Inclusion Criteria:  All nursing care staff employed at the health facilities are eligible for inclusion to receive the quality improvement intervention Willing to provide informed consent Work in one of the ten facilities randomised for the study Involved in HIV patient care Patients receiving care from participating clinics must be aged 16 years and above to be included in the study  Exclusion Criteria:  Expecting to relocate or change jobs during the study duration Unwilling or unable to provide informed consent/refusal to participate