Health care quality improvement assessment in four developing regions of Ethiopia

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Aklilu Yeshitlaa

IntraHealth International, Ethiopia

: J Nurs Patient Care

Abstract

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Background: Developing regions of Ethiopia (Afar, Benishangul-Gumuz, Gambella and Somali) have the country’s worst maternal health including family planning outcome. USAID-supported Transform: Health in Developing Regions (T-HDR) project, led by AMREF with sub partner of IntraHealth, is working with the Federal Ministry of Health to drive large-scale improvements in MNCH/FP clinical performance including access, utilization and quality of care.

Methods: A descriptive cross-sectional survey was employed from September- October 2018 using three data collection methods: 1) medical record review, 2) interviews with health workers and mothers, 3) observations through semistructured questionnaires. Using simple random sampling, 580 medical records were reviewed to determine provision of care and use of national recommended standards.

Results: Only 37% of HCs are practicing BEmONC signals in four regions and 48% of HCs used partographs routinely. Routine infection prevention measures are practiced in 86% of facilities: 74% HCs, 98% hospitals. 48% of HCs lacked continuous water supply and 67% of HCs lacked access to electricity (including generators). Only 6% of HCs apply quality improvement processes, 17% of hospitals have functional quality improvement teams. Providers lack sufficient knowledge of postpartum hemorrhage, eclampsia management, and treatment of newborn sepsis, despite reporting they had this knowledge.

Conclusion & Recommendations: Regional health bureaus and hospitals need supportive supervision and catchmentbased mentorship to improve knowledge and skills of providers and application of national protocols for service quality. Multi-stakeholder collaboration and commitment among bureaus and other government sectors is required for allocation of needed resources.

Biography

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Aklilu Yeshitlaa MPH with Public Health background with 13 years of experience on Maternal, child and neonatal health service. Currently I am working with IntraHealth International on USAID funded project as Quality assurance and Improvement Advisor. Mr Aklilu is in process for publishing four QI interventions and one operational research. I have serving as national quality steering committee for reviewing strategy, intervention package and design innovative approach for quality improvement. In addition, I am member of Quality Equity and Dignity Network of WHO and at international conference I had presented project implementation experience on death reduction intervention through quality improvement.

E-mail: ayeshitla@intrahealth.org