Quality improvement for district plans – reaching the 90-90-90 strategic objectives


This project aims to assess the effectiveness of innovative quality improvement training and strategic support of KwaZulu-Natal provincial district anchors and districts to achieve 90:90:90 targets. The specific objectives are to:

  1. To provide continuous quality improvement training and strategic support to Provincial Managers
  2. To provide mentorship and support to Provincial Managers, and Developmental Support partners in implementing a single quality improvement model towards achieving 90:90:90 targets.
  3. To assess the effectiveness of a single quality improvement model, mentorship and strategic support on achieving 90:90:90 targets.
  4. To determine if quality mentors add value to the implementation of district improvement plans towards achieving 90:90:90 targets.
  5. To attend district and sub district nerve Centre meetings supporting terms of reference on how to run the meetings
  6. Data management and understanding indicators


The project commenced in February 2017, the Department of Health identified three districts that need intensive support towards improving 90 90 90 targets namely (Harry Gwala, Umkhanyakude and Zululand). In May 2017, twenty DoH managers from the Provincial Department of Health were trained in CQI. The three districts are on board with the project. The HAST manager has designed a CQI project to improve ART data towards improving Treatment Retention on ART (TROA) indicators and has partnered with the team in three districts as this program is aligned to one of the deliverables of 90 90 90 has been initiated. On the 20th September 2017, the KZN department of health invited the CRH QI team to be one of four key provincial partners who are tasked with improving the province’s 909090 targets using CQI and revitalizing the district information system and Tier.net. This is part of a broader plan by the National Department of Health under Dr Yogan Pillay. Through a series of consultative meetings and collaboration between partners, standard operating procedures and training plans and modules were developed in October. Operational managers, primary health coordinators and hospital managers from across the province will be trained in October and December on CQI and Tier.net, thereafter partners will support districts on a standard set of CQI activities.

The ultimate aim of the project was the transfer of Quality improving skills to the department of health Primary Health care mangers and the District Support partners. This was achieved through didactic training followed by work integrated supportive mentorship. Mentorship was aligned to the existing meeting platforms within the Department of levels of care. The focus initially was the Clinical Program managers and Primary health care managers.

The District Health services (DHS) Chief director requested the inclusion of community level of care. The community level of care is made up of the Community Care Givers (CCG), their Team leaders and the Sub-district management teams. This is in line with the Primary Health Care re-engineering approach. The DHS has requested the CQI team for the support to be extended to the Community level of care guided the Community Oriented Primary Care (COPC).This is now a school (School of Nursing and Public Health) wide project in view of the need of the multidisciplinary team.This has seen a number of activities being co facilitated by the SONPH and the DOH Management team, duly name PHC Transformation committee. districts.

Department of health, KZN Province opted for CQI methodology for The project is progressing fairly well, preparatory phase ongoing, curriculum for all outreach teams discussed with teams and progress review meetings continued for CBM (Community Based Model and Sub District Model).