Credit: MamaYe!/Tanzania
Midwife and Tanzanian mother during ANC check-up

Quality health services

Everyone should be able to access high quality healthcare in a way and place that is right for them.

Yet in many countries, health services simply do not meet the needs of their populations, including those of mothers and babies.

Every day, 800 women die from preventable causes related to pregnancy and childbirth. Globally, 2.4 million  babies die every year during the first month of life. If we are to increase maternal and neonatal survival, we urgently need to improve the quality of service delivery for mothers and their babies.

We promote quality of care across seven areas:

  • Strengthening human resources so that health workers are proficient, regulated, respectful and motivated, and deliver services using recommended standards and guidelines
  • Improving infrastructure in line with basic quality of care requirements
  • Establishing institutional structures which promote gender equality and social inclusion at all levels of the health system to encourage respect and equity for all service users
  • Ensuring that equipment and medicines are properly stored, maintained and used by trained and skilled staff
  • Improving clinical practice to ensure that care is provided in line with internationally recognised guidelines and within the context of national policies
  • Strengthening continuity of care by building networks of care and integration from the community up and the secondary/tertiary facility down
  • Developing rapid tools to provide data that can inform the design of strategies to scale up services and build on what works.

We listen and learn from our partners in health service delivery and provide technical assistance that supports their strategic goals. Through collaborating closely, we help to scale up quality improvements, ensure continuity and add value to existing efforts.

  • In Kenya, we have implemented the Quality of Institutional Care (QuIC) app-based approach that measures health facility readiness to perform life-saving emergency obstetric and newborn care (EmONC) interventions. Facilities are supported to act upon these results, and this has consistently increased the number of facilities able to provide all emergency life-saving interventions. This in turn has helped improve the quality of care and reduce the obstetric case fatality rate (the proportion of mothers who presented at a facility with an obstetric complication and died) in the four counties where we work.
  • We have also implemented the QuIC approach that measures health facility readiness to perform life-saving emergency obstetric and newborn care (EmONC) interventions.
  • In Tanzania, we supported the government to improve quality of care at different levels of the health system, including continuous quality improvement through supportive supervision, building annual QI plans based on assessment results and developing national guidelines for complaints systems. This resulted in 100% of the district hospitals we supported reaching the minimum quality standard of 3 stars or above during annual Star Rating Assessments, up from a baseline of just 9.1%. The level of satisfaction among female health service users also increased from 49% to 60%.
  • In Nepal, we have worked with the Federal Ministry of Health and Population (MoHP) and its divisions to improve the quality of health services at various levels. At the strategic level, we have supported the development of Minimum Service Standards for primary, secondary and tertiary level facilities to help improve service readiness.  We have trained nearly 200 skilled birth attendant Clinical Mentors over the years who have in turn supported skill development and supervision of approximately 3,500 health providers at the primary facilities. We have also been supporting the Family Welfare Division to regularly monitor the comprehensive EmoNC functionality of over 90 hospitals, which has led to timely improvements in access to emergency services.

Results

  • In Tanzania, 100% of supported district hospitals achieved at least the minimum quality standard from a baseline of just 9.1%
  • In Kenya, our work to improve quality of care contributed to an overall decrease in the obstetric case fatality rate in the counties where we work

Our experts

  • Joanne Hemmings, PhD
    Joanne provides technical expertise across sexual and reproductive health and rights, gender, research and evaluation, social and behaviour change, and business and strategy development. She’s currently supporting programming to end female genital mutilation/cutting (FGM/C) and to support girls’ choices to reduce unsafe abortion.
  • Sara Bandali, DrPH
    Sara uses her expertise in designing, implementing, measuring and overseeing programmes and innovations to improve health outcomes for women and children. She leads Options’ work accelerating the sustainable scale of promising global health solutions. A Doctor of Public Health, Sara brings her ability to harness strategy development analytics, adaptive and design methodologies and business growth to bring innovation to existing and new markets.
  • Sara Nam, PhD
    Sara Nam is a public health professional with close to 20 years’ experience providing technical assistance to and implementing health programmes and conducting research and programme evaluations. Sara is a qualified midwife, bringing technical expertise in the design and delivery of maternal and newborn health services, health planning and management, strengthening human resources and improving quality of care.
  • Nicole Sijenyi Fulton
    Nicole is passionate about improving women’s health and well-being, and building high performing organisations and teams. She supports Options’ delivery of high quality programmes and the development of new business to expand Options’ impact. Nicole draws on her background as a nurse, Team Leader and Kenya Country Representative to improve health care access and quality for all.
  • Gladys Ngeno
    Gladys is zealous about improving women’s access to quality healthcare. She leads Options’ work at county-level health system strengthening in four counties – Kericho, Nandi, Kwale and Mombasa. She’s a public health specialist with 13 years’ experience in the health sector, both in development and humanitarian programmes in Kenya and South Sudan.
  • Ronke Atamewalen
    Ronke is a public health nurse/midwife committed to improving access to safe, sustainable, high-quality reproductive health services for women and girls. With over 20 years’ experience in clinical and preventive interventions in the public, private and NGO sectors, Ronke’s technical expertise includes institutional capacity building, health system strengthening and quality assurance. She is currently responsible for Clinical Quality Assurance.

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