A decade of an HIV workplace programme in armed conflict zones; a social responsibility response of the International Committee of the Red Cross.

The International Committee of the Red Cross (ICRC) works in fragile States and in armed conflict zones. Some of them are affected by the HIV pandemic. Within the framework of its social responsibility programme concerning HIV affecting its staff members, the organization has implemented an HIV workplace programme since 2004. We carried out a retrospective analysis over 10 years. Data collected were initially essentially qualitative and process-oriented, but were complemented over the years by data on annual voluntary counselling and testing (VCT) uptake and on direct annual costs covering awareness, testing and antiretroviral therapy. The number of people covered by the programme grew from none in 2003 to 4,438 in 2015, with an increase in annual VCT uptake over the years increasing from 376 persons (14 %) in 2007 to 2,663 in 2015 (60 %). Over the years, the services were expanded from awareness raising to bringing VCT to the workplace, as well as offering testing and health coverage of other conditions and innovative approaches to facing challenges linked to situations of violence. Within its social responsibility framework, the ICRC has shown the importance and feasibility of a workplace HIV programme in conflict zones. A sustainable workplace programme in these conflict settings requires constant adaptation, with regular follow-up given the relatively high turnover of staff, and ensuring sustainable stocks of condoms and antiretroviral drugs.

Quality improvement programme on the frontline: an International Committee of the Red Cross experience in the Democratic Republic of Congo.

BACKGROUND: Majority of research in Quality Improvement, focuses on developed countries or development programs. Humanitarian organisations frequently work in developing countries, often in emergency situations with rapid staff turnover. Objectives of this study are twofold: first to develop a methodology of motivation and restoration of collapsed health structures through the creation of community based QI indicators; second, to implement these indicators to improve quality of care. METHODOLOGY: Using a community-based approach, the International Committee of the Red Cross (ICRC) team together with local health committee and nurses developed quality indicators divided into six different categories. Of 16 community primary health centers and four hospitals supported by ICRC, six health centers and one hospital were chosen to follow quality indicators for three of six indicator categories. Initial data were collected in January 2003 and compared with data serially gathered throughout the year. RESULTS: In the category rational prescription, all health facilities except for one showed improvement in every category. In the hygiene category, four of seven health structures showed 100% improvement in their score. Three of seven facilities showed impressive improvement in the category pharmacy management. CONCLUSION: Involving the community to design population based indicators helped communities take ownership of the indicators. Our findings that poor performance on indicators prompted communities to seek training and assistance to improve quality of care emphasized this. Continued adherence and improvement in each category confirmed the long term effects of teaching sessions in the areas of rational prescription, hygiene and pharmacy maintenance.