Elom Otchi

Africa Institute of Healthcare Quality Safety & Accreditation

Title: Institutionalizing Quality of Care for Women and Children’s Health in Congo, Malawi and Namibia: Approaches and Lessons Learnt.

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Biography

Abstract

Background: Globally, 4.5 million mothers and newborns die annually mainly from preventable causes, majority in Lower-Middle-Income-Countries (LMICs). High-quality health systems could prevent 1 million newborn and half of maternal deaths each year globally. In 2016, World Health Organization outlined a Vision for improving quality of care for mothers and newborns, operationalization of which is ongoing in countries. This study looked at approaches and lessons learnt in institutionalizing quality of care (QoC) for maternal and newborn health in Congo, Malawi and Namibia.

Methods: This was a qualitative study that used observation, Key Informant Interview (KII) and Focus Group Discussion (FGD) for data collection. We visited twenty (20) health facilities in the three study countries- six were referrals, 6 secondary level and eight (8) primary level; undertook 16 FGDs with an average of 11 participants and interviewed 22 respondents whose roles were service delivery (doctors, nurses, public health officers etc), partners, and administration/policy (medical directors, district directors etc). Data was analyzed thematically along the WHO Health Systems Building Blocks using NVivo 14.0.

Findings: Ninety percent of the facilities visited were government owned while the remaining 10% were Faith based. Seven (35%) of the facilities in Malawi and Namibia were QI learning sites. Overall, notable approaches used in institutionalizing MNH quality of care include development and implementation of National Healthcare Quality Policies and Strategies (NQPS), use of Standards, and health systems strengthening. Lessons learnt: availability of NQPS facilitates a systematic implementation of any QoC program and sustainable financing is core.

Conclusion: Systematic implementation of an NQPS approach is critical for scaling up and integrating QoC interventions into the health systems in the WHO Africa region. This review demonstrated marked differences in QoC between countries that had developed and were implementing NQPS and those that were not. The finding could be attributed to the pervasive health systems weaknesses.