Using the Antenatal Care Quality Improvement Tool and targeted training to strengthen ANC Services including MiP in Tanzania

Malaria prevention in pregnancy (MIP) is a major component of antenatal services in endemic countries. Jasmine Chadewa, Dunstan Bishanga, Elaine Roman, Godlisten Martin, Kristen Vibbert, Lauren Borsa, Agrey Mbilinyi, Jeremie Zoungrana, and Hussein Kidanto describe how they applied a quality improvement tool to strengthen ANC and MIP services at the 66th Annual Meeting of the American Society of Tropical Medicine and Hygiene. Their findings follow:

Malaria in Pregnancy (MiP) is a major, preventable cause of maternal morbidity and poor birth outcomes. In collaborations with partners, Tanzania’s National Malaria Control Program (NMCP) and the Reproductive and Child Health Unit has been working to promote the World Health Organization’s three-pronged approach to address the burden of MiP.

A malaria training for 180 supervisors and 360 ANC providers from 221 health facilities was conducted in the Kagera and Mara regions. Updates included an orientation on MiP as well as malaria case management, screening, data management and ITN promotion.
Prior to the training, facility baseline assessments were conducted using the Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) antenatal care quality improvement (ANC QI) tool to identify gaps in knowledge and skills of health providers to better target trainings to improving the quality of ANC services.

A second assessment took place six months post training. Both assessments included hospital, health facility and dispensary levels and included observation, interviews, record reviews and skills assessments.

Results demonstrated that over 90% of the facilities scored below 30% across all categories in the overall baseline assessment with a high score of 35 %, while the 2nd assessment showed a large improvement with 40% of the facilities scoring below 30% and a high score of 70%.

The ANC QI tool is effective in determining the impact of ANC health provider’s knowledge and skills to target training to improve ANC service quality.

The presentation was made possible through support provided to the USAID Boresha Afya Project, under the terms of the Cooperative Agreement AID-621-A-16-00003 by the President’s Malaria Initiative via the United States Agency for International Development (USAID), an inter-agency agreement with Centers for Disease Control and Prevention (CDC). The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the President’s Malaria Initiative via the US Agency for International Development.

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