targets and improving data, simplifying processes and facilitating local execution, building networks and enabling coordination.
In the first 6 months of the project, six NGO partners were engaged and the program reached 161 facilities. The program spontaneously spread from five planned subdistricts to nine subdistricts and produced a package of tested interventions to assist in scale-up of the PMTCT program elsewhere.
Districts reported high levels of provider engagement in the initiative. In the 6-month project period, a total of 676 health-care workers and managers were trained in quality improvement methods and tools. Coverage of seven key processes in the PMTCT program was tracked on a monthly basis within each subdistrict.
We found that a network model for the A-plan could successfully recruit key stakeholders into a strong partnership leading to rapid scale-up of a life-saving public health intervention.
质量问题与评估：在南非（SA），非政府组织（NGO）在提供卫生服务方面发挥着重要作用，但它们往往为争夺资金和影响力而竞争，而非合作。国家卫生部（NDOH）试图协调现有的非政府组织（NGO），以优化大规模预防母婴传播艾滋病毒（PMTCT）。
我们描述了一群 NGO 和政府合作伙伴如何共同制定“加速计划”（A-Plan），以改善南非卫生保健机构的 PMTCT 服务。A-Plan 利用了四项大规模变革的主要原则来协调 NGO 合作伙伴和 NDOH 的网络：设定目标和改善数据、简化流程和促进本地执行、建立网络和促进协调。
在项目的前 6 个月，有 6 个 NGO 合作伙伴参与，该项目覆盖了 161 个设施。该项目自发地从五个计划中的分区扩展到九个分区，并提供了一套经过测试的干预措施，以协助在其他地方扩大 PMTCT 项目。
各地区报告称，该倡议得到了提供者的高度参与。在项目的 6 个月期间，共有 676 名卫生保健工作者和管理人员接受了质量改进方法和工具的培训。每月在每个分区内跟踪 PMTCT 计划中的七个关键流程的覆盖情况。
我们发现，A-Plan 的网络模型可以成功地将关键利益相关者招募到一个强大的合作伙伴关系中，从而迅速扩大一项拯救生命的公共卫生干预措施的规模。
