Mapping care pathways: Clinical providers' perspectives on process maps of HIV service delivery in Uganda

In Uganda, where HIV prevalence remains high, innovative strategies are sought to achieve 95-95-95 targets in combating the epidemic. In 2020, Uganda joined the Activity-Based Costing and Management (ABC/M) Initiative, a multi-country effort to monitor resource allocation and funding for HIV services. As part of this Initiative, data collectors generated process maps, specific to each facility, from the data collected by observing patients as they navigated the healthcare system. This study assessed clinical providers' perceptions of process maps used in the ABC/M Initiative in Uganda to identify the benefits and limitations in informing service delivery. Clinical providers from 14 purposively selected facilities participated in key informant (KI) interviews to review and discuss process map impressions. Thematic content analysis revealed: (1) KIs were enthusiastic about process maps, recognising their value in quality and efficiency; (2) KIs perceived opportunities for improvements, including revising how process maps depicted the staff and infrastructure; and (3) KIs expressed confusion in interpreting specific facets of process maps. Our study highlights the nuanced perspectives of clinical providers regarding process maps' functions within their facilities. These findings underscore the importance of ongoing review and analysis of process maps within the ABC/M initiative, facilitating a culture of continuous quality improvement and enhanced resource allocation.