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Table 1 Facility-level workflow modifications from the original SAIA trial

From: Scaling-up the Systems Analysis and Improvement Approach for prevention of mother-to-child HIV transmission in Mozambique (SAIA-SCALE): a stepped-wedge cluster randomized trial

Type of change Specific example Process improvement
1. Service reorganization CD4 blood draws changed from daily to weekly HIV+ mothers with CD4 increased from 26% to 56%
2. Expand patient knowledge Maternity tours provided to ANC patients 16% increase in institutional births
3. Improve communication across the health care team ANC nurses pick up lab results instead of waiting Lab return time reduced from 6 weeks to 10 days
4. Improve data and its use At shift change, head nurse cross checks pharmacy and maternity registries on infant ARV administration 54% to 88% increase in correct administration
5. Introduce new approaches (norms, treatments, modalities, technologies) (Re) test women with no test or > 3 months prior HIV test, in family planning 98-fold increase in testing after initial ANC screening (limited impact on identification of HIV+ women)