Implementation of the Policy for Quality Monitoring and Improvement (QMI) of the Brazilian National Health System's (SUS) Outpatient Facilities Providing Care to People Living With HIV/Aids: Qualiaids Project

• Grant number: 23/08543-5
• Support Opportunities: Research Grants - Research in Public Policies
• Start date: February 01, 2024
• End date: January 31, 2027
• Field of knowledge: Health Sciences - Collective Health - Preventive Medicine
• Principal Investigator: Maria Ines Battistella Nemes
• Grantee: Maria Ines Battistella Nemes
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: Aline Maciel Vieira Lima ; Ana Paula Sayuri Sato ; Artur Olhovetchi Kalichman ; Barbara dos Reis Santos ; Draurio Barreira Cravo Neto ; Maria Leticia Rodrigues Ikeda ; Nêmora Tregnago Barcellos ; Ronaldo Campos Hallal ; Tatianna Meireles Dantas de Alencar ; Wania Maria do Espírito Santo Carvalho
• Associated scholarship(s): 24/22070-5 - Assessment of the organization of care in SUS outpatient services for the treatment of HIV infection in Brazil: Qualiaids 2023 survey, BP.MS; 24/21623-0 - Regional Monitor - Midwest/Northeast/North, BP.TT; 24/21640-2 - Regional Monitor - Southeast/South, BP.TT; + associated scholarships 24/13484-0 - Development and validation of a composite indicator of the organizational quality of outpatient services provided by the Brazilian Unified Health System to individuals living with HIV/AIDS, BP.PD; 24/10189-8 - Data and information analyst, BP.TT; 24/06251-0 - Data and information manager, BP.TT - associated scholarships

Abstract

This project is about the running policy "Quality monitoring and improvement of SUS outpatient facilities providing PLWHA care (QMI)." The last 20 years have seen QMI-related measures taken at the various management levels of the HIV/Aids Program, such as assessment surveys on care delivery organization and technical training. These measures, however, have not resulted in the development of QMI-policy components, such as specific work groups, strategies, and goals. The policy is under systematic development by the HIV/Aids Department of the Ministry of Health (MoH), which is responsible for the current federal management of the SUS HIV/Aids Program, and has been proposed as a partnering institution for this project. The policy is targeted at managers and professionals of the care teams within the HIV care facilities. By focusing on improving care quality, it aims to contribute to positive clinical outcomes for service users. Phase 1 of the management project will focus on a situational analysis of facility organization quality, which will inform Phase 2, consisting of decentralized training on interventions for quality improvement. This will in turn support Phase 3, which comprises the participatory establishment of quality guidelines and goals. For the execution of the management project, the following scientific information is necessary: For Phase 1, methodology for the assessment of the quality of care organization. This methodology is validated for the SUS context. For Phase 2, analysis of quality strata according to the administrative characteristics of the facilities and social demographic of the municipalities where the facilities are located. For Phase 3, validation of composite indicators that will support quality goals setting. The partnership between the researchers and the MoH's technical team coordinating the HIV/Aids Program is based on the experience of previous partnerships in nationwide surveys on service quality, as well as in partnerships in managerial training in the state of São Paulo. That experience prompted the MoH's HIV/Aids Department to invite the Qualiaids research team to collaborate in this project. The project design takes into account the necessary breadth of coverage of the QMI policy, which targets a diverse range of approximately 1,350 facilities with different administrative profiles. In its capacity as the MoH's regulatory body for HIV/Aids, the partnering institution will oversee all the project phases with the participation of state- and municipal-level managers. As a whole, the project aims to engage managers and professionals of local facilities in processes that will result in the development of a "quality culture" in HIV/Aids care. Given the variability of the SUS decentralized management across the country, the potential risk is that national participation may be either low or highly heterogeneous. The results of both the management and scientific components will be disseminated among managers, professionals, and facilities. They will be presented at conferences, published on websites, and submitted to journals in the field. The data from the analyses will be made available according to the data management plan. (AU)