Breaking down the walls between the clinic and the community leads to real quality improvement. Joint participation of providers and community members in committees brings about a better understanding of each others values, roles and needs. Involving health workers in the design of a quality improvement tool is a key factor in its use and acceptance. Regular supervision and monitoring allows for joint and efficient problem solving to maintain quality. Where there is little support and no antiretrovirals to offer, bring low-cost and convenient VCT services to the community.
Yearly recognition contributes to maintaining quality.
Having an annual award for which FP service sites compete generates pride and excitement. Quality improvements in FP can positively affect other health services. Keeping providers motivated is a challenge. Maintaining a client-centered approach is a challenge. There is a viable market for the private sector to provide high quality services to middle and lower income people.