Provider-initiated testing and counseling for children under 15 years at inpatient ward, quality improvement experience from Morogoro Regional Hospital, Tanzania (January-December 2015)
Background: In 2015, WHO released a Consolidated Guideline for HIV Testing Services (HTS). One of the approaches advocated in high burdened countries is Provider Initiated HIV testing and counseling - PITC. According to the Tanzania Third Health Sector HIV and AIDS Strategic Plan (2013 - 2017), PITC should be offered to 80 % of patients attending health facilities. However, assessment conducted at our facility in February 2015 revealed that, only 27% of children under 15yrs were tested in January 2015.This is a missed opportunity for identification of HIV infected children. This is a write up to document the quality improvement work done to increase number of children below 15 years admitted in pediatric wards who are tested through PITC.
Methods: At the inception, facility staffs were assisted to analyze PITC performance, identity reasons for low uptake of HIV test and set facility PITC improvement goal and target. Then the facility staffs were supported by team of quality improvement coaches to form quality improvement teams. The QI team was supported to document the improvement plan in monitoring journals every month. Through PDSA cycle, improvement teams tested changes to improve staff performances, availability of HIV test kits and acceptability of HIV test to parents.
Results: HIV Counseling and testing among children less than 15 years admitted in pediatric wards increased from 27 % in January 2015 peeking to 93 %, in October and 90% in December 2015. A total of 2095 children were tested in 2015 from inpatient ward, 75 among them were positive resulting to 4% positivity rate.
Conclusions: QI approach improved uptake of HTC among children less than 15yrs admitted in Pediatric wards. However, efforts to ensure matching demand and supply of test kits with facility PITC targets is important to avoid missed opportunities. 
[Annual profile inpatient pediatrics tested for HIV at Morogoro Regional Hospital-2015]
R. Kisanga1, M. Rwechungura1, A. Leonard1, P. Mzonge2, B. Kilama3, P. Swai4, J. Eshun3, M. Njelekela3
1Christian Social Services Commission, Health, Dar es Salaam, Tanzania, United Republic of, 2Morogoro Municipal Council, Health, Morogoro, Tanzania, United Republic of, 3Deloitte, TUNAJALI II Program, Dar es Salaam, Tanzania, United Republic of, 4USAID Tanzania Mission, Health, Dar es Salaam, Tanzania, United Republic of