Background: Continuous quality improvement (CQI) is a deliberate and a systematic process designed to intervene in issues of quality in voluntary medical male circumcision (VMMC) using 8 WHO quality standards. University Research Company (URC) conducted VMMC baseline assessment at 134 Department of health (DoH) facilities where implementing partners (IP''s) are providing this service. Following this assessment, gaps were identified which revealed non-compliance of sites to different areas of WHO quality standards. URC saw the need to train those who manages this service at a programmatic level as well as those at site level to improve the quality of service provided as well as to reduce adverse events. A CQI training exercise empowers the providers not only to identify gaps and come up with improvement strategies but also to assess themselves, identify bottlenecks and shortfalls and improve going forward.
Description: MMC baseline assessment was conducted in 8 provinces: Mpumalanga (MP); Eastern Cape (EC); Gauteng (GP); Kwazulu Natal(KZN); Limpopo(LP); Northern Cape(NC) and North West(NW) to look at compliance of sites to WHO quality standards. Three days training was then conducted by URC staff to empower the providers so that they can provide good quality service. In total 279 healthcare workers were trained across the eight provinces. Post training 2 subsequent assessments were then conducted to assess improvement in the quality of service and compliance with the standards.
Lessons learned: Post CQI training results shows that provinces improved significantly on average from 76.4 %( baseline) to 92.8 %( reassessment). Individual provinces scored as follows: EC (81.4% to 96%), GP (78.2% to 97.3%), KZN (80.4% to 94.2%), LP (81.4% to 98.5%), MP (63.4% to 90.1%), NC (69.2% to 94.9%), NW (78.0% to 80.6%).
Conclusions/Next steps: CQI training has empowered those providing the MMC service with skills, knowledge, and understanding of the program to enable them to provide safe, high quality MMC service. Results after training showed that provinces improved significantly in their performance as far as providing quality service is concerned.

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