Data Driven Quality Improvement in Uganda Annie Clark, URC Sr. QI Advisor MNCH
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Data Driven Quality Improvement in Uganda Annie Clark, URC Sr. QI Advisor MNCH
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USAID HEALTH CARE IMPROVEMENT PROJECT
What are we trying to accomplish in Uganda?
• Support the MOH and USAID strategy for improving maternal and newborn health outcomes in Uganda
• Demonstrate the effectiveness of modern quality improvement approaches in improving maternal and newborn care at both the facility and community level.
• Operationalize the MOH community strategy
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USAID HEALTH CARE IMPROVEMENT PROJECT
Findings of the facility baseline assessment in Luwero and Masaka districts by HCI/URC in December 2010
• Standard of newborn care could not be ascertained since services were not adequately documented at facilities.
• Only 32% of health facilities surveyed had equipment for resuscitation of newborns
• 46% mothers discharged before 24 hours for facility deliveries• Health workers still emphasized postnatal follow-up 6 weeks after
delivery• No mother/newborn and health worker interface during first week
of life for home or facility births except in presence of danger signs noted by mothers
• Staff unaware of MOH newborn care standards.
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Facility Collaborative Interventions
Provision of locally made cloth childbirth models for ENC/AMTSL training
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Provision of Helping Babies Breathe training equipment, educational material and job aids
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Equipment supplied to facilities in Masaka and LuweroLocally Made Newborn Resuscitation Tables. Bag, Masks and
Penguin Suction Device
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USAID HEALTH CARE IMPROVEMENT PROJECT
TOT for 20 District Coaches in ENC/HBB/AMTSL and Quality Improvement
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USAID HEALTH CARE IMPROVEMENT PROJECT
Training of 82 providers in ENC/HBB/AMTSL & Quality Improvement by the Coaches supported by URC/HCI Staff
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USAID HEALTH CARE IMPROVEMENT PROJECT9
Coaches Preparing Action Plans for Visits to their Assigned Health Facilities
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USAID HEALTH CARE IMPROVEMENT PROJECT10
Monthly Coaching Sessions of Maternal/Newborn Care Providers in Masaka & Luwero Districts
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Facility Improvement Collaborative Learning Session
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USAID HEALTH CARE IMPROVEMENT PROJECT
Assessment of Maternal/Newborn Care at Community Level
• No VHTs trained in ENC • No job aids• No postpartum visits to
mothers and newborns• Poor data collection• No quality improvement
strategy for VHTs• No supportive supervision
mechanism in place
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USAID HEALTH CARE IMPROVEMENT PROJECT
HCI Community Collaborative Improvement Interventions
Training VHTs in Essential Newborn Care, Quality Improvement, and Data
Collection
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USAID HEALTH CARE IMPROVEMENT PROJECT
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USAID HEALTH CARE IMPROVEMENT PROJECT
Looking Ahead - Sustaining Gains and Scaling Up
Uganda:• Demonstrated effectiveness of QI to improve
MNH in Uganda• Harvest Meeting September 2012• Dissemination Meeting September 2012• CORE funded MNCH Project ends Sept. 2012• Opportune time for scale-up