QI changes are focused on the three main gaps along the continuum of HIV services: (1) HIV testing and referral; (2) Linkage and enrollment of PLHIV into care and treatment; (3) ART initiation and adherence. From the package of 42 changes, 13 of them were found to be effective in closing the gaps in the HIV service cascade. Other changes continue being tested through PDSA cycles, and new changes will be developed at the learning sessions. 

Successful QI changes are illustrated through the regional QI success stories (see attachments below). The success is illustrated by process indicators specific to each demonstrating a positive trend, or excess over a baseline median measured before the 
change was implemented. Each process indicator also represents a contribution to the higher-level outcome indicator related to the corresponding gap in the HIV service cascade.