The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #69257

Erin Mielke, MPH, Quality Improvement, EngenderHealth, 440 Ninth Avenue, New York, NY 10001, 212-561-8061, emielke@engenderhealth.org, Brahima Bassane, MD, Burkina Faso Office, Family Care International, c/o 588 Broadway, Suite 503, New York City, NY 10012, and Pamela L. Bolton, MHS, Africa Program, Family Care International, 588 Broadway, Suite 503, New York City, NY 10012.

COPE (Client-Oriented, Provider-Efficient services) is a process and set of tools for all levels of health care staff and supervisors to improve the quality of services. Since 1988, EngenderHealth has been developing, refining and adapting the COPE methodology for a variety of reproductive health services and clients, including for maternity care services.

As part of the Skilled Care Initiative, in July 2002 FCI and local partners implemented Maternity COPE in two sites in Ouargaye District in Burkina Faso: the district hospital and one health center. At each site, staff received training in implementing COPE, and then formed teams that included a spectrum of staff, from guards and cleaners to doctors, nurses and administrators. These teams used the COPE self-assessments guides to investigate quality issues relating to maternity care in their sites, and formulate and implement solutions. Each team has created action plans, identifying a range of problems and creating timelines for their solution. Problems included stock-outs of drugs, inadequate care for women with episiotomies, insufficient privacy for counseling sessions, inadequate benches and shade in the waiting areas, leaky roofs, and dirty toilets. The problems and their solutions will be described. The COPE methodology proved to be easily understood and applied by health facility staff in Burkina Faso. The process helped staff focus on the particular needs of maternity clients and led to a number of easily implemented and low-cost improvements in the obstetric care offered.

Learning Objectives:

• By the end of this presentation, participants will be able to:
• 1. Describe Maternity COPE, an adaptation for maternity care of a facility-based, staff-driven quality improvement process used to improve the quality of care in reproductive health programs and services;
• 2. Discuss the application of this process to a skilled care intervention in Burkina Faso; and
• 3. Articulate results from the application of COPE in maternity care services.

Related Web page: www.engenderhealth.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.