Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

Diana D. Naser

Abstract

Low viral load suppression rate is a significant public health issue in Uganda and similar countries. A nationwide quality improvement (QI) initiative was implemented from January 2019 to improve viral load suppression. Although QI team characteristics have been shown to influence the success of such QI initiatives, no studies have been found to understand how they influence the success of QI efforts to improve HIV viral load suppression in Uganda. The purpose of this cross-sectional, quantitative study was to determine whether there is a significant association between HIV clinic leader involvement in QI teams, QI team functionality, QI team diversity, QI team skill, and HIV viral load suppression rates in Uganda, controlling for age, sex, and health facility type. The study was grounded in the model for success in quality improvement (MUSIQ) and the chronic care model (CCM). Secondary data for 2,758 patients attending 18 HIV clinics across three regions in Uganda were abstracted from the health management information system. Sampling was at the health facility level so that all patients in each sampled clinics were included. Data were analyzed using logistic regression, with one binary dependent variable of viral load suppression recorded as suppressed or unsuppressed. Leadership involvement, team functionality, patient age, patient sex, and health facility type were significantly associated with viral load suppression (p<0.05 for each). QI initiatives should invest in QI team characteristics because they affect patient outcomes. This study could potentially impact social change in low-income settings by improving service delivery for people with HIV in Uganda so that they achieve viral load suppression.

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