Project Objectives

Identify the ‘bottlenecks’ to providing Quality of Care (or “QoC”)

a) Conduct a specialized study of QoC in ANC and PNC clinics, in addition to the use of existing HFA’s and routinely collected data, in a sample of facilities in the identified target districts (if detailed quality of care data is needed);

b) If necessary undertake a secondary analysis of data for a small sample of districts and/or sites where the HFA was implemented in a subset of countries. This would include utilizing the latest epidemiologic information, routine service data and the Health Facility Assessment (or “HFA”) data to help support decision-making at the facility around management and service models (i.e. differentiated care, patient-centred care, task shifting or other Human Resources practices, etc.);

c) Partner with the Ministry of Health at national and/or local levels and work directly with the sites identified to share data and design an action plan based on the findings;

d) Document information collected to refine the specific package of interventions and focus needed for each site or cluster of health facilities to improve the availability and quality of antenatal and postnatal care provided for mothers and new-borns, reflective of a differentiated facility specific approach.

Design and introduce a Quality Improvement process at health facility level

a) Strengthen the capacity of healthcare providers and managers working at participating health care facilities in the provision and assessment of ANC and PNC and on the use of a standards-based audit as a mechanism for improving care;

b) Develop national and locally agreed evidence-based standards for care that are defined and measurable;

c) Identify immediate gaps in terms of essential equipment and supplies at facility level that are essential for the provision of antenatal and postnatal care;

d) Document and disseminate the lessons learnt.

Evaluate effectiveness and efficiency

a) Generate the evidence to reproduce and scale-up intervention packages and solutions to increasing availability and improving quality of care for integrated HIV, TB and malaria services during antenatal and postnatal care;

b) Document differentiated approaches to improving the quality of care at ANC and PNC facilities using a health systems strengthening approach;

Project inception activities are on course and the implementation will start in January 2022. Some of the key deliverables include:

Capacity Building of 1200 health care workers in integrated quality improvement at ANC and PNC targeting Master Trainers and Health care workers in the select districts and health facilities,

Healthcare Facility Improvement – This will entail procurement and distribution of basic ANC and PNC equipment for a total of 30 healthcare facilities (20 in Mainland and 10 in Zanzibar) and implementation of Standards based audits for quality improvement.

Evidence Generation – Conduct baseline health facility assessment, economic assessment and the End line Survey of 30 healthcare facilities.