Quality Improvement

  • Blog post
    December 21, 2012

    Quality Improvement and Human Resources Management Enhances HIV Services in Tanzania

    Dr. Stella Mwita, Dr. Yohana Mkiramwene, Kim Ethier Stover, and Tana Wulji, Quality Improvement Advisors working with USAID’s Health Care Improvement Project (HCI) in Tanzania, also contributed to this blog.

    We are the Quality Improvement Advisors to University Research Co., LLC, in Tanzania. In this role, we support the Tandahimba District in Mtwara Region in combining improvement and health workforce development approaches through the Tanzania Human Resources for Health Quality Improvement Collaborative. Our efforts aim to improve anti-retroviral therapy and prevention of mother-to-child transmission care.

    A quality improvement team develops a process map on enrollment in HIV treatment at Tandahimba District Hospital, Mtwara, Tanzania

    A quality improvement team develops a process map on enrollment in HIV treatment at Tandahimba District Hospital, Mtwara, Tanzania. 

    Photo by Yohane Mkiramweni, URC.

    The Tandahimba District has a severe shortage of health care workers in most of its health facilities. Rather than trying to add more health workers, USAID, HCI, and the Ministry of Health (MOH) decided to focus on maximizing the productivity of the few existing staff.  We expected that improved productivity might cover the service gaps created by the shortage of health workers.  Our work in Tanzania is adapted from HCI’s successful experience in Niger, where teams improved productivity, engagement, and clinical outcomes by combining human resources interventions and improvement approaches. 

    University Research Co.
    Quality Improvement
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  • Blog post
    May 22, 2012

    We Can Make Health Care Better: The Salzburg Call to Action

    We can make health care better for every patient, every time care is needed. We know how—we have the knowledge and the tools to make it happen.  And we can do it largely with the resources available in any given country.

    This novel yet simple idea was the outcome of an intensive, five-day meeting last month of 58 health leaders from 33 countries.  They gathered at the Salzburg Global Seminar, “Making Health Care Better in Low and Middle Income Economies: What are the next steps and how do we get there?” to chart a learning and action agenda to improve the performance of health systems in even the most resource-constrained settings. 

    Image-Salzburg Call to Action

    The Salzburg Call to Action

    They issued their conclusions in a joint statement signed by all 58 participants: Better Care for All, Every Time: A Call to Action. 

    What is different about this call?  I remember well the call for “Health for All by the Year 2000” which went sorely unheeded.  And of course, there are the current Millennium Development Goals, which call for substantial reductions in maternal and child mortality by 2015—a target that many nations are not on track to meet.   

    For one thing, the Salzburg Call to Action focuses on the how—what strategies and policies can get us there. The big idea put forth in Salzburg is that powerful methods are available and can be applied in even weak and severely under-funded settings to make care better now. They are known by many names, but can be termed simply: quality improvement methods.

    Salzburg Call to Action
    Quality Improvement
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  • Postpartum Hemorrhage: Prevention and Management Toolkit
    Updated: September 26, 2012

    Preventing PPH: Why Quality Improvement Matters

    Reliable administration of AMTSL depends on essential health system functions that are often weak in high-mortality settings—hence the common failure of health services to deliver AMTSL even when endorsed by official standards. QI approaches such as the improvement collaborative are an effective strategy for strengthening essential health system functions to accelerate scale-up of AMTSL and other high impact interventions and should be a part of every maternal and newborn health program.