Over the past three years, USAID’s Afya Uzazi has been working with Baringo and Nakuru counties to improve the quality and experience of the care that mothers and newborns receive around the time of childbirth.
As part of a quality improvement (QI) initiative, Afya Uzazi has trained health care workers to identify bottlenecks and opportunities to improve the quality care offered in health facilities.
The trained personnel have formed work improvement teams (WITs) in 38 health facilities. The teams analyze processes of care, identify gaps, test remedial changes for one year and then measure the results.
A good example is in Marigat Sub-County in Baringo County. In 2018, Afya Uzazi and the county health management team conducted a rapid quality of care assessment of facilities in the county and found weaknesses in documentation of maternity care.
Only 40 % of the maternity files had an accurately completed partograph, a graphic record of vital observations to assess progress during labour and nursing notes that aid in quick intervention in emergencies.
Six facilities that receive the most clients were selected for a work improvement project. Health workers from the facility were trained to apply the Kenya Quality model for health(KQMH). Back in their facilities, they assessed the situation and made change plans to improve documentation.
A joint team of county and project staff helped them through supportive supervision, mentorship and use of data for decision making. One year later, all the facilities has shown great improvement. Almost all (90%) the vital records were accurate. Other indicators of quality care also improved.