Webinar recording and materials from webinar organized by the Network for Improving Quality of Care for Maternal, Newborn and Child Health on 'Adapting and adopting quality of care standards for maternal and newborn health in facilities; the example of Bangladesh' on October 22, 2018.

The Network for Improving Quality of Care for Maternal, Newborn and Child Health hosted a webinar on 24 September on ‘Family participatory care in India: partnering with families to care for small and sick newborns’.

Prof. Arti Maria has pioneered this approach in which the parents and close relatives of small and sick newborns are trained in simple care practices and become full partners in care.  She explained how the idea started, how changing the attitudes of healthcare workers, who can be weary of sharing some of their power, was the main obstacle to the approach being adopted, and how involving fathers in the care of their newborn proved to be critical.

Dr Harish Kumar presented the scale up model for the family-participatory care approach and how it works both at facility and community levels to change attitudes of health workers, teach parents care practices for their sick and small newborns, and try to ensure a continuum of care once the baby is discharged. He talked about the work in the facilities to implement family-centred care, and how state and national governments were involved at every step.

Dr P.K Prabhakar explained how the family-participatory care approach evolved from an innovation in one tertiary facility to a nation-wide initiative that is about to be implemented in over 800 SNCUs across India. 

Listen to a Quality Talks podcast episode with Prof. Arti Maria: Building trust between families and health care workers to care for sick and small newborns in India

The Network for Improving Quality of Care for Maternal and Newborn Health (Quality of Care Network), just organized a webinar on ‘WASH FIT in Cambodia: An Adaptive Management Tool to Drive WASH Improvements and Enhance Quality of Care’.

The webinar introduced the WASH FIT tool, launched in Cambodia June 2017 in 21 health care facilities across three provinces. The tool is intended to drive improvements at the facility level in the areas of water, sanitation, healthcare waste management, hand hygiene, cleaning and disinfection, environmental management, and facility management. The testing was led by the Ministry of Health, in partnership with WaterAid, WHO and UNICEF.

Dr Hoy Vannera talked about the Cambodian context for maternal and newborn health, where the maternal mortality ratio has dropped from 472 deaths per 100,000 live births in 2005, to 170 deaths per 100,000 live births in 2014 but neonatal mortality decreases at a much slower rate, and now accounts for half of all deaths in children under-five. He explained that water, sanitation and hygiene interventions and expected to have a strong impact on maternal and newborn health outcomes and that this is an area where improvements are needed: while 91% of public health care facilities in Cambodia have access to an improved water sources, only 15% have a hand washing station at OPD, delivery room and within 5 meters from toilets, and 10% segregate heath care waste and dispose of infectious/sharp waste safely.  The National Health Strategic Plan 2016-2020 lists as one strategic intervention to improve the supportive environment for overall quality made it a point to push for appropriate hygiene and sanitation in health facilities contributing to improve quality and safety for patients and health personnel

Sophary Phan described the steps for quality improvement that facilities took in implementing the WASH FIT tool, and some of its impact so far, which included notably some facilities being noticeably cleaner, installing bathing facilities for patients, separate toilets for women and men.

Resources on WASH FIT

• Water and sanitation for health facility improvement tool (WASH FIT): A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities
• Achieving quality universal health coverage through better water, sanitation and hygiene services in health care facilities – a focus on Cambodia and Ethiopia
• WASH FIT in Cambodia National Review Meeting Report

(Photo: A mother holds her child as a vaccine is administered at the health centre in the village of Preak Krabao, Kang Meas District, Cambodia, in June 2015. ©UNICEF/Pirozzi)

On 9 February, the Quality of Care Network hosted a webinar on 'Cleaner hospitals for better quality of care: the example of Ethiopia’s Clean & Safe Health Facility Initiative'

Molla Godif Fisehatsion and Tewodros Fantahun  presented the Clean and Safe Health Facility initiative (CASH), a programme of the Ethiopian Federal Ministry of Health to make healthcare facilities clean, safe and comfortable to patients, visitors and staff.  They explained how the CASH initiative supports the overall national proirity of improving quality of care, and what specific impact it had in the case of St Paul's hospital staff motivation, infrastructure improvement, and patients' experience of care.

With CASH in its 4th year of implementation, and now active in all public hospitals in the country, the webinar provided an opportunity to look at the successes, challenges and requirements of a long standing, ambitious programme targeting simulteaneously health workers and managers, hospital cleaning staff and  patients and their families.

The Network for Improving Quality of Care for Maternal, Newborn and Child Health held a webinar showcasing the design, results, and learning from the Expanded Quality Management Using Information Power (EQUIP) in Uganda and Tanzania. Dr Peter Waiswa presented EQUIP, a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys.

It ran from 2010 and 2014 and has a wealth of lessons to share on working simultaneously at community, facility and district levels to make quality improvement impactful, what it takes to collect and use data in a strategic manner, and what barriers stand in the way of quality improvement teams.

EQUIP has published a paper documenting these learnings, as well as a series of briefs and a video.

The Network for Improving Quality of Care for Maternal and Newborn Health (Quality of Care Network), organized a webinar to share some of the lessons from the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) project which the Makerere University School of Public Health run in 2012-2015.

The study was conducted in three districts in Eastern Uganda to help reduce maternal and neonatal deaths through the use of a participatory action research approach.

The speaker, Dr Suzanne Kiwanuka, explained how this approach involved communities, district and facility management simultaneously. She highlighted how mentoring and supervising quality improvement teams were key in seeing quality improvement take hold in a facility.

Read more:

The MANIFEST project has published a Supplement in Global Health Action. The lessons of the project are also documented in a series of nine Briefing Papers and a documentary.

This webinar, organized by the Global Learning Laboratory for Quality UHC and the Quality of Care Network provided an overview of the MNCH Quality of Care Network as well as highlight the potential pathfinder role of quality MNCH in wider efforts to enhance the quality of health services within the context of UHC. Specific country examples of change drivers were examined with a focus on how MNCH can act as a pathfinder to progress towards people-centred services. Finally, the webinar examined how lessons learned from early work of the network can be cascaded to inform further work on quality at the national, regional and global level.

In this webinar, Dr Vikram Datta presented how a medical college in New Delhi started using quality improvement (QI) techniques to address hypothermia in newborns and subsequently reduce newborn mortality. He explained how his team then gradually connected with other health professionals and spread its learnings and know how to create a self sustained learning network dedicated to QI for newborns. Dr Datta also explained the prerequisites to establish such a network and encouraged participants to start their quality improvement work without waiting for more resources, staff or time. 

To date, the National Quality of Care Network  in India includes nine states and is working to expand its reach.