In 2017, ICAP at Columbia University launched the HIV Coverage, Quality, and Impact Network (CQUIN)—a multi-country learning network funded by the Bill & Melinda Gates Foundation and dedicated to improving differentiated service delivery (DSD) for people living with HIV in sub-Saharan Africa.
Over two years, CQUIN has grown from six to eleven countries. The network continues to receive strong support from ministries of health, implementing partners, recipients of care, civil society, and other stakeholders.
How It Works
- Countries join at the ministry of health level with a formal letter of interest
- Most engage a core group—some combination of representatives from the ministry of health, PEPFAR country teams, implementing partners, civil society, and recipients of HIV services
- Country teams complete a baseline and periodic self-assessment using the CQUIN dashboard, a capability maturity model
- Countries develop DSD workplans, commitments, and targets
- An opt-in, demand-driven approach to participation is used for various network activities and technical assistance
- Each country team gives an annual presentation on their progress
CQUIN's Activities Include South-to-South Learning, Focused Technical Assistance, and Implementation Research
South-to-South Learning
CQUIN members engage in collaborative learning, including meetings and workshops, quarterly webinars, a monthly newsletter, journal club, south-to-south learning exchange visits, and online virtual communities of practice.
Visit the CQUIN website to learn more, and to sign up for our monthly newsletter
Focused Technical Assistance
CQUIN has seconded national DSD coordinators to the Eswatini and Zimbabwe Ministries of Health, supported national DSD review meetings, and provided consultation and technical assistance to ministries of health on topics such as DSD monitoring and evaluation.
Implementation Research
CQUIN supports catalytic research projects focused on emerging areas of DSD, including male engagement in DSD in Zimbabwe, and service delivery needs of adolescents in Kenya. With these projects, ministries of health are conducting targeted evaluations to guide the development of enhanced DSD models.
View all of CQUIN's catalytic projects and read our latest story on the male engagement study in Zimbabwe.
2018 Highlights
- Côte d'Ivoire and Tanzania both join the network
- CQUIN workshop on the science and practice of scale-up (Eswatini, June 2018)
- South-to-south exchange visits involving 11 country delegations
- M&E technical assistance visits to Zambia and Zimbabwe
- CQUIN-supported DSD review meetings in Kenya and Zimbabwe
- Satellite session at AIDS 2018 in Amsterdam
- Quality Improvement for DSD workshop in Malawi, with Eswatini, Uganda, and Zimbabwe*
- CQUIN Dashboard updates (Dashboard 3.0 and Sub-National Dashboard)
- CQUIN project extended through 2022
Workshops & Meetings
- Launch Meeting (Durban, March 2017)
- DSD for Patients at High Risk of HIV Disease Progression (P@HR) (Harare, July 2017)
- DSD for Adolescents (Johannesburg, October 2017)
- Annual Meeting (Maputo, February 2018)
- The Science and Practice of DSD Scale-Up (Ezulwini, June 2018)
- Second Annual Meeting (Addis Ababa, November 2018)
SOUTH-TO-SOUTH VISITS
12 visits have been completed by eight countries in Years 1 and 2
- Malawi hosted Eswatini in June 2017
- Eswatini hosted Zimbabwe in July 2017
- Eswatini hosted Mozambique in August 2017
- Malawi hosted Mozambique in August 2017
- Uganda hosted Malawi, Eswatini, and Kenya in June 2018
- Eswatini hosted Cote d’Ivoire, Malawi, Uganda, Zambia, and Zimbabwe in June 2018
virtual communities of practice
Led by ICAP, these multi-country technical working groups meet using videoconferencing and WhatsApp™ to discuss and identify common challenges, share best practices, and identify gaps in DSD implementation.
- Differentiated M&E
- Patients at High Risk of HIV Disease Progression
- Adolescent DSD
- National DSD Coordinators
- Recipients of Care (coming soon)
CQUIN partners with the African Society of Laboratory Medicine on a Laboratory Community of Practice (LabCoP), ASLM's lab system strengthening network. The partnership is designed to identify lab barriers and facilitators for DSD models.
ICAP and CQUIN have seconded national DSD coordinators to the Ministries of Health in Zimbabwe and Eswatini. These professionals support DSD implementation and evaluation. The DSD coordinators community of practice links and supports DSD coordinators in all CQUIN network countries.
Learn more about the coordinators and their role in DSD scale-up
TAILORED technical assistance
CQUIN has provided support to ministries of health for:
- Self-staging using the CQUIN dashboard
- M&E consultations in Eswatini, Zimbabwe, and Zambia)
- Support for DSD review meetings in Zimbabwe and Kenya
- Quality improvement for DSD including participant training for Malawi and Zambia and workshops for participants from Eswatini, Malawi, Uganda, and Zimbabwe
- Support for national DSD action plans
A new DSD Dashboard
Feedback from network countries prompted the development of the third version of the DSD Dashboard (3.0) with:
- Revised definitions
- More quantitative staging criteria
- More specific instructions for completing
- Online staging questionnaire that auto-populates the dashboard based on responses
- Development of a Sub-national Dashboard