Key Findings of the Assessment of Quality of Reproductive, Maternal, Newborn, Child, and Adolescent Health Care in Uganda and Kenya
The USAID Office of Health Systems (OHS) and USAID Office of HIV/AIDS (OHA) in Washington tasked the Applying Science to Strengthen and Improve Systems Project (ASSIST) team to develop a survey toolkit for assessing the quality of integrated Reproductive, Maternal, Newborn, Child, Adolescent Health (RMNC+A) including HIV services for pregnant women, exposed infants, sick children, and adolescents and to test the tools in 2-3 priority Preventing Child and Maternal Death (PCMD) and US President’s Emergency Plan for AIDS Relief (PEPFAR) countries, as existing facility-based tools did not provide the information necessary for this type of assessment.
Uganda and Kenya have adopted World Health Organization (WHO) recommendations for RMNC+A services to varying degrees, with the degree to which adopted recommendations have been implemented unclear. The aim of this study was to describe the quality of RMNC+A health services and to gather evidence of the extent to which evidence-based (EB) practices and interventions are being implemented. Services of focus were antenatal care (ANC), delivery and newborn care, outpatient care of the sick child and young infant, adolescent health services, and patient-centered care. The content of the childbirth section of the assessment and supporting systems for quality improvement are largely based on the WHO Quality of Care Standards for Maternal and Newborn Care.1
Additionally, Uganda and Kenya are identified as two of three countries in the world with the largest HIV epidemics. Both have adopted the main WHO recommended policies for integrated HIV services and for services for Prevention of Mother to Child Transmission (PMTCT). This report highlights the key findings of the assessment of quality of reproductive, maternal, newborn, child, and adolescent health Care in Uganda and Kenya.