Quality of Care: Improving Services for the Whole Person in Times of Change

July 18, 2022

by Guest Contributor

by Skylar Yan, CCIH Intern

Speakers in the fifth session of the CCIH 2022 Conference on June 21 focused on quality, including quality of health care and quality in the supply chain and logistics. Leading us through the session was Dr. Priya John, General Secretary of the Christian Medical Association of India, who was the moderator for the day.

Quality in Our Business

When talking about improvement, most people think of the institutions themselves. Dr. Sodzi Sodzi-Tettey, Senior Technical Director at the Institute for Healthcare Improvement, focused on the organization’s approach to quality improvement in his interview with Dr. Priya John (see photo above). Dr. Sodzi-Tettey pointed out that quality improvement is a science of its own, and focuses on understanding performance gaps and root analysis, similar to psychology. The Institute for Healthcare Improvement also places an emphasis on patient and client care as well. By empowering patients with community feedback and quality check teams, healthcare organizations can work hand in hand with the communities they serve.

However, sometimes some members of a community don’t have access to the same resources. Leticia Nkonya, PhD, Technical Advisor for Gender Equality and Social Inclusion at World Vision US, (pictured above) focused on access to quality care for vulnerable groups. World Vision focuses on underrepresented groups such as Internally Displaced Persons (IDP), refugees, Persons Living with HIV (PLWH), and Persons with Disabilities (PWD), and work toward delivering spiritual and physical well-being to these groups.

Quality in Community Efforts

While quality improvement is important on the business side, some speakers spotlighted community-led initiatives as well. Peter Chalusa, Project Manager at World Relief; Pirira Cathy Nthanda Ndaferankhande, Executive Director at Malawi Interfaith AIDS Association (MIAA); and Khama Daudi, the District HTS Coordinator, Machinga DHO, Malawi Ministry of Health (pictured below) presented their community’s efforts to combat HIV stigma in Malawi.

Through the SCOPE HIV project, PEPFAR sought to help boys and young men in these communities with HIV testing, monitoring and evaluation, and removing the negative stigma around HIV/AIDS. MIAA also ran a similar program to empower women in these communities. By partnering with World Relief, they sought to build capacity among women while addressing gender imbalances, gender-based violence, and removing negative stigma around HIV testing. Additionally, both organizations have also provided psychological relief for survivors of gender-based violence.

Not only have these two programs been influential in building a community of faith, but also in building quality in the community and the services they provide. Kasande Meble, a Nursing Student at Bishop Stuart University in Uganda (pictured below) also looked at the factors in retention in care among HIV patients. In the study she worked on, the researchers not only focused on reducing the negative stigmas related to HIV, but also focused on shortening queue times for drug distribution. Along with that, they created peer support groups, where those who were virally suppressed could come together and hold each other accountable to taking care of each other, bolstering their community and building strength through their faith.

Although the HIV/AIDS epidemic united some communities, other members of the CCIH conference seek to tackle different issues. In Uganda, David Balikitenda, Monitoring & Evaluation Specialist, Uganda Protestant Medical Bureau (UPMB) (see slide below) has sought to raise awareness of non-communicable diseases. After noticing an increasing trend of non-communicable disease (NCD) patients in UPMB hospitals, UPMB has partnered with district health workers, town mayors, and other community officials to circumvent these largely preventable diseases. In the city clinics that they set up, over 2.3 million people have been screened for hypertension, 359 thousand people have been screened for asthma, and over 1900 have been educated on NCDs.

Quality in Facility Programs

Douglas Huber, MD, MSc, Senior Technical Advisor for Reproductive Health for CCIH and Stembile Mugore, MPH, Nurse and Midwife at World Vision US (see slide below) focused on family planning with their presentation on Postpartum and Postabortion Family Planning. By emphasizing the importance of pregnancy spacing, they have sought to increase contraceptive awareness. In their study, they found that only about 305 of patients used effective planning and many women don’t leave a health facility with a contraceptive.

When educated about the importance of spacing future pregnancies, the rate of women leaving with a contraceptive greatly increased and led to proper pregnancy spacing. With proper spacing, they found infant mortality was almost three times lower with significantly less chances for birth defects. When asked what makes quality, they cited respectful services, updated policies, competent providers and education.

Quality in the Supply Chain

COVID-19 arguably hit supply chains very hard, making maintaining high quality difficult. CCIH Program Advisor Carolyn O’Brien, MSPH; Karen Hardee, PhD, President of What Works Association Consulting; and Ngah Edward Ndze, B-Pharm, General Manager, Central Pharmacy, Cameroon Baptist Convention Health Services wrapped  up the conference session with a discussion on this crucial issue (pictured below). Through capacity building for faith based supply chain programs, they have improved knowledge gaps, storage and transportation.

In the future, CBCHS is planning workshops and long term programs for pharmacy assistants and pharmaceuticals. However there’s still work to be done. Transportation of imported supplies must be more efficient and current systems are getting older and in need of replacement. If given the opportunity for donor appeal, it should be mentioned that the government in Cameroon provides only about 50 percent of healthcare, with 40 percent provided by faith-based organizations. If there’s a time to make a difference, it’s now.

See more about the conference and see recordings of sessions here.

About the Author: Skylar Yan was a CCIH Intern and a third year Economics major at Pepperdine University. As an aspiring young researcher, he hopes to one day combine his passions for economics and healthcare to create an impact in the world. He completed his internship with CCIH in July 2022.

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