1. The Ethiopia healthcare quality initiative: design and initial lessons learned.
- Author
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Magge H, Kiflie A, Nimako K, Brooks K, Sodzi-Tettey S, Mobisson-Etuk N, Mulissa Z, Bitewulign B, Abate M, Biadgo A, Alemu H, Seman Y, Kassa M, Barker P, and Burrsa DG
- Subjects
- Ethiopia, Female, Humans, Infant, Infant, Newborn, Pregnancy, Program Evaluation, Retrospective Studies, Rural Population, Maternal-Child Health Services standards, Quality Improvement organization & administration, Quality of Health Care
- Abstract
Objective: To describe the development, implementation and initial outcomes of a national quality improvement (QI) intervention in Ethiopia., Design: Retrospective descriptive study of initial prototype phase implementation outcomes., Setting: All public facilities in one selected prototype district in each of four agrarian regions., Participants: Facility QI teams composed of managers, healthcare workers and health extension workers., Interventions: The Ethiopian Federal Ministry of Health (FMoH) and the Institute for Healthcare Improvement co-designed a three-pronged approach to accelerate health system improvement nationally, which included developing a national healthcare quality strategy (NHQS); building QI capability at all health system levels and introducing scalable district MNH QI collaboratives across four regions, involving healthcare providers and managers., Outcome Measures: Implementation outcomes including fidelity, acceptability, adoption and program effectiveness., Results: The NHQS was launched in 2016 and governance structures were established at the federal, regional and sub-regional levels to oversee implementation. A total of 212 federal, regional and woreda managers have been trained in context-specific QI methods, and a national FMoH-owned in-service curriculum has been developed. Four prototype improvement collaboratives have been completed with high fidelity and acceptability. About 102 MNH change ideas were tested and a change package was developed with 83 successfully tested ideas., Conclusion: The initial successes observed are attributable to the FMoH's commitment in implementing the initiative, the active engagement of all stakeholders and the district-wide approach utilized. Challenges included weak data systems and security concerns. The second phase-in 26 district-level collaboratives-is now underway., (© The Author(s) 2019. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2019
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