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

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

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.

Facility Collaborative Interventions

Provision of locally made cloth childbirth models for ENC/AMTSL training

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

USAID HEALTH CARE IMPROVEMENT PROJECT

TOT for 20 District Coaches in ENC/HBB/AMTSL and Quality Improvement

USAID HEALTH CARE IMPROVEMENT PROJECT

Training of 82 providers in ENC/HBB/AMTSL & Quality Improvement by the Coaches supported by URC/HCI Staff

USAID HEALTH CARE IMPROVEMENT PROJECT9

Coaches Preparing Action Plans for Visits to their Assigned Health Facilities

USAID HEALTH CARE IMPROVEMENT PROJECT10

Monthly Coaching Sessions of Maternal/Newborn Care Providers in Masaka & Luwero Districts

Facility Improvement Collaborative Learning Session

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

USAID HEALTH CARE IMPROVEMENT PROJECT

HCI Community Collaborative Improvement Interventions

Training VHTs in Essential Newborn Care, Quality Improvement, and Data

Collection

USAID HEALTH CARE IMPROVEMENT PROJECT

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