uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
How people-centred health systems can reach the grassroots: experiences implementing community-level quality improvement in rural Tanzania and Uganda
Ifakara Health Institute, Dar es Salaam, Tanzania.
Makerere Uniververisty School of Public Health, Kampala, Uganda.
Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
Makerere University School of Public Health, Kampala, Uganda.
Show others and affiliations
2018 (English)In: Health Policy and Planning, ISSN 0268-1080, E-ISSN 1460-2237, Vol. 33, no 1, p. e1-e13Article in journal (Refereed) Published
Abstract [en]

Background

Quality improvement (QI) methods engage stakeholders in identifying problems, creating strategies called change ideas to address those problems, testing those change ideas and scaling them up where successful. These methods have rarely been used at the community level in low-income country settings. Here we share experiences from rural Tanzania and Uganda, where QI was applied as part of the Expanded Quality Management Using Information Power (EQUIP) intervention with the aim of improving maternal and newborn health. Village volunteers were taught how to generate change ideas to improve health-seeking behaviours and home-based maternal and newborn care practices. Interaction was encouraged between communities and health staff.

Aim

To describe experiences implementing EQUIP’s QI approach at the community level.

Methods

A mixed methods process evaluation of community-level QI was conducted in Tanzania and a feasibility study in Uganda. We outlined how village volunteers were trained in and applied QI techniques and examined the interaction between village volunteers and health facilities, and in Tanzania, the interaction with the wider community also.

Results

Village volunteers had the capacity to learn and apply QI techniques to address local maternal and neonatal health problems. Data collection and presentation was a persistent challenge for village volunteers, overcome through intensive continuous mentoring and coaching. Village volunteers complemented health facility staff, particularly to reinforce behaviour change on health facility delivery and birth preparedness. There was some evidence of changing social norms around maternal and newborn health, which EQUIP helped to reinforce.

Conclusions

Community-level QI is a participatory research approach that engaged volunteers in Tanzania and Uganda, putting them in a central position within local health systems to increase health-seeking behaviours and improve preventative maternal and newborn health practices.

Place, publisher, year, edition, pages
2018. Vol. 33, no 1, p. e1-e13
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-233512DOI: 10.1093/heapol/czu070ISI: 000419574400001PubMedID: 29304250OAI: oai:DiVA.org:uu-233512DiVA, id: diva2:752948
Funder
EU, FP7, Seventh Framework Programme, 265827Available from: 2014-10-06 Created: 2014-10-06 Last updated: 2018-02-26Bibliographically approved

Open Access in DiVA

fulltext(302 kB)8 downloads
File information
File name FULLTEXT01.pdfFile size 302 kBChecksum SHA-512
4cec963c381aaa72a3bc7a5d7d1f05e320b087223050d8a67aaac3b47df659a06e1b004c2c2d05d87072bfb2d574aab51cedd3b554031ab11d1030e63c3f3358
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Peterson, Stefan

Search in DiVA

By author/editor
Peterson, Stefan
By organisation
International Maternal and Child Health (IMCH)
In the same journal
Health Policy and Planning
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 8 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 530 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf