Improving HIV counseling and testing in tuberculosis service delivery in Ukraine: Profile of a pilot quality improvement team and its scale-up journey

Abstract

This case study describes the experience of a successful pilot team in Chervonograd, a mining city in Lviv Province of Western Ukraine, that participated in an effort beginning in March 2013 to use quality improvement (QI) methods to raise the rates of HIV counseling and testing (HCT) offered to all clients tested for tuberculosis (TB). With a population of close to 67,500, Chervonograd has a higher number of drug users than the rest of the country. State statistics revealed that 75% of AIDS patients diagnosed in the city in 2013 were coinfected with TB, but only 4% of suspected TB cases citywide were offered HIV counseling by TB doctors and only 0.04% were actually tested for HIV. The efforts of Chervonograd’s pilot QI team proved critical to both improving the rates of HCT for TB clients in the pilot sites and the overall success of the scale-up of this work throughout Lviv Province.