Health Worker TB Prevention at Msambweni Hospital, Kenya – ACQUIRE QI Patient Safety Cohort 2 2026

Triza Ireri shares how the Msambweni County Referral Hospital team in Kwale, Kenya is increasing uptake of tuberculosis preventive therapy (TPT) among the hospital's own eligible health workers. As of June 2026, only 15 of 291 eligible health workers had been screened and started on TPT, an uptake of just 5.2%. In line with the facility's mission and national TPT targets, the team set out to raise uptake from 5.2% to 50% by 31 December 2026. Their current state analysis found many unscreened health workers, no standardised screening workflow, incomplete TPT documentation and limited knowledge of TPT; what surprised them most was how many opportunities were missed because staff simply did not know about the programme. A fishbone diagram and Pareto chart pointed to low awareness and fear of side effects as the two biggest causes. The team identified five key drivers and ran its first PDSA cycle on sensitising health workers. Despite an industrial action from July to the first week of September, uptake rose from 5% at baseline to 12.3% by the first week of October, and the team is continuing towards its 50% target. To sustain the work, the IPC and TPT teams will keep raising awareness through routine screening, while the CQI team and TPT champions monitor uptake. Their key learning: continuous mentorship and a clear understanding of CQI principles strengthen teamwork, while keeping data collection going during disruptions remains the challenge. Samora Michelle, Lead Coach, commended the team for keeping up the momentum through the industrial action, noting that prevention is the first safety measure. Team leadership: Triza Ireri Mentorship: Ruth Molefhe Team: Hanifa Mwarora, Mercy Mazera, Michael Wanyori, Peter Wahome, Risper Kahindi Chapters 0:00 Introduction 0:30 Problem statement 1:01 Target and baseline 1:28 Current state analysis 1:57 Root causes 2:20 Key drivers and interventions 2:35 Results and expected impact 3:31 Sustain plan 3:55 Learning and challenges 4:40 Feedback and celebration This project is part of the 2026 ACQUIRE Quality Improvement-Patient Safety (QI-PS) Experiential Leadership Program, where frontline health workers across sub-Saharan Africa learn improvement science by leading real change in their own facilities. Quality takes a team! Learn more: https://acquirefrontline.org #QualityImprovement #PatientSafety #Tuberculosis #TBPrevention #HealthWorkerSafety #Kenya #ACQUIRE