The Maternal and Newborn Improvement Quality of Care project

The Maternal and Newborn Improvement Quality of Care (MANI-QC) project focused on improving the quality of health services for mothers and babies in four counties in Kenya: Nandi, Kericho, Mombasa and Kwale.

Funded by UK Aid from 2019 to 2022, we worked with the Ministry of Health and other partners to reduce maternal and newborn mortality.

Our approach

The MANI-QC programme built on the earlier work and achievements made by Options on the MANI programme in Bungoma County (2015 – 2018).

Our approach involved tailoring cost-effective and proven interventions from the MANI programme and scaling them up in four other counties to accelerate maternal and newborn survival.

The programme used a health systems approach to improve the quality of service delivery. The main components were:

• Measuring the quality of emergency obstetric and newborn care (EmONC) services using the bespoke Quality of Institutional Care (QuIC) approach for each county, using mobile technology.
• Strengthening maternal and perinatal death surveillance and response systems
• Building the skills and confidence of health professionals to manage obstetric and newborn emergencies through EmONC mentorship
• Providing targeted health systems strengthening support to bolster interventions where strategic technical expertise and support could further our programme aims.

Results

EmONC Readiness Assessment

More facilities are able to provide the life-saving interventions needed to manage emergency obstetric and newborn care emergencies in each of the four counties by September 2020 compared to our baseline in July 2019. In the four focus counties, the percentage of health facilities achieving EmONC-ready status increased by 45%.

• EmONC Readiness Assessment learning brief

Skilled Birth Attendance Rate

The proportion of pregnant women who sought skilled delivery services in health facilities in the four counties increased by 13%  after two years of implementation.

• MANI-QC 2- year projects achievements progress brief

EmONC Mentorship

285 mentees mentored from 119 facilities across the four counties by 33 mentors on managing emergency obstetric and neonatal complication.

• Mentorship learning brief

Maternal Perinatal Death Surveillance and Response (MPDSR)

Four county, 22 sub-county and 14 high-volume health facility MPDSR committees facilitated to conduct regular mortality reviews and implement actions to prevent future incidences. Upload of maternal and perinatal reviews improved significantly. Maternal death reviews increased by 81% (6% at baseline and 87% at end of year 2). Perinatal death reviews improved from zero (0) at baseline to 59% at March 2021 over the two years of implementation.

• MPDSR learning brief

Health Systems Strengthening

Kericho, Mombasa and Nandi counties supported to develop Facility Improvement Funds (FIF) Bills, which would ring-fence funding for health services. FIF bill already passed in Nandi county.

Conducting blood drives to increase blood availability in Counties

Over 50% of maternal deaths are a result of hemorrhage. We ran blood drives that collected 9,895 pints of blood to ensure blood is available for mothers who need it most.

• Haemovigilance learning brief
• Decentralising blood services: lessons from Kwale County