Sandy Kubaj – evaplan Irene Omogi – GIZ Kenya Integrated Quality Management System (IQMS) for Maternal, Neonatal & Reproductive Health Care Sandy Kubaj – evaplan Irene Omogi – GIZ Kenya

Challenges in the Kenyan context Low awareness of QI policies Insufficient harmonization of multitude of QI initiatives and approaches Performance in quality of services not objectively measured Lack of HR in health facilities Insufficient standards and SOPs in health facilities 17/01/2019 SNHeSP Accra 2014

What is IQMS? Participatory multi-perspective, indicator based Integrated Quality Management System Indicators derived from national standards and guidelines and validated by national panel (modified RAND/UCLA) Methodology adopted from the European Practice Assessment (EPA) with proven scientific methods and instruments Design open for integration of different QM systems and approaches Supported by visualization and benchmarking software (VISOTOOL ®) Uses coaching and mentoring to improve quality of service delivery 17/01/2019 SNHeSP Accra 2014

4 5 1 3 2 Check-list Team-session & feed-back Inter-view w/ FMT Health Facility visit by Quality Facilitator Self-assess-ment 1 Staff - survey 3 Patient - survey 2 People Interface In/Out Patient Quality & Safety Management Clinical Care Bench marking Contin. Quality improve-ment

Achieved Results Implementation of IQMS in 10 facilities (with first assessments) Institutionalization of quality improvement teams in all 10 facilities Implementation of QI measures in the facilities: Development of SOPs for key processes Improved documentation of ANC and PNC records Health workers more tuned to the voice of the customer Improved privacy in delivery room by installing curtains Accurate documentation of Partographs Implementation of 5S and designation of 5S days Increased partner understanding, acceptance and support 17/01/2019 SNHeSP Accra 2014

Strenghts of the approach Precise measurement leads to little variation in assessment results Detailed results provide focus for QI measures (development of QI plans) Objective and repeatable assessments generate transparency Uses already existing measuring and information systems, is flexible, non-competitive and avoids duplications Works with local partners to assure ownership and sustainability Low resource – high impact Allows for monitoring of each facility’s progress over time – as well as benchmarking Incorporates all essential preconditions for accreditation 17/01/2019 SNHeSP Accra 2014