Implementation of Quality Assurance in Reproductive & Child Health Services Project in Maharashtra State
Keywords:
Checklists, Team, Assessment, Visits, GradingAbstract
Introduction: Globally ‘quality health care’ and particularly the domain of Reproductive and Child Health (RCH) services attract substantial attention. United Nations Population Fund (UNFPA) implemented Quality Assurance in Reproductive and Child Health Services Project in India. This study was conducted to document evolution and process of implementation of that project.
Methodology: It was a descriptive study using mixed methods. Authors analysed statistics generated through reviewing secondary data, visits to health care institutions, interviewing various stake holders and focused group discussions.
Results: Regular visit to health institutions by a multidisciplinary trained team was the core strategy. The districts in the project were added in four phases. In each selected district institutions were added in rounds. The number of institutions covered in first three phases was 1,231. Checklists and grades were prepared for different types of institutions. Government trained 903 personnel for paying visits to institutions. Only 53.65% planned visits were actually paid. There was improvement in grades. The women appreciated the quality improvement activities.
Conclusions: The process of expansion adopted in this project demonstrates its applicability in any large geographical areas and particularly resource-crunch areas. The involvement of in-house multidisciplinary team is effective and self-sustaining.
References
World Health Organization. Standards for improving quality of maternal and newborn care in health facilities. 2016. Available at https://www.who.int/maternal_child_ado-lescent/documents/improving-maternal-newborn-care-quality/en/. (Accessed in March, 2019).
Bruce J. Users' perspectives on contraceptive technology and delivery systems highlighting some feminist issues. Technology in Society. 1987 Jan 1;9(3-4):359-83.
Bruce J. Fundamental elements of the quality of care: a simple framework. Studies in family planning. 1990 Mar 1;21(2):61-91.
Jain AK. Fertility reduction and the quality of family planning services. Studies in family planning. 1989 Jan; 20 (1):1-6.
Engender Health’s Quality Improvement Series. COPE, for Reproductive Health Services, A Tool book to Accompany the COPE Handbook. 2003. Available at https://www. en-genderhealth.org/files/pubs/qi/toolbook/cope_toolbook-a.pdf. (Accessed in October, 2018).
Ninama R, Bhola C, Kadri AM, Vala M. Assessment of quality of MCH care services and client satisfaction for these services provided under primary health care in Rajkot district, Gujarat. India. Healthline, Journal of Indian Association of Preventive and Social Medicine. 2014;5 (1):14-8.
Singh K, Speizer I, Handa S, Boadu RO, Atinbire S, Barker PM, Twum-Danso NA. Impact evaluation of a quality improvement intervention on maternal and child health outcomes in Northern Ghana: early assessment of a national scale-up project. International journal for quality in health care. 2013 Aug 7;25(5):477-87.
Rashmi BV. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District). Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2010 Jan;35(1):24-28.
Akachi Y, Kruk ME. Quality of care: measuring a neglected driver of improved health. Bulletin of the World Health Organization. 2017 Jun 1;95(6):465-472.
Prayas. Annual report 2010-11, Chittorgarh-312 001, Rajasthan, India. 2011: 9-16.
Chavda P, Misra S. Evaluation of input and process components of quality of child health services provided at 24× 7 primary health centers of a district in Central Gujarat. Journal of family medicine and primary care. 2015 Jul;4(3):352-358.
Tamburlini G, Yadgarova K, Kamilov A, Bacci A. Improving the quality of maternal and neonatal care: the role of standard based participatory assessments. PLoS One. 2013 Oct 22; 8(10):e78282.
Tamburlini G, Siupsinskas G, Bacci A, Maternal and Neonatal Care Quality Assessment Working Group. Quality of maternal and neonatal care in Albania, Turkmenistan and Kazakhstan: a systematic, standard-based, participatory assessment. PLoS One. 2011 Dec 22;6(12):e28763.
Khan ME, Mishra A, Sharma V, Varkey LC. Development of a quality assurance procedure for reproductive health services for district public health systems: implementation and scale-up in the state of Gujarat. Population council, USAID, UNFPA. 2008 Apr.
National Health Mission. Quality Assurance Project. Available at https://www.nrhm.maharashtra.gov.in/qap.htm (Accessed in October, 2018).
National Accreditation Board for Hospitals & Healthcare Providers. Available at http://www.nabh.co/frmView Accredited PHC.aspx (Accessed in October, 2018).
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