HOW TO USE / HELP

Each topic of the toolkit has the following elements:

Description: defines the topic and how broadly or narrowly it will be discussed.

Checklist: serves as an assessment of the extent to which you are currently covering the topic. It uses the same set of questions to assess each topic. The checklist has links to guidance and advice for improving a particular aspect. It also allows you to document the improvement actions you decide on in an action plan at the end of each section.

Indicate your answer to each question by choosing green for YES, yellow for PARTLY and red for NO. If you find that a question does not apply, you can leave it blank, but we recommend that you document your reasons. If you chose yellow or red, it is an indication that you can improve this item. The further left in the checklist the red or yellow answers are, the more urgent is the need to improve them. You can find information, guidance and tools to improve your response by following the links. If you decide on actions, type them into the space in the last column and click to transfer them to the action plan.

This is what the checklists look like.

Guidance and tools: these sections only appear if you click on the links in the checklists. They provide detailed information and advice for each item and examples from CBVCT practice. They may contain the following:

• An explanation, including an acknowledgment of any contrasting viewpoints or current debates
• Guidance by experts and links to good practice documents
• Pointers for local adaptation about what is essential and what may be adapted, including examples and, where applicable, options for reducing costs
• Simple templates you can adapt for use in your CBVCT
• Recommendations for quality improvement methods and tools suitable for the topic.

Action plan: a table that automatically summarises the actions you typed into the last column of the checklist. It includes planning questions for making them easier to integrate into your day-to-day operational management.

You can fill in the action plan and then save or print, or save or print it now and fill it in later.

The toolkit covers core and complementary components of operating a CBVCT service for MSM. You can use the checklists in this toolkit to guide you through the operational planning of your CBVCT service:

4. Use the ‘Item’ column as a ‘To Do’ list.
5. Go to the next columns and list tasks to be completed, e.g.: find or draft policies, standards or procedures, negotiate contracts and agreements where appropriate.
6. Go to the next column and ensure that each item is adapted to your local context.
7. Skip the ‘Is it working as intended?’ column until your CBVCT has been operating for a sufficiently long period of time, and you have enough data and experience to review it.
8. Use the ‘Action’ column to monitor your planning process and fill any gaps.

The ‘Guidance and tools’ sections for each topic refer to examples and existing documents, or provide templates that you can use or adapt for your CBVCT.

Please note:

• You can use the toolkit in this way even after starting operations ­– sometimes you have to act without much planning if you are under pressure to provide services. The toolkit can help consolidate all aspects of CBVCT operations at any point in the development of the service.
• The toolkit is a practice-oriented guide. It does not cover the programme logic that documents the reasoning behind the strategic decision to set up a CBVCT service. This normally includes developing overall aims, specific objectives and evaluation indicators based on epidemiological and demographic data, needs and situation analyses, as well as references to higher order strategic documents or action plans such as national HIV policy documents or organisational plans. There are many useful planning tools that can guide the programme logic of your CBVCT, e.g.

Tools 1 to 3 in the toolkit of the CDC’s HIVTestingImplementationGuide_Final, available at http://www.cdc.gov/hiv/testing/nonclinical/

Intervention mapping resources, available at www.interventionmapping.com

The SMART Criteria, ZiWi and Programme Logic methods within the Participatory Quality Development (PQD) tool on www.quality-action.eu.

The topics in the toolkit and the items in each checklist form a basic standard for operating a CBVCT according to current practice and expert advice in Europe. You can therefore use the toolkit as a general quality assurance tool.

Please be aware that formal quality assurance standards and tools may apply to particular aspects of CBVCT operations, such as infection control, data management, waste disposal etc. These vary according to local regulations and this toolkit does not cover or replace any legal obligations you may have as the operator of a CBVCT facility in your location.

If you would like to use this toolkit for quality assurance, the topics ‘Operating environment’, ‘CBVCT Services’ and ‘Counselling and linkage to care’ are essential to include in an initial assessment. You can add the rest later for a more comprehensive assessment.

This toolkit has not been designed or validated to provide quality ratings, but your answers in the checklists indicate whether your CBVCT has the prerequisites for providing a quality service:

• If your answers are green in the first column (‘Does your CBVCT have this in place?’), and green or yellow in the second (‘Is there a documented standard, guideline, plan, policy, procedure, contract or agreement?‘), it is an indication that your CBVCT is able to operate at a basic level of quality.
• If your answers are green in the first two columns, and green or yellow in the third (‘Is it adapted to local conditions?‘), it is an indication that your CBVCT covers basic elements of a quality service and has the potential to reach its key population and fulfil its objectives.
• A red answer in the first column (‘Does your CBVCT have this in place?’) indicates that a core component of a CBVCT is missing. A red answer in the second (‘Is there a documented standard, guideline, policy, plan, procedure, contract or agreement?‘) or third (‘Is it adapted to local conditions?‘) column indicates that a component does not have a reliable enough foundation or may not suit the local context to function properly.

Apart from the specialised Euro HIV EDAT Self-Assessment Grids, there are broader quality assurance and improvement tools available to check the quality of your CBVCT as an HIV prevention intervention. You can use the Succeed tool for self-assessment or the QIP tool for an external review that includes specific recommendations by expert reviewers. You can find both tools, including further information and online learning resources at www.quality-action.eu.

Please also see ‘Quality improvement and innovation’ for details.

Apart from listing basic components of operating a CBVCT for MSM and making sure you have covered them, you can use this toolkit for developing your service further and for creating innovative approaches.

While quality assurance ensures that you meet the essential standards to achieve your objectives, quality improvement enables you to increase your ability to meet and exceed standards and maximises your chances of reaching your objectives. Quality improvement tools are designed to lead to change independent from your starting point; they aim for continuous improvement and innovation beyond any recognised standards (which may or may not exist).

In the checklists, the ‘Is it working as intended?’ question and your answer to it are the first steps towards structured quality improvement. You can use the Euro HIV EDAT Self-evaluation Grids as a starting point for quality improvement. In the ‘quality improvement’ sections, you can find further references to quality improvement tools that are particularly suited to each topic.

The quality improvement tools available on www.quality-action.eu are based on the principles of self-reflection and participation. This means that they encourage a safe and supportive working environment to enable a range of stakeholders to participate, reflect on their practice and develop new and innovative ideas to improve all aspects of a project. The participation of the key population is especially important in order to extend reach and maximise accessibility.

The involvement of the key population in quality improvement and innovation can be of particular benefit to services targeting disadvantaged groups, and is therefore relevant for CBVCTs targeting MSM. Several existing European CBVCTs targeting MSM have used the Succeed and PQD (Participatory Quality Development) tools and documented their experiences in short case studies. You can find these case studies in the searchable database on www.quality-action.eu.

*(statistics (e.g. COBATEST reporting), evaluation forms, client feedback, staff observations)

Part 1 of the quality improvement plan lists the actions you wrote in the ‘Action’ column while working through the checklist. 

*(staff, volunteer and stakeholder feedback)

Quality improvement plan part 2 lists the actions you wrote in the ‘Action’ column while working through the checklist. They can be concrete, practical improvements or further reviews (returning to the relevant section of the toolkit and working through the detailed checklist there).