Webinar Series: Improving Quality of Care From a Health Systems Perspective

 {Photo by SCOPE.}Health care providers in Kenya review pregnancy club messaging scrolls and share their thoughts on the usefulness of these tools.Photo by SCOPE.

Through our quality of care webinar series, we reflect on what “quality care”— comprehensive and respectful care—means for our work and to the people we serve in lower- and middle-income countries.

Our conversations have examined quality through:

Provision of care: 

  • How Accreditation Institutionalized Quality in Rwanda: After implementing new standards for infection control (antibiotic prophylaxis, hand hygiene, and sterilization, combined with staff training and patient education), hospitals reduced and sustained post-surgery infections among women delivering by Cesarean, from 8 percent to 1.8 percent in three years. The group discussed findings from Rwanda’s national health care accreditation program with support from the MSH-led USAID Rwanda Health Systems Strengthening (RHSS) Project.

  • Addressing Deficiencies in Care and Improving Provider Competencies in Malawi: Our discussion focused on how technical assistance hones in on deficiencies in the care and targeted mentorship improves provider competencies. Staff from the Organized Network of Services for Everyone’s Health (ONSE) Activity presented recent results and lessons learned through the application of Outreach Training and Supportive Supervision (OTSS), as part of a broader quality assurance system, to improve the provision and quality of malaria services. While the overall compliance of using rapid diagnostic tests for malaria among health care providers was high, by breaking down the steps, testing prior to treatment of malaria increased to nearly 100%. 


Experience of care:

  • Tailoring TB Treatment for Urban Populations in Afghanistan: Combining a person-centered approach (understanding people's unique needs and circumstances) with standard directly observed treatment, short-course (DOTS) activities led to improvements in evidence-based practices in Kabul. Through the Challenge TB Afghanistan project, the urban DOTS model incorporated the challenges of reaching populations in an urban setting and tailored TB interventions to meet clients where they were. The resulting TB case detection improved from 26% to 55%, with a treatment success rate increasing from 49% to 73%. Implemented by USAID's Challenge TB Project in partnership with MSH and a broad coalition of organizations and health workers in public and private health facilities, urban DOTS has improved TB treatment coverage and increased case notifications and treatment success rates.


  • New Model of Antenatal Care in Kenya and Uganda: How does implementing a new model of antenatal care (ANC) meet client needs and preferences and change how ANC services are delivered and organized in Kenya and Uganda? This model presented promising results in improving social supports and influencing women’s health literacy, while at the same time improving the quality and coverage of ANC.