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01-08-2019 | Public Health | Implementation Science (E Geng, Section Editor)

Making Smarter Decisions Faster: Systems Engineering to Improve the Global Public Health Response to HIV

Authors: Anjuli D. Wagner, Jonny Crocker, Shan Liu, Peter Cherutich, Sarah Gimbel, Quinhas Fernandes, Melissa Mugambi, Kristjana Ásbjörnsdóttir, Sarah Masyuko, Bradley H. Wagenaar, Ruth Nduati, Kenneth Sherr

Published in: Current HIV/AIDS Reports | Issue 4/2019

Abstract

Purpose of Review

This review offers an operational definition of systems engineering (SE) as applied to public health, reviews applications of SE in the field of HIV, and identifies opportunities and challenges of broader application of SE in global health.

Recent Findings

SE involves the deliberate sequencing of three steps: diagnosing a problem, evaluating options using modeling or optimization, and providing actionable recommendations. SE includes diverse tools (from process improvement to mathematical modeling) applied to decisions at various levels (from local staffing decisions to planning national-level roll-out of new interventions). Contextual factors are crucial to effective decision-making, but there are gaps in understanding global decision-making processes. Integrating SE into pre-service training and translating SE tools to be more accessible could increase utilization of SE approaches in global health.

Summary

SE is a promising, but under-recognized approach to improve public health response to HIV globally.

UNAIDS (2018) Miles to go: closing gaps, breaking barriers, righting injustices. Geneva.

Bowen S, Zwi AB. Pathways to “evidence-informed” policy and practice: a framework for action. PLoS Med. 2005;2:e166. https://doi.org/10.1371/journal.pmed.0020166.CrossRefPubMedPubMedCentral

Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4. https://doi.org/10.1186/1748-5908-4-50.

Kapiriri L, Norheim OF, Martin DK. Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda. Health Policy (New York). 2007;82:78–94. https://doi.org/10.1016/j.healthpol.2006.09.001.CrossRef

Schlager KJ. Systems engineering-key to modern development. IRE Trans Eng Manag. 1956;3:64–6.CrossRef

Buede D. The engineering design of systems: models and methods. 2nd ed. Hoboken, New Jersey: John Wiley & Sons, Inc; 2009.CrossRef

NASA (2007) NASA Systems Engineering Handbook.

Rau EP. Combat science: the emergence of operational research in world war II. Endeavour. 2005;29:156–61. https://doi.org/10.1016/j.endeavour.2005.10.002.CrossRefPubMed

Deming WE (2018) The new economics for industry, government, education, third. MIT Press, Cambridge, MA.

10.

Rogers EM. Diffusion of innovations. 5th ed. New York: Free Press; 2003.

11.

Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O, Peacock R. Storylines of research in diffusion of innovation: a meta-narrative approach to systematic review. Soc Sci Med. 2005;61:417–30. https://doi.org/10.1016/j.socscimed.2004.12.001.CrossRefPubMed

12.

Berwick DM. Disseminating innovations in health care. JAMA. 2003;289:1969–75. https://doi.org/10.1001/jama.289.15.1969.CrossRefPubMed

13.

Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press; 2001.

14.

• Reid PP, Compton WD, Grossman JH, Fanjiang G. Building a better delivery system: a new engineering/health care partnership. Washington, DC: National Academies Press; 2005. This work describes systems engineering applied to health care, both a framework and action plan.

15.

Tu SP, Feng S, Storch R, Yip MP, Sohng HY, Fu M, et al. Applying systems engineering to implement an evidence-based intervention at a community health center. J Health Care Poor Underserved. 2012;23:1399–409. https://doi.org/10.1353/hpu.2012.0190.

16.

Tropello SP, Ravitz AD, Romig M, Pronovost PJ, Sapirstein A. Enhancing the quality of care in the intensive care unit: a systems engineering approach. Crit Care Clin. 2013;29:113–24. https://doi.org/10.1016/j.ccc.2012.10.009.CrossRefPubMed

17.

White BA, Chang Y, Grabowski BG, Brown DF. Using lean-based systems engineering to increase capacity in the emergency department. West J Emerg Med. 2014;15:770–6. https://doi.org/10.5811/westjem.2014.8.21272.CrossRefPubMedPubMedCentral

18.

Korenromp E, Komatsu R, Katz I, et al (2007) Operational research on HIV/AIDS, tuberculosis and malaria control in Global Fund-supported programmes: round 1-6 grants. In: 5th European conference on tropical medicine and international health. Amsterdam.

19.

Kopach-Konrad R, Lawley M, Criswell M, Hasan I, Chakraborty S, Pekny J, et al. Applying systems engineering principles in improving health care delivery. J Gen Intern Med. 2007;22:431–7. https://doi.org/10.1007/s11606-007-0292-3.CrossRefPubMedPubMedCentral

20.

•• Monks T. Operational research as implementation science: definitions, challenges and research priorities. Implement Sci. 2016;11:81. https://doi.org/10.1186/s13012-016-0444-0. This text highlights the role of operations research within implementation science and offers practical examples of models used to answer questions that saved time and money. CrossRefPubMedPubMedCentral

21.

Pitt M, Monks T, Crowe S, Vasilakis C. Systems modelling and simulation in health service design, delivery and decision making. BMJ Qual Saf. 2016;25:38–45. https://doi.org/10.1136/bmjqs-2015-004430.CrossRefPubMed

22.

Boy GA, Narkevicius JM. Unifying human centered design and systems engineering for human systems integration. Complex Syst Des Manag. 2014:151–62.

23.

Brugha R, Varvasovszky Z. Stakeholder analysis: a review. Health Policy Plan. 2000;15:239–46. https://doi.org/10.1093/heapol/15.3.239.CrossRefPubMed

24.

Okoli C, Pawlowski SD. The Delphi method as a research tool: an example, design considerations and applications. Inf Manag. 2004;42:15–29. https://doi.org/10.1016/j.im.2003.11.002.CrossRef

25.

Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. 2nd ed. Thousand Oaks, California: SAGE Publications; 1994.

26.

Strauss A, Corbin J. Basics of qualitative research: techniques and procedures for developing grounded theory. Thousand Oaks, California: SAGE Publications; 1998.

27.

•• Sherr K, Gimbel S, Rustagi A, et al. Systems analysis and improvement to optimize pMTCT (SAIA): a cluster randomized trial. Implement Sci. 2014;9:55. https://doi.org/10.1186/1748-5908-9-55. This is an example of three systems engineering tools packaged together into an effective intervention to improve prevention of mother-to-child transmission of HIV in 3 African countries. CrossRefPubMedPubMedCentral

28.

Rustagi AS, Gimbel S, Nduati R, et al. Impact of a systems engineering intervention on PMTCT service delivery in Cote d’Ivoire, Kenya, Mozambique: a cluster randomized trial. J Acquir Immune Defic Syndr. 2016;72:e76–82. https://doi.org/10.1097/QAI.0000000000001188.CrossRef

29.

Bardfield J, Agins B, Akiyama M, Basenero A, Luphala P, Kaindjee-Tjituka F, et al. A quality improvement approach to capacity building in low- and middle-income countries. Acquir Immune Defic Syndr. 2015;29:S179–86. https://doi.org/10.1097/QAD.0000000000000719.CrossRef

30.

Armitage G, Hodgson I, Wright J, Bailey K, Mkhwana E. Exploring the delivery of antiretroviral therapy for symptomatic HIV in Swaziland: threats to the successful treatment and safety of outpatients attending regional and district clinics. BMJ Qual Saf. 2011;20:52–9. https://doi.org/10.1136/bmjqs.2009.034512.CrossRefPubMed

31.

• Golden LM, Fairlie L, Might F, Mojela S, Motsamai D, Motshepe S, et al. HIV retesting in pregnant women in South Africa: outcomes of a quality improvement project targeting health systems’ weaknesses. South Afr J HIV Med. 2018;19:784. https://doi.org/10.4102/sajhivmed.v19i1.784.CrossRefPubMedPubMedCentral

32.

Lang R, Charlton C, Beckthold B, Kadivar K, Lavoie S, Caswell D, et al. HIV misdiagnosis: a root cause analysis leading to improvements in HIV diagnosis and patient care. J Clin Virol. 2017;96:84–8. https://doi.org/10.1016/j.jcv.2017.10.005.CrossRefPubMed

33.

Izudi J, Akot A, Kisitu GP, Amuge P, Kekitiinwa A. Quality improvement interventions for early HIV infant diagnosis in northeastern Uganda. Biomed Res Int. 2016;2016:1–8. https://doi.org/10.1155/2016/5625364.CrossRef

34.

Izudi J, Mugenyi J, Mugabekazi M, Muwanika B, Tumukunde Spector V, Katawera A, et al. Retention of HIV-positive adolescents in care: a quality improvement intervention in mid-western Uganda. Biomed Res Int. 2018;2018:1–8. https://doi.org/10.1155/2018/1524016.CrossRef

35.

Jeffery C, Beckworth C, Hadden WC, Ouma J, Lwanga SK, Valadez JJ. Associations with HIV testing in Uganda: an analysis of the lot quality assurance sampling database. AIDS Care. 2016;28:519–23. https://doi.org/10.1080/09540121.2015.1112350.CrossRefPubMed

36.

Pintye J, Kinuthia J, Roberts DA, Wagner AD, Mugwanya K, Abuna F, et al. Integration of PrEP services into routine antenatal and postnatal care: experiences from an implementation program in Western Kenya. Acquir Immune Defic Syndr. 2018;79:590–5. https://doi.org/10.1097/QAI.0000000000001850.CrossRef

37.

Baddour AA, Saleh HA. Use Six Sigma approach to improve healthcare worker safety. Int J Pure Appl Sci Technol. 2013;18:54–68.

38.

Monroe-Wise A, Reisner E, Sherr K, Ojakaa D, Mbau L, Kisia P, et al. Using lean manufacturing principles to evaluate wait times for HIV-positive patients in an urban clinic in Kenya. Int J STD AIDS. 2017;28:1410–8. https://doi.org/10.1177/0956462417711624.CrossRefPubMed

39.

Institute for Healthcare Improvement (IHI) science of improvement: how to improve. www.ihi.org/resources/pages/howtoimprove/scienceofimprovementhowtoimprove.aspx. Accessed 19 Jan 2017.

40.

Wagner AD, Mugo C, Bluemer-Miroite S, Mutiti PM, Wamalwa DC, Bukusi D, et al. Continuous quality improvement intervention for adolescent and young adult HIV testing services in Kenya improves HIV knowledge. Acquir Immune Defic Syndr. 2017;31:S243–52. https://doi.org/10.1097/QAD.0000000000001531.CrossRef

41.

Kohler PK, Namate D, Barnhart S, Chimbwandira F, Tippet-Barr BA, Perdue T, et al. Classification and rates of adverse events in a Malawi male circumcision program: impact of quality improvement training. BMC Health Serv Res. 2016;16:61. https://doi.org/10.1186/s12913-016-1305-x.CrossRefPubMedPubMedCentral

42.

Institute for Healthcare Improvement (IHI) Run Chart Tool. www.ihi.org/resources/pages/tools/runchart.aspx. Accessed 19 Jan 2017.

43.

Alistar SS, Long EF, Brandeau ML, Beck EJ. HIV epidemic control-a model for optimal allocation of prevention and treatment resources. Health Care Manag Sci. 2014;17:162–81. https://doi.org/10.1007/s10729-013-9240-4.CrossRefPubMed

44.

El-Rifai O, Garaix T, Augusto V, Xie X. A stochastic optimization model for shift scheduling in emergency departments. Health Care Manag Sci. 2015;18:289–302. https://doi.org/10.1007/s10729-014-9300-4.CrossRefPubMed

45.

Gimbel S, Voss J, Mercer MA, Zierler B, Gloyd S, Coutinho MJ, et al. The prevention of mother-to-child transmission of HIV cascade analysis tool: supporting health managers to improve facility-level service delivery. BMC Res Notes. 2014;7. https://doi.org/10.1186/1756-0500-7-743.

46.

Njuguna IN, Wagner AD, Otieno VO, et al. Hospitalized children reveal health systems gaps in the mother-child HIV care cascade in Kenya. AIDS Patient Care STDs. 2016;30:119–24. https://doi.org/10.1089/apc.2015.0239.CrossRefPubMedPubMedCentral

47.

Sibanda EL, Weller IV, Hakim JG, Cowan FM. The magnitude of loss to follow-up of HIV-exposed infants along the prevention of mother-to-child HIV transmission continuum of care: a systematic review and meta-analysis. Acquir Immune Defic Syndr. 2013;27:2787–97. https://doi.org/10.1097/QAD.0000000000000027.CrossRef

48.

Deo S, Topp SM, Garcia A, Soldner M, Yagci Sokat K, Chipukuma J, et al. Modeling the impact of integrating HIV and outpatient health services on patient waiting times in an urban health clinic in Zambia. PLoS One. 2012;7:e35479. https://doi.org/10.1371/journal.pone.0035479.CrossRefPubMedPubMedCentral

49.

Gonsalves GS, Paltiel AD, Cleary PD, Gill MJ, Kitahata MM, Rebeiro PF, et al. A flow-based model of the HIV care continuum in the United States. J Acquir Immune Defic Syndr. 2017;75:548–53. https://doi.org/10.1097/QAI.0000000000001429.CrossRefPubMedPubMedCentral

50.

Liu N, Stone PW, Schnall R. Impact of mandatory HIV screening in the emergency department: a queuing study. Res Nurs Health. 2016;39:121–7. https://doi.org/10.1002/nur.21710.CrossRefPubMed

51.

Kok S, Rutherford AR, Gustafson R, et al. Optimizing an HIV testing program using a system dynamics model of the continuum of care. Health Care Manag Sci. 2015;18:334–62. https://doi.org/10.1007/s10729-014-9312-0.CrossRefPubMedPubMedCentral

52.

Negoescu DM, Owens DK, Brandeau ML, Bendavid E. Balancing immunological benefits and cardiovascular risks of antiretroviral therapy: when is immediate treatment optimal? Clin Infect Dis. 2012;55:1392–9. https://doi.org/10.1093/cid/cis731.CrossRefPubMedPubMedCentral

53.

Negoescu DM, Zhang Z, Bucher HC, Bendavid E, Swiss HIV Cohort Study. Differentiated human immunodeficiency virus RNA monitoring in resource-limited settings: an economic analysis. Clin Infect Dis. 2017;64:1724–30. https://doi.org/10.1093/cid/cix177.CrossRefPubMedPubMedCentral

54.

Enns EA, Brandeau ML. Inferring model parameters in network-based disease simulation. Health Care Manag Sci. 2011;14:174–88. https://doi.org/10.1007/s10729-011-9150-2.CrossRefPubMedPubMedCentral

55.

Enns EA, Brandeau ML. Link removal for the control of stochastically evolving epidemics over networks: a comparison of approaches. J Theor Biol. 2015;371:154–65. https://doi.org/10.1016/j.jtbi.2015.02.005.CrossRefPubMedPubMedCentral

56.

Enns EA, Brandeau ML, Igeme TK, Bendavid E. Assessing effectiveness and cost-effectiveness of concurrency reduction for HIV prevention. Int J STD AIDS. 2011;22:558–67. https://doi.org/10.1258/ijsa.2011.010322.CrossRefPubMedPubMedCentral

57.

Sharma M, Smith JA, Farquhar C, Ying R, Cherutich P, Golden M, et al. Assisted partner notification services are cost-effective for decreasing HIV burden in western Kenya. Acquir Immune Defic Syndr. 2018;32:233–41. https://doi.org/10.1097/QAD.0000000000001697.CrossRef

58.

•• Francke JA, Penazzato M, Hou T, Abrams EJ, MacLean RL, Myer L, et al. Clinical impact and cost-effectiveness of diagnosing HIV infection during early infancy in South Africa: test timing and frequency. J Infect Dis. 2016;214:1319–28. https://doi.org/10.1093/infdis/jiw379. This is an example of using a complex mathematical model to decide between introduction of a new infant HIV testing timepoint or optimizing system performance for existing timepoints. CrossRefPubMedPubMedCentral

59.

Suraratdecha C, Stuart RM, Manopaiboon C, Green D, Lertpiriyasuwat C, Wilson DP, et al. Cost and cost-effectiveness analysis of pre-exposure prophylaxis among men who have sex with men in two hospitals in Thailand. J Int AIDS Soc. 2018;21:E25129. https://doi.org/10.1002/jia2.25129.CrossRefPubMedPubMedCentral

60.

Price JT, Wheeler SB, Stranix-Chibanda L, Hosek SG, Watts DH, Siberry GK, et al. Cost-effectiveness of pre-exposure HIV prophylaxis during pregnancy and breastfeeding in sub-Saharan Africa. J Acquir Immune Defic Syndr. 2016;72:S145–53. https://doi.org/10.1097/QAI.0000000000001063.CrossRefPubMedPubMedCentral

61.

Smith JA, Sharma M, Levin C, Baeten JM, van Rooyen H, Celum C, et al. Cost-effectiveness of community-based strategies to strengthen the continuum of HIV care in rural South Africa: a health economic modelling analysis. Lancet HIV. 2015;2:e159–68. https://doi.org/10.1016/S2352-3018(15)00016-8.CrossRefPubMedPubMedCentral

62.

Mitchell KM, Lepine A, Terris-Prestholt F, et al. Modelling the impact and cost-effectiveness of combination prevention amongst HIV serodiscordant couples in Nigeria. Acquir Immune Defic Syndr. 2015;29:2035–44. https://doi.org/10.1097/QAD.0000000000000798.CrossRef

63.

Alistar SS, Owens DK, Brandeau ML. Effectiveness and cost effectiveness of oral pre-exposure prophylaxis in a portfolio of prevention programs for injection drug users in mixed HIV epidemics. PLoS One. 2014;9:e86584. https://doi.org/10.1371/journal.pone.0086584.CrossRefPubMedPubMedCentral

64.

•• Cherutich P, Farquhar C, Wamuti B, et al. HIV partner services in Kenya: a cost and budget impact analysis study. BMC Health Serv Res. 2018;18:721. https://doi.org/10.1186/s12913-018-3530-y. This is an example of a budget impact analysis that had direct impact on national policy in Kenya and accelerated translation of randomized controlled trial efficacy findings to programmatic scale up. CrossRefPubMedPubMedCentral

65.

• de Savigny D, Adam T. Systems thinking for health systems strengthening. Geneva, Switzerland: World Health Organization; 2009. Excellent introduction to systems thinking in practical terms, with focus on context.

66.

World Health Organization. Everybody’s business: strengthening health systems to improve health outcomes: WHO’s framework for action. Geneva, Switzerland; 2007.

67.

Hoffmann CJ, Milovanovic M, Kinghorn A, et al (2018) Value stream mapping to characterize value and waste associated with accessing HIV care in South Africa.

68.

Alamo ST, Wagner GJ, Ouma J, Sunday P, Marie L, Colebunders R, et al. Strategies for optimizing clinic efficiency in a community-based antiretroviral treatment programme in Uganda. AIDS Behav. 2013;17:274–83. https://doi.org/10.1007/s10461-012-0199-9.CrossRefPubMed

69.

Kwena ZA, Njoroge BW, Cohen CR, Oyaro P, Shikari R, Kibaara CK, et al. The feasibility, time savings and economic impact of a designated time appointment system at a busy HIV care clinic in Kenya: a randomized controlled trial. J Int AIDS Soc. 2015;18:19876. https://doi.org/10.7448/IAS.18.1.19876.CrossRefPubMedPubMedCentral

70.

Henley C, Forgwei G, Welty T, Golden M, Adimora A, Shields R, et al. Scale-up and case-finding effectiveness of an HIV partner services program in Cameroon: an innovative HIV prevention intervention for developing countries. Sex Transm Infect. 2013;40:909–14. https://doi.org/10.1097/OLQ.0000000000000032.CrossRef

71.

Cherutich P, Golden MR, Wamuti B, Richardson BA, Ásbjörnsdóttir KH, Otieno FA, et al. Assisted partner services for HIV in Kenya: a cluster randomised controlled trial. Lancet HIV. 2017;4:e74–82. https://doi.org/10.1016/S2352-3018(16)30214-4.CrossRefPubMed

72.

World Health Organization (2016) Guidelines on HIV self-testing and partner notification: supplement to consolidated guidelines on HIV testing services.

73.

Balas EA, Boren SA. Managing clinical knowledge for health care improvement. Yearb Med Inform. 2000;1:65–70.

74.

•• Masyuko S, Mukui I, Njathi O, Kimani M, Oluoch P, Wamicwe J, et al. Pre-exposure prophylaxis rollout in a national public sector program: the Kenyan case study. Sex Health. 2018;15:578–86. https://doi.org/10.1071/SH18090. This is an example of a partnership between Kenyan Ministry of Health and technical modeling experts to design a rollout strategy for HIV pre-exposure prophylaxis using a publically available and user-friendly simplified model interface. CrossRefPubMed

75.

Avenir Health (2018) SPECTRUM.

76.

Bhavaraju N, Muther K, Kiragu M, et al. Who, where, and how? Developing scenarios for the rollout of oral PrEP in Kenya. Paris, France: International AIDS Society; 2017.

77.

AVAC PrEPWatch: OPTIONS plan 4 PrEP tool offers countries support for rollout. www.prepwatch.org/plan-4-prep-tool/. Accessed 30 Nov 2018.

78.

Deo S, Crea L, Quevedo J, Lehe J, Vojnov L, Peter T, et al. Implementation and operational research: expedited results delivery systems using GPRS technology significantly reduce early infant diagnosis test turnaround times. J Acquir Immune Defic Syndr. 2015;70:e1–4. https://doi.org/10.1097/QAI.0000000000000719.CrossRefPubMed

79.

Jani IV, Meggi B, Loquiha O, Tobaiwa O, Mudenyanga C, Zitha A, et al. Effect of point-of-care early infant diagnosis on antiretroviral therapy initiation and retention of patients. Acquir Immune Defic Syndr. 2018;32:1453–63. https://doi.org/10.1097/QAD.0000000000001846.CrossRef

80.

Gimbel S, Chilundo B, Kenworthy N, Inguane C, Citrin D, Chapman R, et al. Donor data vacuuming in global health partnerships. Med Anthropol Theory. 2018;5:79–99. https://doi.org/10.17157/mat.5.2.537.CrossRef

81.

Wagenaar BH, Sherr K, Fernandes Q, Wagenaar AC. Using routine health information systems for well-designed health evaluations in low- and middle-income countries. Health Policy Plan. 2016;31:129–35. https://doi.org/10.1093/heapol/czv029.CrossRefPubMed

82.

Gloyd S, Wagenaar BH, Woelk GB, Kalibala S. Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information. J Int AIDS Soc. 2016;19:20847. https://doi.org/10.7448/IAS.19.5.20847.CrossRefPubMedPubMedCentral

83.

Wagenaar BH, Gimbel S, Hoek R, Pfeiffer J, Michel C, Manuel JL, et al. Effects of a health information system data quality intervention on concordance in Mozambique: time-series analyses from 2009-2012. Popul Health Metrics. 2015;13:9. https://doi.org/10.1186/s12963-015-0043-3.CrossRef

84.

Njoroge A, Dunbar M, Betz B, et al (2016) Feasibility and acceptability of a biometric identification system using iris recognition in routine HIV services in Kenya. In: 9th International AIDS Society Conference (IAS). Durban, South Africa.

85.

Gimbel S, Coutinho J, Kawakyu N, et al (2018) Usability and feasibility of a provider decision support smartphone application for frontline health workers in Kenya and Mozambique. In: 5th Global Symposium on Health Services Research. Liverpool, UK.

86.

Saywell D, Crocker J. Process learning on partnerships: building functioning research and practice organizational relationships. Waterlines. 2019;38:3–19. https://doi.org/10.3362/1756-3488.18-00014.CrossRef

87.

Walker RM, Damanpour F, Devece CA. Management innovation and organizational performance: the mediating effect of performance management. J Public Adm Res Theory. 2010;21:367–86. https://doi.org/10.1093/jopart/muq043.CrossRef

88.

Boyko JA, Riley BL, Willis CD, Stockton L, Zummach D, Kerner J, et al. Knowledge translation for realist reviews: a participatory approach for a review on scaling up complex interventions. Heal Policy Res Syst. 2018;16:101. https://doi.org/10.1186/s12961-018-0374-1.CrossRef

89.

Petkovic J, Welch V, Jacob MH, Yoganathan M, Ayala AP, Cunningham H, et al. The effectiveness of evidence summaries on health policymakers and health system managers use of evidence from systematic reviews: a systematic review. Implement Sci. 2016;11:162. https://doi.org/10.1186/s13012-016-0530-3.CrossRefPubMedPubMedCentral

90.

Mijumbi-Deve R, Rosenbaum SE, Oxman AD, Lavis JN, Sewankambo NK. Policymaker experiences with rapid response briefs to address health-system and technology questions in Uganda. Heal Res Policy. 2017;15:37. https://doi.org/10.1186/s12961-017-0200-1.CrossRef

91.

Murthy L, Shepperd S, Clarke MJ, Garner SE, Lavis JN, Perrier L, et al. Interventions to improve the use of systematic reviews in decision-making by health system managers, policy makers and clinicians. Cochrane Database Syst Rev. 2012;9:CD009401. https://doi.org/10.1002/14651858.CD009401.pub2.CrossRef

92.

Tricco AC, Cardoso R, Thomas SM, Motiwala S, Sullivan S, Kealey MR, et al. Barriers and facilitators to uptake of systematic reviews by policy makers and health care managers: a scoping review. Implement Sci. 2016;11:4. https://doi.org/10.1186/s13012-016-0370-1.CrossRefPubMedPubMedCentral

93.

• Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the sustainable development goals era: time for a revolution. Lancet Glob Heal. 2018;6:e1196–252. https://doi.org/10.1016/S2214-109X(18)30386-3. These three texts frame the need for systems engineering within the global focus on quality.

94.

• Berwick D, Snair M, Nishtar S. Crossing the global health quality chasm: a key component of universal health coverage. JAMA. 2018;320:1317–8. https://doi.org/10.1001/jama.2018.13696. These three texts frame the need for systems engineering within the global focus on quality.

95.

• World Health Organization, World Bank (2018) Delivering quality health services: a global imperative for universal health coverage. Geneva, Switzerland. These three texts frame the need for systems engineering within the global focus on quality.

Title: Making Smarter Decisions Faster: Systems Engineering to Improve the Global Public Health Response to HIV
Authors: Anjuli D. Wagner
Jonny Crocker
Shan Liu
Peter Cherutich
Sarah Gimbel
Quinhas Fernandes
Melissa Mugambi
Kristjana Ásbjörnsdóttir
Sarah Masyuko
Bradley H. Wagenaar
Ruth Nduati
Kenneth Sherr
Publication date: 01-08-2019
Publisher: Springer US
Keywords: Public Health
Human Immunodeficiency Virus
Published in: Current HIV/AIDS Reports / Issue 4/2019
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-019-00449-2

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ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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Current and Future PrEP Medications and Modalities: On-demand, Injectables, and Topicals

How to Evolve the Response to the Global HIV Epidemic With New Metrics and Targets Based on Pre-Treatment CD4 Counts

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage