Communication Strategy For the Quality of Care Initiative

From Background

In July 2000, representatives from the Ministry of Health, District Health Services, DISH II, and Population Council developed a strategy to improve and maintain basic standards of care at health facilities. The rationale behind this strategy development was the general consensus that quality of health services needed improvement in the DISH II districts. Health services in the districts were under-utilised and DISH HMIS sentinel reports showed that utilisation for reproductive health services had been declining for the past year. Typically, low utilisation occurs when service quality is poor. In addition, studies and supervision visits to health facilities have found need to improve services in a number of key areas.

Based on successful interventions in Egypt and Brazil, the developed quality of care strategy is designed to:

1. enhance service provider self confidence and performance;
2. institute a team approach to support better quality services;
3. involve communities in quality improvements; and
4. maintain quality through a system of certification and reward.

Since that time, the basic standards for health care have been drafted, as well as a standardised, objective assessment tool to use when evaluating a facility based on these measurements. In late January 2001, the assessment tool was validated in seven different districts: Hoima, Mpigi, Luwero, Mbarara, Ssembabule, Kamuli and Mbale. The validation exercise took place at 4 facilities in each district - a Health Centre II, III, IV and a Hospital.

The validation evaluated not only the operational feasibility of the tool, but collected feedback from the community, providers and district health officials on standards, the tool and the quality of services in their district. The results were summarised and presented to the working group for further examination. At that point, additional changes were made to the standards, incorporating discoveries from the exercise. Currently, the Ministry of Health is considering the Quality of Care strategy for nation-wide implementation.

The next stage of the quality of care programme is the dissemination and implementation of the basic standards in 12 DISH districts. For this phase to take place successfully, a carefully crafted communication strategy must be implemented simultaneously. The communication strategy for the quality of care initiative involves three aspects.

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