9. Conduct CQI re-assessments

CQI is an ongoing process for assessing performance and applying measures to improve the quality of services. Quality services address a client's needs in an effective, responsive and respectful manner. In order to establish whether quality has improved, been sustained, or declined, the performance of VMMC services needs to be measured at different points in time to assess the effect of improvement efforts.

To ensure that re-assessment findings are comparable to baseline findings, the same evaluation criteria and assessment tool should be used for each re-assessment.

CQI re-assessment are conducted much like baseline assessments:  the assessment is usually carried out by a team of 3-4 individuals, including clinicians knowledgeable about surgical circumcision.  The assessment team should include a staff member from the VMMC unit being assessed and may also include a representative of the implementing partner, a representative from the Ministry of Health, and the CQI partner.  

In Uganda, the MOH uses the color-coded dashboard shown below to display CQI assessment results by standards area for each assessed site.  The sheet can be printed ahead of time, and the color column corresponding to the site’s score for each standard is marked with an X.  The assessment team writes in comments and leaves the scorecard with the assessed site.

The color-coded dashboard can also be displayed for multiple sites and over time to provide a quick overview of the areas where sites are experiencing gaps.  The image below shows the baseline assessment and two re-assessments for 30 sites in South Africa.

CQI teams can also use the entire assessment tool or sections on individual standards areas for periodic self-assessment to check that quality has been maintained.

In Mozambique, Jhpiego has introduced a tablet-based assessment tool that mirrors the EQA tools.  The data focal point in each Jhpiego-supported site is directed to fill out the tablet-based app and submit data weekly to a web-accessible database.

Why CQI re-assessments are needed: CQI assessments are conducted to identify performance gaps and inform quality improvement aims. Periodical re-assessments measure progress towards achieving improvement aims and performing to service standards.