1. 1 Human Resources for Health Improvement Collaborative Lauren Crigler Senior QI Advisor USAID Health Care Improvement Project Initiatives, Inc. www.hciproject.org/healthworkforce International Forum on Quality Improvement, Amsterdam, 7 April

2. Roles and Responsibilities Career Path Performance Incentives

3. USAID HEALTH CARE IMPROVEMENT PROJECT Niger Lifetime risk of maternal mortality Sub-Saharan Africa Developing countries

4. USAID HEALTH CARE IMPROVEMENT PROJECT One doctor for every 100,000 people 1 nurse per 8,000 population One midwife per 9,000 women of child-bearing age Human resources for health: Tahoua, Niger

5. USAID HEALTH CARE IMPROVEMENT PROJECT Clear Tasks Competency Development Performance Feedback Fair Evaluation Reward & Recognition Career Advancement Adequate Environment Applying improvement methods in Human Resources Improve quality of services and HR management

6. Clinical Objectives Improvement objective IndicatorsWho measures Increase rates for assisted deliveries - Number of new ANC enrolled - % of facility deliveries - % of skilled deliveries by qualified staff - % compliance to ENC norms - % of compliance to PreEclampsia and Eclampsia - Compliance to norms District Hospitals, Health Centers (CSI), Regional Maternity Reduce post partum hemorrhage Post partum hemorrhage rate Maternity Hospital, District Hospitals, CSI Increase family planning coverage in health facilities - Contraceptive Prevalence - Number of newly enrolled women for FP services Maternity Hospital, District Hospitals, CSI

7. USAID HEALTH CARE IMPROVEMENT PROJECT Aligning goals: National, regional, district and facility 7

9. USAID HEALTH CARE IMPROVEMENT PROJECT Rationalizing roles and clarifying expectations: Process mapping for health workers

11. USAID HEALTH CARE IMPROVEMENT PROJECT % adherence to norms for essential newborn care % health workers with job descriptions Improving adherence to norms in Essential Newborn Care in five district hospitals Strategy for Change: Clarified roles and job descriptions

12. USAID HEALTH CARE IMPROVEMENT PROJECT Improving contraceptive prevalence Niger Strategy for Change: Rationalizing and reassigning tasks in order to reach out into communities

13. USAID HEALTH CARE IMPROVEMENT PROJECT Improving client wait time in three district hospitals

14. USAID HEALTH CARE IMPROVEMENT PROJECT Other Quality Improvement /Human Resources Applications This approach is also being applied in Tanzania as part of a ART/PMTCT collaborative In Mali in MNCH at the community level In Ethiopia to improve community level HIV care and support

15. 15 www.hciproject.org/ healthworkforce Lauren Crigler Senior Technical Advisor USAID HCI Project./Initiatives Inc