Allinder Sara M, Moses Edward, Enock Moses, Kawalazira Gift, Nyirenda Rose, Gonani Andrew, Kamgwira Yohane, Agins Bruce, Birchard Richard, Murungu Joseph, Hoege Deborah, Holmes Charles B, Joshua Martias
Center for Innovation in Global Health, Georgetown University, Washington, DC, United States.
Independent Consultant, Lilongwe, Malawi.
Front Reprod Health. 2025 Jun 19;7:1558630. doi: 10.3389/frph.2025.1558630. eCollection 2025.
Application of quality improvement (QI) methodology to HIV prevention is relatively nascent but has the potential to transform national and local programs. In Blantyre, Malawi, a unique government-led partnership known as the Blantyre Prevention Strategy (BPS) is applying QI as a core element of a cohesive sub-national HIV prevention system. BPS launched a QI collaborative (QIC) in early 2021-the first of its kind dedicated to HIV prevention within a health system context-focused on scale-up of pre-exposure prophylaxis (PrEP) to prevent HIV. Known as PrEPUp!, the QIC included 23 participating facilities-representing the public and private sectors, drop-in centers for key populations, and a tertiary education clinic-and has become the major platform for facility teams to exchange knowledge and share progress. Based on the implementation of QI activities, interventions identified for testing resulted in health center system modifications that promotes increased uptake of PrEP. In addition, knowledge generated through the QIC informs other stakeholders, including implementing partners funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), and improves coordination and mentoring executed by the Blantyre District Health Office (DHO). In a departure from traditional QI, BPS has engaged community labs that generate insights from clients and other influential stakeholders about demand and service access barriers and has connected those labs with facilities through learning sessions. This approach has been widely lauded locally in Malawi and is being adapted in Lilongwe District to underpin implementation science for injectable PrEP.
将质量改进（QI）方法应用于艾滋病预防领域相对较新，但有潜力改变国家和地方项目。在马拉维的布兰太尔，一个独特的由政府主导的伙伴关系——布兰太尔预防战略（BPS），将QI作为一个有凝聚力的次国家级艾滋病预防系统的核心要素加以应用。BPS于2021年初发起了一个QI协作项目（QIC）——这是首个在卫生系统背景下专注于扩大暴露前预防（PrEP）以预防艾滋病的此类项目。这个名为PrEPUp!的QIC有23个参与机构，代表了公共和私营部门、关键人群的救助中心以及一家高等教育诊所，并且已成为机构团队交流知识和分享进展的主要平台。基于QI活动的实施，确定用于测试的干预措施导致了卫生中心系统的改进，从而促进了PrEP的更多使用。此外，通过QIC产生的知识为其他利益相关者提供了信息，包括由美国总统艾滋病紧急救援计划（PEPFAR）资助的实施伙伴，并改善了布兰太尔区卫生办公室（DHO）所开展的协调和指导工作。与传统的QI不同，BPS与社区实验室合作，这些实验室从客户和其他有影响力的利益相关者那里获取关于需求和服务获取障碍的见解，并通过学习会议将这些实验室与各机构联系起来。这种方法在马拉维当地广受赞誉，并且正在利隆圭区进行调整，以支持注射用PrEP的实施科学。
