Clean births and quality care could save the lives of 4,200 mothers a year and 38 newborns a day in Malawi. So how can we improve quality of care? Who makes decisions about quality of care? And how can we influence those decision makers? These were some of the questions discussed by district, zone and national representatives at a quality of institutional care (QuIC) training workshop in Salima on 4-5 August.
What is QuIC?
QuIC is a fast, low-cost approach that uses telephone-based data collection to assess different dimensions of quality of care. In Malawi, QuIC data has been collected by district implementation teams, including the district health management team (DHMT) and Safe Motherhood Coordinator, in four districts since 2014. Data is collected during a short phone call and entered directly into an app.
We all agreed that evidence is the key to influencing decision makers. But Kate Phiri, Safe Motherhood Coordinator in Nkhata Bay, said that evidence alone is not enough.
The evidence needs to be presented in a clear, relevant format. It also needs to be available quickly, so that decision makers – such as the DHMT – can respond to gaps in quality of care at health facilities. Drugs, water and soap, qualified health workers, a safe blood supply, and electricity save lives!
QuIC collects, analyses and presents data quickly, so results are available for immediate action. District implementation teams in Malawi use the results to advocate to decision makers to address gaps in quality of care.
For example, findings from the QuIC assessment in Mchinji district in early 2015 found that only three of the 11 basic emergency obstetric and newborn care (BEmONC) facilities were fully functional.
The other eight facilities faced challenges such as drug stockouts, lack of equipment and skilled health workers.
The District Health Management Team
The Mchinji district implementation team informed the DHMT of these findings. In response, the DHMT urged health facilities who foresaw a drug shortage to contact the DNO to request additional drugs from the central stores. Thanks to this action, four more health facilities met the standards for a fully operational BEmONC by the QuIC assessment in December 2015.
Workshop participants learned how to download and use the QuIC app on their phones. They also practised calling facilities in their districts to collect and enter data into the QuIC app.
Dr Likaka, Director of the Quality Management Unit at the Ministry of Health, awarded participants with a certificate of recognition for the training. He called on district staff to use QuIC data for decision making to help save the lives of mothers and babies.
Every life is very precious. Let us be angry to see mothers and children dying. We must ask how our system can respond to save these deaths. I want you to use the data you collect to make decisions.