"Doing the right things right": benefits of structured quality improvement (Q1) in HIV prevention

Christiana Nöstlinger, Bea Vuylsteke, D Seery, V Urwitz, M Wentzlaff-Eggebert M

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HIV is a major public health concern in Europe. Contextual, programme and implementation-related factors influence the effectiveness of prevention and health promotion. Quality improvement (QI) is a systems-focused and data-driven method to improve health processes and outcomes. The European Joint Action “Quality Action” aimed to build the capacity of HIV prevention organisations in 26 countries to use innovative, HIV-specific QI tools. Five tools were developed for different target groups and implementation levels. We present the main results of the projects’ process and outcome evaluation.


The evaluation used a mixed method strategy. A logic framework defined QI tool application process, output and outcome indicators (i.e. self-reported changes 6 months after QI tool use), which were assessed using data from anonymous online surveys, 9 focus group discussions and 33 in-depth interviews.


The project trained 105 implementers, 84 QI tool applications were completed. 79 respondents filled in the process, 73 the outcome questionnaire. Respondents reported successful QI applications: improved evidence-based selection of target groups (80%), increased reach of target groups (84%), more participation of priority groups in prevention (84%). Most important benefits of QI were improvements in planning processes (33%), collaboration with external partners (18%) and within project teams (16%). Qualitative findings showed increased self-reflection, participation and collaboration. Resource constraints and missing policy support were perceived barriers to structured QI strongly emphasising the need for enabling policy environments.


QI benefits were reported mainly on the individual and organisational level. Structured QI is new to many in the HIV field. The Quality Action QI approach has shown to be feasible, and to increase prevention quality. However, structural and policy support is needed to sustainably impact on prevention outcomes.
Original languageEnglish
Article numberckw165.049
JournalEuropean Journal of Public Health
Issue numberSupplement 1
Publication statusPublished - 2016


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