The 130th Annual Meeting of APHA

Abstract #49874

Janet Bradley¹, Moustapha Diallo, MBA¹, Fatoumata Fofana¹, Alpha Camara¹, Frederick Sawe, MD¹, Susan Igras, MPH², Amy Shire, MPH¹, and Julie Becker, MSc¹. (1) EngenderHealth, 440 Ninth Avenue, New York, NY 10001, (2) Health Unit, CARE International - USA, 151 Ellis Street, NE, Atlanta, GA 30303

“We ourselves can solve most problems”: Participatory approaches to quality improvement for child health

Learning Objectives: After the presentation, participants will be able to: describe the impact of staff-driven problem-solving on quality of care at eight child health facilities in Kenya and Guinea; assess the applicability of participatory quality improvement approaches to other clinical health care settings.

COPE (Client Oriented, Provider Efficient) is a team self-assessment methodology developed by EngenderHealth to improve the quality of reproductive health services. Within a framework of clients’ rights and provider needs, staff in a service delivery site use group assessment tools to observe services and gather feedback from clients. Drawing upon their findings and their own expertise, staff collectively develop action plans to resolve problems identified, using local resources where possible. In 1998, EngenderHealth adapted COPE to child health services.

From 1999-2001, EngenderHealth conducted an evaluation of COPE for Child Health’s use in Guinea and Kenya, comparing eight intervention and eight non-intervention sites. Final results - after five cycles of COPE exercises at each intervention site - show intervention sites performing significantly better than control sites on almost every indicator of service provision. Changes include more respect for clients, more information and greater privacy given to clients, and improvements in communication skills, diagnostic skills, home care instructions, prescribing practices and immunization practices. Staff developed a strong sense of empowerment, as typified by one participant: “Before, most problems were someone else’s responsibility… we now see that we ourselves can solve most problems.”

Learning Objectives: By the end of the presentation, participants will be able to

• Describe the impact of staff-drived problem-solving on the quality of care at eight child health facilities in Guinea and Kenya;
• Assess the applicability of participatory approaches to quality improvement to other clinical health care settings.

Keywords: Quality Improvement, International MCH

Presenting author's disclosure statement:
Disclosure not received
Relationship: Not Received.