Introduction

Zambia has been scaling up its voluntary medical male circumcision (VMMC) program for HIV prevention since 2009. Since the commencement of Zambia’s national VMMC programme, more than 4million males have been circumcised. Ministry of Health (MOH) with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR),made great contribution to reductions in HIV incidence and progress towards ending the AIDS epidemic. Among HIV negative men, medical circumcision increased by 12.7% from 22.2% in 2016 to 34.9% in 2021(Zambia Population Based HIV Impact Assessment Surveys). VMMC national operational plan has seven pillars and one of them is on quality improvement. To understand changes in male circumcision on quality improvement for safety of clients, two external quality assessment (EQA) results were compared the 2020 and 2022 in the ten provinces of Zambia.

Aim

To understand changes in male circumcision on quality improvement for safety of clients. Ministry of Health annually conducts external quality assessment (EQA) in the ten provinces in selected districts and facilities that measures quality improvement in the Zambia.

 

Methods

A structured tool was used to collect data, with several domains that included; infrastructure and equipment, human resource, quality assurance and quality improvement systems, observed practices, commodities and supplies, data management and record keeping and guidelines and protocols. Scoring ranged with colour coding from 1- poor (red), 2-needed improvement (yellow), 3-good (light green) and highest score was 4-very good (Dark green). Selection of facilities was based on high volume sites, supported by different partner also urban and rural.

Results

The results from the two EQA showed variation in meeting quality standards in all pillars of the national operational plan. In 2020 EQA key findings indicated that the domains of comprehensive services and data management scored 3, which represented the highest score while the rest of the domains scored 2 indicating need for improvement. The follow on EQA in 2022, showed significant improvement in six domains: commodities and supply, comprehensive services, data management and system, equipment, observed practices and quality improvement with the highest score of 3. Overall, quality improvement showed significant improvement in 2022.

Conclusions

Quality standards improved across the provinces over time demonstrating the VMMC programs focus on client safety. The achievement of 2022 was largely due to regular assessment conducted in the provinces in enhancing quality standards in the Zambia. Significant progress is still needed to achieve quality standards in all the pillars by domain.

 

ACKNOWLEDGEMENT

 Ministry of Health Headquarters Zambia, Centres for Diseases Control and Prevention (CDC), Lusaka, Zambia. Clinton Health Initiative Access Lusaka Zambia. World Health Organization (WHO), Lusaka, Zambia

CONTACT INFORMATION

Joseph Masiye VMMC QA/QI Program Officer, Ministry of Health Headquarters, P.O Box 50205, Lusaka, Zambia.

E:joseph.masiye@yahoo.com/Phone:+260977781753

 

References

Zambia Ministry of Health. VMMC National Operational Plan 2021 – 2025. https://www.moh.gov.zm/wpcontent/uploads/filebase/vmmc/VMMC-National-Operational-Plan-2021- 2025.pdf