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Quality of Care in Service Delivery Programs

HEILBRUNN DEPARTMENT OF POPULATION AND FAMILY HEALTH. Quality of Care in Service Delivery Programs. RHRC Consortium Monitoring and Evaluation ToolKit Quality of Care. Quality of Care. Why do we want it? Human right Creates a stronger causal pathway What is it?

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Quality of Care in Service Delivery Programs

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  1. HEILBRUNN DEPARTMENT OF POPULATION AND FAMILY HEALTH Quality of Care in Service Delivery Programs RHRC Consortium Monitoring and Evaluation ToolKit Quality of Care

  2. Quality of Care • Why do we want it? • Human right • Creates a stronger causal pathway • What is it? • A program of high quality is one that is client oriented and aims to help individuals achieve their reproductive intentions or goals.Jain, Bruce and Mensch, 1993 • “Being treated like a human being.” Clinic user, Santiago, 1993 RHRC Consortium M&E ToolKit

  3. Previous QOC definitions/ concepts • Medical standards • More services  increased coverage • Technical / interpersonal model of care • User perspective / client perspective RHRC Consortium M&E ToolKit

  4. Judith Bruce QOC Framework • Elements of Quality of Care • Choice of method • Technical competence • Information given to clients • Interpersonal relations • Mechanism of follow-up • Appropriate constellation of services Source: Bruce, Judith. “Fundamental Elements of the Quality of Care: A Simple Framework.” Studies in Family Planning, 21,2:61-91. March/April 1990. RHRC Consortium M&E ToolKit

  5. Elements of Quality of Care Choice & availability of supplies/services • adequate inventory and control system? • logistics pipeline? • adequate, functioning equipment? • appropriate medical waste disposal? • convenient days and times of service? RHRC Consortium M&E ToolKit

  6. Elements of Quality of Care Technical competence: number and skills of staff • job description • treatment protocols • basic preparation • refresher training • universal precautions • ongoing supervision and support RHRC Consortium M&E ToolKit

  7. Elements of Quality of Care Information given to clients • what are the key messages for each topic? • what methods are best to communicate the messages? • who should best communicate them? RHRC Consortium M&E ToolKit

  8. Elements of Quality of Care Interpersonal relations • privacy, confidentiality, safety • courtesy • appropriateness of staff • sensitivity of staff RHRC Consortium M&E ToolKit

  9. Elements of Quality of Care Mechanisms of follow-up • continuity of care • links between facility and community • inform the client! RHRC Consortium M&E ToolKit

  10. Elements of Quality of Care Appropriate constellation of services • comprehensive RH • safe motherhood • family planning • prevention and treatment of STD/RTI/HIV • protection from and response to sexual and gender-based violence • adolescent–friendly service • other services ?? RHRC Consortium M&E ToolKit

  11. Steps in measuring QOC • Define terms • Develop indicators • Develop tools and methods • Adapt what already exists • Set a standard or desired level of quality, and measure against it RHRC Consortium M&E ToolKit

  12. Lessons learned about QOC • Everyone is for it • Too few programs address it systematically • If it is not addressed systematically: • we cannot know if it is improving, worsening or static • we cannot link it to population’s knowledge, attitudes and behavior RHRC Consortium M&E ToolKit

  13. Lessons learned about QOC(cont.) • Quality can be improved …... ….. when it is addressed systematically as an integral part of the project • training • education and counseling • logistics • SUPERVISION!!! • JUST DO IT!!! RHRC Consortium M&E ToolKit

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