Health Systems Strengthening: Improving quality of services for prevention of malaria in pregnancy through the Standards-Based Management and Reward approach in Kenya

Colleagues[1] from the USAID-MCSP Project and Jhpiego (an affiliate of the Johns Hopkins Bloomberg School of public Health) are presenting a poster at the 64th ASTMH Annual Meeting in Philadelphia at noon on Monday 26th October 2015. Please stop by Poster 385 and discuss the results as presented in the Abstract below

Performance quality cyclePerformance quality improvement (PQI) is one of Jhpiego’s 9 health systems strengthening components in provision of health services towards improvement of maternal health including better pregnancy outcomes. The Standards-Based Management and Reward (SBM-R) approach has been used in improving as well as assessing the quality of services provided at health facilities.

Kenya developed 15 malaria in pregnancy (MIP) SBM-R standards for use by service providers in provision of MIP services and is also used by supervisors to assess the quality of services provided at service delivery points. Facility incharges were trained on the 15 MIP SBM-R performance standards and they oriented service providers in their facilities on use of the performance standards.

Performance IPTpA baseline on SBM-R practices was done in all facilities before orientation in Kakamega east and Kakamega central subcounties and 1st assessment on practices done after three months of practice. A total of 30 health facility incharges from the two malaria endemic subcounties (Kakamega east 16 Kakamega central 14) were trained on the 15 MIP SBM-R performance standards.

The facility incharges oriented 291 service providers (127 Kakamega east, 164 Kakamega central) on use of SBM-R performance standards in provision of MIP services in health facilities. Baseline assessment had an average score of 57% for Kakamega east and 58% for Kakamega central.

Performance Score1st assessments were conducted after three months of practice and showed an average score of 76% for Kakamega east and 64% for Kakamega central giving an overall increase in score of 19% and 13% between baseline and 1st assessment for Kakamega east in Kakamega central respectively.

Use of MIP SBM-R performance standards ensures services provided at health facility level are in line with WHO recommendations and national guidelines. Establishment of PQI as a health systems strengthening component is feasible and is an approach that would make available quality MIP services at facility level. Provision of quality MIP services ensures protection of pregnant women against the effects of malaria in pregnancy.

[1] Augustine M. Ngindu, Gathari Ndirangu, Sanyu N. Kigondu, Isaac M. Malonza

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