South Africa: Where Collaborative Methods are Rapidly Spreading AIDS Care

This improvement story originally appeared in IHI's 2006 Progress Report
Disparities in care can seem especially dramatic on the global level. But IHI’s methods of rapid improvement and collaborative learning are applicable anywhere, as demonstrated by the encouraging early results of an improvement project currently underway in South Africa.
In partnership with governmental, academic and non-governmental organizations, IHI is working in five of South Africa’s nine provinces to improve HIV/AIDS care. The project’s aim is to reduce morbidity and mortality by improving access to antiretroviral therapy (ART) and integrating disparate components of comprehensive HIV/AIDS care.
Led by Pierre Barker, MD, IHI’s work in South Africa is broader than the specific project aims. “IHI has conducted two formal Learning Sessions in South Africa on improvement methodology for leaders in our partner and governmental organizations,” says Barker.
The results are promising. In most projects, the monthly rate of initiating ART has doubled or more within a few months of health systems redesign. Some of the most encouraging results are in very resource limited rural areas. In Mhlontlo District, Eastern Cape Province — with a population of 200,000 and an estimated HIV prevalence of 12.5 percent — ART initiation rates have quadrupled.
The project aims are compelling — each additional person given access to ART represents a life saved.
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