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ASSIST Relays Project Impact to Tanzania's National Quality Improvement Forum
"It's not enough to be thinking about how we can deliver the care in the facility. We need to think what is the organizational context in which this facility operates, what is the environmental context in which this whole Ministry and this whole district or region operates and how can we support it so that this becomes the way in which care is provided all the time and not some of the time."
Dr. M. Rashad Massoud, USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project Director and URC Senior Vice President for the Quality & Performance Institute, brought these words to a keynote audience in November at the 3rd National Quality Improvement (QI) Forum in Dar es Salaam, Tanzania. The forum welcomed over 300 participants from within and outside Tanzania to share knowledge and best practices as a way of harvesting improvement innovations and experiences from different countries.
Highlighting the work of the USAID ASSIST Project, Dr. Massoud's address focused on "Quality Improvement in Health Service Management." He stressed that in order to provide quality care, the micro-system where processes of care happen and the health centers where things take place cannot be taken out of the context. This could be at district, regional, and/or Ministry levels, where processes such as health systems financing, human resources, and information systems are facilitated to work cohesively in supporting the delivery of care where needed most (e.g., facilities, communities, etc.). He added, "Of course it needs the supportive environment that allows us to have the rules, the regulations, the designs that make all of this come together—not every now and then as we see in health care, but for every patient, every time it is needed."
Dr. Massoud further pointed out that much effort and focus have been on techniques to improve care, but there is less emphasis on other elements, including strategies on how to set priorities within systems, how to mobilize human and financial resources in order to support work in these priorities, how to empower people to attain prioritized goals, and how to build problem-solving skills: all key strategic issues that need to be addressed in addition to the how facilities function.
In addition to Dr. Massoud's presentations, several URC staff from the ASSIST and Tibu Homa (febrile illness) projects made the following presentations:
- Flora Nyagawa, QI Advisor: "Involvement of most vulnerable children in responding to improving their health services" and "Optimizing linkages between the community and health facilities to improve care and treatment of PLHIV in Tanzania."
- Dr. Yohana Mkiramweni, QI Advisor: "Using improvement methods to meet the FP needs of PLHIV in Manyara, Kilimanjaro and Morogoro regions in Tanzania."
- Dr. Joseph Kundy, QI Advisor: "Exploring the relationship between engagement and performance of health workers delivering HIV services in Tanzania."
- Victor Masbayi, Chief of Party, Tibu Homa Project: "Strengthening health systems: Regional, district leadership and facility pediatric quality improvement teams (PQIT) as champions of implementation sustainability."
- Dr. Kristina Lugangira, Senior QI Advisor: "Facility-based quality improvement practices improve seeking of care for under-fives within 24 hours of onset of fever."
- Albert Ikonje, Strategic Information Specialist: Strengthening data management and use in decisions to improve health care services."
Regional Health Management Team (RHMT) Member
- Carle Lyimo, RHMT member, Morogoro Region: "Let's clean this mess! A community-based strategy to improve food hygiene and sanitation at a highway travel stop: Lugono experience, Morogoro region, Tanzania."
- Dr. Stella Mwita, Senior QI Advisor: "Instituting a data quality protocol to verify quality of data within CTC and RCH services within ASSIST Project" and "Preparedness for Option B+ in districts supported by the Partnership for HIV-Free Survival in Tanzania."
- Dr. Elizabeth Hizza, Senior QI Advisor: "Can communities contribute to improving service uptake? Community PMTCT Experience in Iringa District Council."
Launching the National Quality Improvement Plan
The Permanent Secretary of the Ministry of Health and Social Welfare, Mr. Charles A. Pallangyo, launches the National Health and Social Welfare Quality Improvement Strategic Plan 2013–2018 at forum. Photo by Delphina Ntangeki.
URC supported the Ministry of Health and Social Welfare to develop its Quality Improvement Strategic Plan, 2013–2018. It defines the national improvement agenda on health and social welfare and will help create an enabling environment to improve the quality of the health and social welfare system and the delivery of health care and social services.
ASSIST Quality Improvement Advisor Monica Ngonyani (right) discusses ASSIST activities with visitors at the URC booth. Photo by Delphina Ntangeki.
The URC booth displayed ASSIST work from Tanzania and other countries where ASSIST is active.
December 11, 2013