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USAID Health Care Improvement Project Recognized for “Excellence in Evaluation”
The US Agency for International Development (USAID) named the USAID Health Care Improvement Project (HCI) one of five winners in its first-ever "Excellence in Evaluation" contest. The contest recognized the best evaluation reports undertaken by USAID-funded projects. The winning report evaluated the results of 27 health care improvement interventions in low- and middle-income countries carried out by HCI, which is managed by University Research Co., LLC (URC).
USAID recognized the award winners in a short video, shown below, that features Ms. Lani Marquez, HCI's Knowledge Management and Communications Director, who co-authored the report, and Dr. James Heiby, Medical Officer in the USAID Global Health Bureau.
"This study was the first time...that we had pulled together results from so many different applications of this approach, and so it really caught a lot of people's attention," said Ms. Marquez in the video.
Ms. Marquez and the HCI research team looked at data from 12 countries on interventions carried out over a 10-year period to show whether a quality improvement method widely used in the U.S. called collaborative improvement is also effective in low- and middle-income countries.
Collaborative improvement involves a team-based approach to quality improvement. Teams consisting of health care workers in clinics, hospitals, and other levels of the health system work together on common aims to improve particular aspects of the system. The teams test changes in health care processes, share their experiences, and then apply the successful changes on a wider scale.
The report measured the magnitude and duration of changes achieved through collaborative improvement addressing diverse health services, including maternal, newborn, and child health; HIV/AIDS care; family planning; and malaria and tuberculosis diagnosis and treatment. A distinguishing feature of the evaluation was that it drew on results achieved in a range of health systems: Benin, Bolivia, Ecuador, Guatemala, Honduras, Nicaragua, Niger, Russia, Rwanda, Tanzania, Uganda, and Vietnam.
"This multi-country study provides the largest body of evidence yet published on the effectiveness of collaborative improvement in lower and middle-income countries," said Dr. Heiby. "We still have a lot to learn about improving care in these health systems, but the average level of improvement achieved across 27 different settings suggests remarkable potential; much wider use of improvement methodologies like this appears to be feasible."
The study showed that many health care processes can be readily improved, even in low-resource settings. Of the 135 time-series charts evaluated for more than 1300 teams of health workers, the study found that nearly nine out of ten teams attained performance levels (measured as compliance with standards) of at least 80%, while two-thirds reached at least 90%, even though over half of the teams had a starting performance level of 50% or lower.
February 29, 2012