The Sustaining Technical Achievements in Family Planning/Reproductive Health (STARH) Program in Indonesia used the Quick Investigation of Quality (QIQ) methodology to assess improvements in health service quality at public-sector facilities, an important part of new health delivery strategies under decentralization. The 2002 QIQ baseline survey covered eight provinces along with DKI Jakarta covering 136 facilities and observations of 373 client-provider interactions. Baseline data informed development of quality-improvement interventions that were integrated into detailed work plans to improve the quality of family planning and reproductive health services. STARH then implemented annual follow-up QIQ surveys to document changes following these quality improvement interventions and to facilitate improvement in capacity of the Ministry of Health to implement and use QIQ. QIQ follow-up results were very positive, documenting the effectiveness of the interventions across district-level health services:

• FP guidelines were available in 75% of the facilities, compared to 33% at baseline 80% of providers washed their hands before IUD insertions compared to 35% at baseline
• 91% of clients received a speculum exam for STIs, an improvement from 51% at baseline
• 55% of the facilities services complied with standards for clinical procedures for injectables, compared to 39% at baseline

QIQ has proved to be a valuable programmatic tool for assessing the quality of services in health facilities and foundational to facility performance monitoring. Quality improvement at community-based facilities promotes community level demand generation, reflecting the transition of the national family planning movement to a more mature stage using a client-oriented approach.