Closing the delivery gap: Operationalizing the care delivery value chain and continuous quality improvement for HIV/AIDS services in Kara, Togo

Kevin Peter Fiori, Jennifer Schechter, Sesso Christophe Gbeleou, Sandra Braganza, Joseph Rhatigan, Spero Houndenou, Andrew Lopez, Emily Bensen, Lisa Hirschhorn

Research output: Contribution to journalArticlepeer-review


Purpose: The purpose of this paper is to describe the authors’ experience operationalizing the care delivery value chain (CDVC) as a management and continuous quality improvement (QI) approach to strengthen HIV/AIDS services provided in Northern Togo through addressing gaps across a care continuum. Design/methodology/approach: The authors led a series of discussions to develop a CDVC specific to existing HIV/AIDS services in Northern Togo. Using the CDVC framework, 28 specific gaps in service delivery were identified and integrated into a strategic QI plan. Findings: At 12 months, 92 percent of delivery gaps had demonstrated improvement. The CDVC framework proved to be valuable in the following ways. First, it facilitated the first comprehensive mapping of HIV/AIDS services in the Kara region of Togo. Second, it enabled the identification of gaps or insufficiencies in the currently available services across the full continuum of care. Third, it catalyzed the creation of a strategic QI plan based on identified gaps. Research limitations/implications: This case description is the authors’ experience in one setting and should not be considered comparative in nature. Furthermore, the approach described may not be applicable to all initiatives and/or organizations. As described, the lack of sophisticated and comprehensive data collection systems limited the authors’ ability to collect reliable data on some of the QI initiatives planned. Practical implications: The operationalization of the CDVC framework is an effective approach to drive continuous QI. Originality/value: Through the operationalization of the CDVC, the authors developed a new approach for assessing existing services, identifying gaps in service delivery and directing continuous QI initiatives in a strategic manner.

Original languageEnglish (US)
Pages (from-to)327-336
Number of pages10
JournalInternational Journal of Health Care Quality Assurance
Issue number4
StatePublished - 2018


  • Care delivery value chain
  • Continuous quality improvement
  • Togo

ASJC Scopus subject areas

  • General Business, Management and Accounting
  • Health Policy


Dive into the research topics of 'Closing the delivery gap: Operationalizing the care delivery value chain and continuous quality improvement for HIV/AIDS services in Kara, Togo'. Together they form a unique fingerprint.

Cite this