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Data Driven QualityImprovement 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 improvingmaternal and newborn health outcomes in Uganda
•Demonstrate the effectiveness of modern qualityimprovement approaches in improving maternal andnewborn care at both the facility and community level.
•Operationalize the MOH community strategy
USAID HEALTH CARE IMPROVEMENT PROJECT
Findings of the facility baseline assessment inLuwero and Masaka districts by HCI/URC inDecember 2010
•Standard of newborn care could not be ascertained sinceservices were not adequately documented at facilities.
•Only 32% of health facilities surveyed had equipment forresuscitation of newborns
•46% mothers discharged before 24 hours for facilitydeliveries
•Health workers still emphasized postnatal follow-up 6weeks after delivery
•No mother/newborn and health worker interface during firstweek of life for home or facility births except in presence ofdanger signs noted by mothers
•Staff unaware of MOH newborn care standards.
Facility Collaborative Interventions
Provision of locally made cloth childbirth models forENC/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 Luwero
Locally Made Newborn Resuscitation Tables. Bag, Masks andPenguin Suction Device
USAID HEALTH CARE IMPROVEMENT PROJECT
TOT for 20 District Coaches in ENC/HBB/AMTSL andQuality Improvement
USAID HEALTH CARE IMPROVEMENT PROJECT
Training of 82 providers in ENC/HBB/AMTSL & QualityImprovement by the Coaches supported by URC/HCI Staff
USAID HEALTH CARE IMPROVEMENT PROJECT
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Coaches Preparing Action Plans for Visits to theirAssigned Health Facilities
USAID HEALTH CARE IMPROVEMENT PROJECT
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Monthly Coaching Sessions of Maternal/Newborn CareProviders in Masaka & Luwero Districts
Facility Improvement Collaborative Learning Session
USAID HEALTH CARE IMPROVEMENT PROJECT
Assessment of Maternal/Newborn Care atCommunity Level
•No VHTs trained in ENC
•No job aids
•No postpartum visits tomothers and newborns
•Poor data collection
•No quality improvementstrategy for VHTs
•No supportive supervisionmechanism in place
USAID HEALTH CARE IMPROVEMENT PROJECT
HCI Community Collaborative ImprovementInterventions
Training VHTs in EssentialNewborn Care, QualityImprovement, and DataCollection
USAID HEALTH CARE IMPROVEMENT PROJECT
USAID HEALTH CARE IMPROVEMENT PROJECT
Looking Ahead - Sustaining Gains and Scaling Up
Uganda:
•Demonstrated effectiveness of QI to improveMNH in Uganda
•Harvest Meeting September 2012
•Dissemination Meeting September 2012
•CORE funded MNCH Project ends Sept. 2012
•Opportune time for scale-up