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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-53Learning from the Expansion of HIV-Related Stigma and Discrimination (S+D)Reduction Quality Improvement (QI) Project in Government Primary Health ClinicsMalaysiaNur Ezdiani M1, Samsiah A1, Izzatur Rahmi MU1, Divya Nair N1, Normaizira H1, Nurhayati S1, KhalidahM1, Zailatul Hani MY2, Roslina S1, Mariyah M1, Mazliza R2, Anita S31 Centre for Healthcare Quality Research, Institute for Health Systems Research, National Institute for Health,Selangor2 HIV/STI/Hep C Sector, Disease Control Division, Ministry of Health Malaysia3 Disease Control Director Of ice, Ministry of Health MalaysiaINTRODUCTION:Stigma and discrimination (S+D) can harm the well-being of people living with HIV (PLHIV) by creatingobstacles to prevention, treatment and care. In Malaysia, this concern impedes achieving UNAIDS%u201995-95-95 targets. To address this, a partnership was formed involving the national HIV technical advisor(HIV/STI/Hep C Sector, Ministry of Health (Sector)), the research institute leading the qualityimprovement (QI) training (Institute for Health Systems Research), and the Malaysian AIDS Council,with support from UCSF-HEALTHQUAL. This collaboration aimed to use the QI approach to reducestigma and discrimination in government health facilities.METHODOLOGY:Phase 1, conducted between February 2020 and December 2021, involved four hospitals and six primarycare clinics. In this phase, the baseline survey involving 3880 healthcare workers and 1173 PLHIVmeasured their S+D status. The phase 2 staggered expansion encompassed 55 clinics and measured S+Damong 6215 healthcare workers and 1499 PLHIV.RESULTS:Critical expansion factors involved established governance roles between the Sector, IHSR and MAC forproper project management. Strengths-based learning involved Phase 1 change champions sharingexperiences for emulation in Phase 2 clinics. A scalability assessment tool explored input from the Phase2 clinics to identify facilitators and barriers in the expansion preparation. Shared tools like a nationalcentralised data collection system, knowledge, attitude, and practice assessment tool, best practicecompendium and QA workbook were used. A total facility approach improved team coordination byengaging all clinic staff across various in surveys, observing their work process to identify S+D pitfalls,and involving them in designing and implementing the remedial measures. Staggered regionalimplementation enhanced organisational learning via targeted facility training sessions. Inter-cliniclearning was fostered through understanding analysis or intervention designing.DISCUSSION:Defined governance, shared learning, structured activities and a total facility approach facilitatedexpansion. Yet, the reducing response trend and plateauing results warrant exploration to ascertainwhether strategies were institutionalised.156 | Page