Developing HIV indicators for clinical care quality assessment: relevance and practicality evaluated by healthcare practitioners in South Africa and Democratic Republic of Congo

Abstract

Background: The use of quality indicators in healthcare systems is one of the factors that improve the quality of health services. However, indicators for assessing HIV clinical care in the context of low- and middle-income countries are not fully explored. Some existing indicators were established within the context of developed countries and are primarily defined for community care, with limited emphasis on the hospital setting. Additionally, these indicators often do not account for the local practicality and relevance of quality measures in the context of low- and middle-income countries.

Aim: To assess the clinical significance and practical applicability of these indicators from the perspective of healthcare professionals specialising in HIV care in South Africa and Democratic Republic of Congo.

Methods: After performing a systematic review of quality indicators employed in the evaluation of clinical care for individuals with HIV, we conducted an observational, cross-sectional study. In this research, 30 physicians filled out two questionnaires with a core set of indicators, to establish the most pertinent and practically indicators for evaluation of the HIV clinical care. A Likert scale was used to rank the indicators. Kendall's tau-B rank correlation analysis was also performed.

Results: From the initial list of 88 quality indicators, 43 were identified as the most relevant and practical in HIV clinical care. Healthcare professionals deemed the monitoring and therapy domain to be the most pertinent and useful indicators out of the seven different clinical domains, followed by the functional organisational structure domain.

Conclusion: This instrument may be a tool for healthcare professionals and hospital administrators to improve the quality of HIV clinical care.

Keywords: Healthcare quality improvement; Outcome Assessment, Health Care; Quality improvement.