wards of Uganda, enrolling patients into their studies and adding to the evidence base for appropriate care. But what they see all too frequently is care that is not tied to strong medical evidence. Patients go undiag-
dedicated to disseminating the guidelines. We are an in-country partner for the Alliance and support their efforts to scale training. In addition, we developed the Severe Illness Management Support (SIMS) program,
A doctor at Mulago Hospital assessing a patient with a Walimu diagnostic kit.
nosed, or improperly managed. And while the lack of resources plays a role, it is only part of the explanation. Walimu was founded to bridge the gap between what we know works and what actually happens everyday on the wards. We work primarily as a strategic and implementation partner for the IMAI-IMCI Alliance, an organization
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which supports the training through a series of behavioral change interventions that enable uptake and reinforce adoption of the IMAI guidelines. The program includes essential diagnostic equipment to enable health worker uptake of recommended practices, point-ofcare access to the guidelines via mobile phones or tablet computers, and regular per-
formance feedback to reinforce adherence to IMAI management guidelines. Even as we support the training efforts of the Alliance, we are exploring new ways to change health provider behavior. At Mulago National Referral Hospital, we have begun a continuous quality improvement program. The program collects data on essential tasks for severe illness management, feeds that data back to ward staff, and then works with ward staff to design quality improvement projects. We hope to gradually transform management on the ward to adhere to international standards of excellence. A focus on quality of care can yield great improvements in health, even while decreasing the cost of care. As the evidence base for resource-limited settings grows, the global health community should add quality alongside access and prevention as a central goal of international efforts. www
Elijah is a Junior in Pierson College. He is interested in leveraging technology and data to improve global health. You can reach him at elijah.goldberg@yale.edu.