No 1 – 02/2014

Quality now in Action!
In brief: What is Quality Action?
Quality Tools for Action
Applying the Tools
Quality Improvement Workshops about to start

Quality now in Action!

On behalf of all 42 associated and collaborating partners in 25 European countries, welcome to the first newsletter of Quality Action, the European Joint Action on improving quality in HIV prevention.

As coordinating partner, the team at the Federal Centre for Health Education (BZgA) in Cologne, Germany hopes this update will catch your interest and encourage you to find out how you can participate in and benefit from the activities of Quality Action.

In this edition you will find updates from the work packages on recent work and the key activities coming up in the next period.

Not only Quality Action partner organisations can access the QA/QI tools and participate in their practical application. If you are interested, go to and follow the menu to ‘get involved’. Quality Action offers a range of ways to benefit from its activities. You can subscribe to the newsletter, select and use one of the tools or even join as a collaborating partner.

In brief: What is Quality Action?

  • EU co-funded Joint Action – governmental and non-governmental organisations represent EU Member States
  • Aims to increase effectiveness by improving quality
  • Participation and self-reflection: self-directed process in a supportive environment, reflecting on our own work and involving stakeholders for a broader perspective
  • Evidence-based, practical quality assurance and quality improvement tools
  • Building capacity: train-the-trainer approach supports the use of the tools
  • Uses results for a ‘Charter for Quality in HIV Prevention’
  • Develops policy kit to integrate quality at the strategic level


Quality in implementation as a key factor in effectiveness is attracting the attention of people who plan, implement and evaluate HIV prevention interventions.

‘It is not enough to do the right things, we need to do the right things right’.

Are we focussing on the right target groups? Are we using all the resources we could access? Are we reaching as many people as we could? Do our methods fit our objectives? Are we collaborating with all important stakeholders? Is everyone clear about their role?

When the impact is less than we expected or hoped for – did we do all the right things, just not at a sufficient scale? Was it a good plan implemented poorly or a bad plan implemented well? And if the results are excellent, do we know why?

Improving quality is already part of the project cycle in most teams. But often it takes place inside the minds of individuals; it isn’t shared, checked or documented. Good ideas are lost because there is no time or structure to capture them and use them more widely. This is where evidence-based, practical quality assurance and quality improvement (QA/QI) tools make a contribution.

Quality Action takes an empowering approach to quality. It encourages HIV prevention teams at every level, from national or regional government programme managers to small NGO projects, to self-reflect on their work and to increase the participation of their stakeholders in making improvements. Each team is in charge of its own QA/QI process, deciding who to involve and how to use and share the results. Those who participate in Quality Action feed back anonymous data on the tools, the process and their results to inform our evaluation, a Charter for Quality in HIV Prevention and a policy kit.

The practical activities of Quality Action – building the capacity of trainers/facilitators and applying the QA/QI tools to programmes and projects in the participating countries – are getting started very soon. They take place in the second year of the project (March 2014 –February 2015). You can find more details about the activities of the different work packages and how you can get involved in this newsletter.

As coordinating partner for Quality Action, the BZgA team hopes you will want to find out more about using quality assurance and quality improvement from the partners in the Quality Action network. Even if you can’t formally participate, the tools and materials we use are freely available on our website.

Matthias Wentzlaff-Eggebert, BZgA

Quality Tools for Action

Quality Action is a unique EU- wide project because it promotes evaluated tools for quality assurance (QA) and quality improvement (QI) that are adapted to practice and useful for practitioners. The tools employ different methodologies and processes and can be matched to different contexts and approaches in HIV prevention. An important aspect of the tools is that they make participation of target groups and other stakeholders possible. The need for this participation in policy, programme and project development is often emphasised in international guidelines.

The tools are based on scientific research findings about methods and success factors in implementation. They are adapted to HIV prevention and can be used in the different settings where prevention activities take place. HIV prevention is a long term endeavour, and is constantly being adapted to new settings. The purpose of the tools and their methodologies is to mobilise the interest and commitment of the people working in HIV prevention to strengthen the quality of the long-term HIV prevention response.
Researchers and practitioners in Germany and Sweden developed three of the tools – Quality in Prevention (QIP), Participatory Quality Development PQD and Succeed – prior to Quality Action. We have developed two additional tools: a quality assurance tool for health promotion and prevention targeted to people who inject drugs (PWID) (working title: QATH PWID) and a quality improvement tool for use at the programme level (working title: ‘Schiff’). We will revise these new tools based on feedback from projects and organisations participating in Quality Action.

Quality in Prevention (QIP) is a comprehensive questionnaire that is useful for well-defined interventions and/or projects who are interested in an external review. It takes several days of work to document all the necessary information, which is then reviewed and scored by external experts. QIP provides the scores and feedback from the external experts to the project team. The feedback focuses on areas where quality improvement is possible and will help strengthen the project.

Succeed is a straightforward self-assessment questionnaire that works well when applied with a participatory approach. Stakeholders and representatives of target groups can join the analysis and discussions on quality improvement. Succeed can be used by small projects and also as a first step into quality improvement for all projects, large or small. The assistance and support of a trained facilitator will help the process.

Participatory Quality Development (PQD) offers some core principles such as participation, local knowledge and collaboration and a toolbox of participatory methods that can be used at different stages of a project. The intention is to use them throughout the project cycle, from needs assessment through planning and implementation to evaluation. The toolbox does not provide a structured assessment, but as long as you know which aspects of your project need improvement (which you will know after applying, for example, QIP or Succeed) the PQD methods can be used to achieve improvements.

Quality Action has developed the programme-level tool ‘Schiff’ to support national and regional program managers and strategic planners and/or committees. It builds on the existing tools, indicators used for global and European HIV reporting and policy documents. Schiff is a discussion guide to reflect on and analyse current programmes and identify gaps and needs for improvement. A participatory approach involving the main stakeholders (policy makers, experts, target group representatives etc.) is recommended. This tool requires facilitation by a trained facilitator. Schiff will be tested and evaluated by programmes and experts participating in Quality Action.

The ‘QATH PWID’ tool is a quality assurance tool for health promotion interventions targeting people who inject drugs (PWID). It is based on an existing, well-documented Dutch tool called ‘Preffi’. It focusses on social determinants and the behavioural aspects of HIV prevention for people who inject drugs (PWID). These aspects are not always covered by official indicators, although PWID are a key population for HIV prevention across Europe, and one for whom social determinants play an important role. This new quality assurance tool provides structured and practical assessment and measurements and helps you identify areas for improvement. It will also help you track quality over a period of time. This tool will be tested and evaluated by projects and organisations participating in Quality Action.

Quality Action focuses on the quality of HIV prevention activities in a broad sense. Social and behavioural interventions are often described in general terms in scientific guidelines and recommendations. The many different interdependent factors and aspects of the practical work are often difficult to reflect in indicators, research, monitoring and evaluation. The Quality Action tools provide options for structured analysis and reflection in a manner that is practical and meets the needs of the different, complex projects and approaches that exist in HIV prevention.

Viveca Urwitz & Frida Hansdotter, The Public Health Agency of Sweden

Applying the Tools


Whether in local grassroots organisations, in civil society or in governmental organisations – there is far too rarely an opportunity for employees to break free from their daily working routine and look analytically at their own work from a distance.

Quality assurance and quality improvement (QA/QI) tools for HIV prevention enable organisations and empower people to locate their own strengths and the rationale behind successful interventions. If nothing else, this is how ideas can arise about how to further improve the work.

Quality Action aims to provide interested organisations and initiatives all over Europe with tools to improve quality and effectiveness in HIV prevention.

“In Quality Action, participating organisations and individuals are empowered to use QA/QI tools for self-determined processes to examine success factors” says Carolin Vierneisel. Carolin works for Deutsche AIDS-Hilfe (Berlin, Germany), the partner coordinating the practical applications of QA/QI tools.

Practical application of QA/QI tools seeks to support processes of reflection and team building and builds on the key principle of participation. Quality Action has published a ‘Participation guide’ on its website. The guide aims to support all organisations, programmes and projects that are interested in applying the tools to get involved in Quality Action. As each tool has different advantages, the guide includes an introduction to each. The diversity of the tools reflects the variety of HIV prevention projects and programmes. Selecting the most suitable tool will depend on the type, size and complexity of a project or programme, available resources and many other factors.

We have established a contact point to provide support and additional information in each country that is a partner in Quality Action.

For more information on the practical application of QA/QI tools, visit our website

Team of Deutsche AIDS-Hilfe e.V.

Quality Improvement Workshops about to start


“Quality is never an accident; it is always the result of intelligent effort”. (John Ruskin)

Quality Action originally aimed to train at least 60 people in Europe in the use of QA/QI tools for HIV prevention. To date, more than 90 people have already registered to attend the first round of Europe-wide training workshops. Further training sessions will be organised at the country level. The Europe-wide training will provide knowledge and skills to apply the five Quality Action tools. Participants have chosen to learn about using QIP, Succeed, PQD, QATH (PWID) or the programme-level tool ‘Schiff’. All materials about the tools will be available on the Quality Action website soon.

Training workshops will take place in four different cities across Europe: Dublin (April 9th to 11th), Barcelona (April 28th to 30th), Ljubljana (May 7th to 9th) and Tallinn (May 13th to 15th). Four follow-up workshops will be held in November 2014 and January 2015 to further strengthen the skills of participants once they have had the opportunity to implement the tools in their particular settings.

The training workshops offer an exciting opportunity for professionals working in HIV prevention to apply a structured and evidence-based approach to quality assurance and improvement in their work. They will also enable interaction with other experts on the national and international level. After the first round of training, participants will return to their organisations and apply one of the tools in their work as well as assisting others to do the same.

In addition to organising the training workshops, a general training manual on QA/QI will be developed to support the trainers/facilitators in delivering training in their own countries. An eLearning programme will be available through the Quality Action website. The aim of the capacity building work and of the training materials developed in Quality Action is to ensure the use of QA/QI tools in an on-going way, beyond the project period of Quality Action.

There is a saying in Ireland, “Ní neart go cur le chéile”, which means “there is no strength without unity”. Quality Action provides a unique opportunity to improve HIV prevention work, connect with others and benefit from the experiences of those who have developed and applied the tools. Most importantly, this is a Joint Action across Europe and, as such, each country commits to doing better. What a great opportunity!

Deidre Seery, Sexual Health Centre



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