From Learning Sessions to the Clinic: How HIVE Nigeria is Transforming Care in Delta State
In our recent HIV Impact Network for Vertical Transmission Elimination (HIVE) blog, we explored how Quality Improvement (QI) learning sessions are equipping frontline healthcare providers and facility teams with practical skills to strengthen the Vertical Transmission prevention (VTP) of HIV, syphilis, and hepatitis B. But the true value of QI lies not only in learning the methodology – it lies in how facilities apply these lessons to improve patient care in real time.
In March 2026, the HIVE Nigeria team, together with the National AIDS and STDs Control Programme (NASCP), the State AIDS and STDs Control Programme (SASCP), and the Excellence Community Education Welfare Scheme (ECEWS), conducted a joint monitoring support visit across PATA HIVE-supported facilities in Delta State.
The visits provided an opportunity to assess how QI principles introduced during learning sessions are being translated into day-to-day improvements in service delivery for pregnant and breastfeeding women. Across facilities visited – including General Hospital Okwe, Eku Baptist Government Hospital, Central Hospital Warri, and Central Hospital Ughelli – teams demonstrated growing ownership of QI processes through problem-solving, multidisciplinary teamwork, and strategic data use. This shows that QI is most effective when it becomes part of routine service delivery rather than a standalone activity.
Supportive supervision (in the HIVE context) is a collaborative, data-driven approach led by field technical officers working with facilities and districts to identify gaps, strengthen skills, and provide on-site mentorship. It supports continuous improvement by integrating QI and VTP approaches into routine service delivery through practical guidance, mentorship, in-service training, and ongoing follow-up.
A critical link between the QI learning sessions and the improvements being seen at the facility level is the role of Field Technical Officers who provide ongoing supportive supervision. Beyond facilitating learning sessions, Field Technical Officers work closely with facility teams to ensure that QI approaches are not treated as isolated, once-off activities within VTP programmes, but are fully integrated into routine service delivery across all service areas. They apply supportive supervision through skills transfer, hands-on mentorship, routine data review, and strengthening facility and district ownership of data quality processes.
During the Delta State support visits, this ongoing supervision created crucial opportunities for healthcare providers to:
- Clarify indicator definitions
- Strengthen their understanding of reporting tools
- Improve service and file flow within the clinic
- Address structural challenges collaboratively
- Test practical solutions within their unique facility settings
Shifting Mindsets: Data as a Driver for Action. One of the strongest themes emerging from the Delta State visits was the increasing use of routine data to guide facility improvement efforts. Teams reviewed registers, validated Nigeria National Data Repository (NDARS) data against facility records and assessed gaps in documentation and reporting.
These exercises reinforced one of the core messages of the HIVE QI learning sessions: "Data should not only be collected for reporting purposes; it should also actively drive action and accountability."
Regular data reviews and multidisciplinary discussions are now helping teams make faster, evidence-based decisions to improve patient outcomes.
Turning Priorities into Quick Wins
The Delta State support visits highlighted a clear roadmap of immediate actions (quick wins) designed to optimise maternal and infant care:
Some of the immediate wins identified during the visits included:
- Stronger follow-up systems, so that clients who miss appointments can be traced and supported back into care
- Improved communication between antenatal care, labour ward, and antiretroviral treatment and care services, so that pregnant and breastfeeding women receive more connected support
- More opportunities to talk to pregnant and breastfeeding women about PrEP as part of routine antenatal care, so they can understand their prevention options and make informed choices
- Simple quality improvement tools being used to review progress, identify gaps, and guide the next steps for each facility
- Stronger collaboration between clinical, data, and management teams, helping them solve problems together as one healthcare provider team
Closing reflection
The Delta State support visits demonstrated that the QI learning sessions are actively reshaping
how supportive supervision is implemented and how facilities approach service delivery, problem-solving, and teamwork. More importantly, the visit highlighted that QI is not a one-time intervention; it is an ongoing process of learning, testing, adapting, and improving. Through continuous supportive supervision, healthcare providers are encouraged to apply these core QI principles beyond VTP, extending them into postnatal care, paediatric services, and ART clinics. This helps shift facilities away from siloed programming toward more integrated, patient-centred systems of care.
By tackling documentation gaps and testing practical solutions for oral PrEP demand today, Delta State facilities are actively applying the "4 As" framework — Adopting best practices and Adjusting interventions to ensure health systems are fully prepared for future innovations like Lenacapavir (long-acting injectable PrEP).
Access HIVE Tools and Materials
Interested in learning more about HIVE methodology? Check out these resources:
- QI tools: QI-TOOLS-2.0.pdf
- PrEP flyer: Flyer-2.0.pdf
