Quality of Care Strategy

The SFPS Project supports family planning (FP) service delivery in the West and Central Africa (WCA) region and has committed to increasing the Contrecptive Prevalence Rate (CPR) by 1% point per year in four target countries. DHS findings show that about 50-70% of married women want to either space or limit the number of their children. How can SFPS help bridge the gap between these figures? One strategy is to improve access of clients to the services. A second strategy adopted by the SFPS Project is to improve quality of care (QoC) to increase utilization of FP services.

In developing the second of these strategies, SFPS built on successful past initiatives in quality improvement projects in WCA. A number of SFPS staff played key roles in designing and implementing these initiatives, which include:

• Integration of RH services by Columbia University in Ouagadougou (1988)
• SEATS I experience in implementing integration in Burkina Faso (1992- 1995)
• SEATS I experience in continuous quality improvement (PAQS) in Togo (1992- 1995)
• Recommendations and teachings of USAID MAQ conference in Ouagadougou (1995)
• Work of CAs with their partners in the subregion and the ACQUIS initiative (1997)

The key concern of SFPS in applying these past experiences is to focus and streamline the above strategies and to simplify them as much as possible. Accordingly, the SFPS QoC strategy focuses on the following three elements:

• Continuous quality improvement that incorporates client perspective
• Provider practices, knowledge and skills
• Programmatic and management systems

ELEMENTS OF SFPS QOC STRATEGY

Continuous improvement of quality of care

In order to improve quality of care at SFPS sites, the project is working to improve clinic management, upgrade training sites, and conduct periodic supervision of service delivery points through trained integrated supervision teams. In addition, SFPS is integrating RH services such as STDs, child survival, diarrheal diseases and breastfeeding into FP services. These interventions will be complemented by the continuous quality improvement (CQI) approach, which consists of a cycle of problem identification, selection, and solving. CQI will be applied in a step-by-step process as follows:

• Test CQI approach at selected sites by focussing on processes, team work, client perspective and community involvement.
• Follow-up sites where CQI has been introduced in the four target countries.
• Select competent health professionals in the CQI approach in the countries to discuss results of the approach, make recommendations for expansion and develop strategies for expansion.
• Implement CQI expansion strategy to other sites in the 4 countries.

Provider practices, knowledge and skills

In order to produce competent service providers for FP/RH services, SFPS is supporting and conducting training of providers in the following topics: clinical FP skills, IEC/Counseling, infection prevention, STD/AIDS diagnosis and management. This training will be reinforced by trainee follow-up during supervision visits to ensure that the provider continues to be competent in service provision and uses standardized skills.

Programmatic and Management Systems

SFPS plans to conduct the following activities to support programmatic and management systems essential to the support of quality in FP and RH services:

• Logistics system: Conduct assessments in the four target countries to determine situation of contraceptives stock outs at SFPS service delivery points; distribute contraceptives to sites where there is a stockout; design a contraceptive procurement table for each country; procure contraceptives for service delivery sites; monitor contraceptive availability at sites, and train appropriate staff in contraceptive management.

• Management information system: Design an MIS system; recruit and train MIS officers in each country; collect and analyze service delivery data, and ensure the feedback and reporting of analyzed information.

• Clinical protocols and policy documents: Review and update clinical protocols and RH policy documents as needed in the four countries; as well as update in-country FP training curricula for clinical services and IEC/counselling.

• Equipment and materials: Procure needed clinical equipment, supplies and IEC materials according to site needs and a standard list of necessary equipment.

CLIENTS OF THE SFPS QoC STRATEGY

In designing its QoC strategy, SFPS strives to meet the requirements of the following clients:

• Individuals and couples in the four target countries who seek information and services to satisfy their RH needs.
• Service providers who must be able to deliver appropriate services to clients.
• USAID, the funding agency who has a keen interest in quality improvement.
• Collaborating institutions, Ministries of Health and NGOs.
• Individual African consultants who expect of SFPS to upgrade their skills.

Home Page / Project Overview / Project Components / Resources & Contacts / African Institutions / Focus Countries / Sponsors