Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Defining Quality of HIV
Services for MSM and
Transgender Women:
Results of a systematic review
Katherine Andrinopoulos, Ph...
Global, five-year, $180M cooperative agreement
Strategic objective:
To strengthen health information systems – the
capacit...
Improved country capacity to manage health
information systems, resources, and staff
Strengthened collection, analysis, an...
Global footprint—32 countries (2016)
• Men who have sex with men (MSM) and
transgender women are key populations
disproportionately affected by HIV
• Provision...
Evolution of quality concepts
• To establish a definition of quality for HIV services for
MSM and transgender women
• To develop an analytical framework...
• Literature review
• Searched PubMed, relevant websites
• Inclusion criteria: Published after 2000;
focused on quality he...
Literature review
Literature review analysis
• Coded documents
using NVivo software
• Codes developed from
seminal frameworks on
quality & H...
Document availability
Focus population
N=137 documents identified
43%
15%
42%
MSM Transgender Both
Document availability
Service delivery venue
53%
38%
9%
1%
Facility Multiple Community Home
N=137 documents identified
Document availability
Geographic location
66%
32%
5% 4%
15%
NA/Eur/Aus Africa LAC Asia Global
N=137 documents identified
• From an emphasis on providers to a multi-level
systems perspective on how to design and
monitor programs using quality b...
Quality HIV services for MSM and
transgender women are those that are:
• Based on scientific evidence
• Culturally and tec...
Analytical framework
Technical competency
• Understand the difference between sexual orientation and gender
identity, use correct terminology a...
Technical competency
• Develop and enforce appropriate protocols following national
and global standards
• Maintain the ne...
Technical competency
• Promote special credentialing for providers related to MSM and
transgender healthcare
• Support eff...
• Support a multi-level systems perspective to
achieving quality in service provision
• Move towards the adoption of measu...
Available at
www.measureevaluation.org
Defining Quality of HIV Services
for MSM and Transgender Women
This presentation was produced with the support of the United States Agency for
International Development (USAID) under th...
Upcoming SlideShare
Loading in …5
×

Defining Quality of HIV Services for MSM and Transgender Women: Results of a systematic review

Presented by Katherine Andrinopoulos at a July 2016 brown bag lunch.

  • Login to see the comments

  • Be the first to like this

Defining Quality of HIV Services for MSM and Transgender Women: Results of a systematic review

  1. 1. Defining Quality of HIV Services for MSM and Transgender Women: Results of a systematic review Katherine Andrinopoulos, PhD MEASURE Evaluation Tulane University School of Public Health and Tropical Medicine July 12, 2016 Acting on the Roadmap for Health Measurem and Accountability USAID BROWNBAG PRESENTATION
  2. 2. Global, five-year, $180M cooperative agreement Strategic objective: To strengthen health information systems – the capacity to gather, interpret, and use data – so countries can make better decisions and sustain good health outcomes over time. Project overview
  3. 3. Improved country capacity to manage health information systems, resources, and staff Strengthened collection, analysis, and use of routine health data Methods, tools, and approaches improved and applied to address health information challenges and gaps Increased capacity for rigorous evaluation Phase IV Results Framework
  4. 4. Global footprint—32 countries (2016)
  5. 5. • Men who have sex with men (MSM) and transgender women are key populations disproportionately affected by HIV • Provision of quality HIV services is necessary to reach the 90-90-90 targets • Stigma, discrimination, and other unique factors affecting MSM and transgender women’s service use warrant special consideration in the conceptualization of quality Activity rationale
  6. 6. Evolution of quality concepts
  7. 7. • To establish a definition of quality for HIV services for MSM and transgender women • To develop an analytical framework for quality to include appropriate domains and levels for measuring quality Activity purpose
  8. 8. • Literature review • Searched PubMed, relevant websites • Inclusion criteria: Published after 2000; focused on quality healthcare for MSM & transgender women • Search terms were related to quality, HIV, MSM, and transgender populations • Expert review via two webinars Methods
  9. 9. Literature review
  10. 10. Literature review analysis • Coded documents using NVivo software • Codes developed from seminal frameworks on quality & HIV guidance documents • Examined differences in concepts across MSM & transgender women
  11. 11. Document availability Focus population N=137 documents identified 43% 15% 42% MSM Transgender Both
  12. 12. Document availability Service delivery venue 53% 38% 9% 1% Facility Multiple Community Home N=137 documents identified
  13. 13. Document availability Geographic location 66% 32% 5% 4% 15% NA/Eur/Aus Africa LAC Asia Global N=137 documents identified
  14. 14. • From an emphasis on providers to a multi-level systems perspective on how to design and monitor programs using quality benchmarks • From an emphasis on stigma and discrimination to one that also gives equal weight to technical and cultural competency Shifting the quality paradigm
  15. 15. Quality HIV services for MSM and transgender women are those that are: • Based on scientific evidence • Culturally and technically competent • Delivered through efficient and effective linkages across a variety of service delivery models to ensure continuity of care • Voluntary, confidential, and timely • Delivered in a stigma-free environment by providers capable of addressing a number of MSM and trans health needs Definition of quality
  16. 16. Analytical framework
  17. 17. Technical competency • Understand the difference between sexual orientation and gender identity, use correct terminology and communicate with clients in a way that builds trust and rapport • Possess the skills to appropriately deliver HIV and ancillary services to make effective referrals and track them • Ensure the consent and confidentiality of services Cultural competency • Be familiar with the culture of MSM and transgender populations as affects healthcare (age, past experiences of healthcare discrimination, etc.) • Be able to include same-sex spouses in care Stigma-free • Deliver services in a non-judgmental manner without discrimination Provider level
  18. 18. Technical competency • Develop and enforce appropriate protocols following national and global standards • Maintain the necessary commodities and equipment • Provide supportive supervision for providers • Establish networks for referrals and mechanisms for tracking them Cultural competency • Be responsive to preferred time a places for service provision • Provide gender neutral bathrooms • Adopt policies that recognize same-sex partners of clients Stigma-free • Develop and post non-discrimination policies publicly • Monitor waiting rooms for discrimination; sensitize reception and security personnel Organization level
  19. 19. Technical competency • Promote special credentialing for providers related to MSM and transgender healthcare • Support effective linkages across service delivery models and types of services Cultural competency • Ensure variety in the manner by which HIV services are delivered appropriate for the context, and to cater to different clients’ needs Stigma-free • Include sexual orientation and gender identity in non- policies tied to appropriate follow-up and sanctioning • Engage MSM and transgender women in the design and delivery of HIV services, and as members of HIV governing bodies Health system
  20. 20. • Support a multi-level systems perspective to achieving quality in service provision • Move towards the adoption of measures for the three quality domains • Track elements of quality at each level Recommendations
  21. 21. Available at www.measureevaluation.org Defining Quality of HIV Services for MSM and Transgender Women
  22. 22. This presentation was produced with the support of the United States Agency for International Development (USAID) under the terms of MEASURE Evaluation cooperative agreement AID-OAA-L-14-00004. MEASURE Evaluation is implemented by the Carolina Population Center, University of North Carolina at Chapel Hill in partnership with ICF International; John Snow, Inc.; Management Sciences for Health; Palladium; and Tulane University. Views expressed are not necessarily those of USAID or the United States government . www.measureevaluation.org

×