Improving the Quality of Integrated Management of Newborn and Childhood Illnesses in Gulu, Omoro, and Nwoya Districts in Northern Uganda
ASSIST held learning sessions with teams from the intervention health facilities with participation of district health management teams to identify and discuss the successful changes that helped improve the quality of common childhood conditions. To inform learning and scale up IMNCI improvement countrywide, successful changes were synthesized and compiled under a so-called “change package” as a standalone document. Key recommendations and lessons learned from the intervention are summarized below:
- Improvement is a continuous process that is based on EB clinical recommendations (content) and the constant process of identifying the gaps in care practices and testing, implementing, monitoring, refining, and instituting changes to deliver recommended care for every patient every time.
- Proper severity assessment and classification form the backbone of quality IMNCI service delivery upon which appropriate diagnosis, treatment and follow up care are built on.
- There are effective IMNCI improvement strategies that can improve care effectiveness, reduce cost of care and improve access to lifesaving services and medications.
- Bringing on board all frontline staff and nurturing champions is essential for successful QI efforts.
- Buy-in from district and health facility administration is critical to build accountability and sustain human and financial resources.
- To promote a culture of improvement, resistance to change needs to be addressed first through a non-judgmental approach.
- It is important to offer timely and relevant feedback to improvement teams and celebrate their successes in order to understand their performance gaps and progress.