Quality improvement interventions take a systematic approach and encourage continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups, such as mothers of premature babies. Quality improvement interventions require workforce training, counseling and workflow redesign.
Health workers at the All India Institute of Medical Science (AIIMS) knew that breastfeeding and Kangaroo Mother Care (KMC), or the prolonged skin-to-skin contact between a mother and premature baby, were life savers for newborn babies. Yet they weren’t seeing the improvements in health that they expected. With USAID support, AIIMS implemented a seven step process to develop a quality improvement team, identify issues, identify the cause of the problem, and test and measure success of solutions. Identifying insufficient hours of KMC as a problem, the team recognized that allowing fathers to spend the night and placing more comfortable chairs in the newborn room would increase the amount of time newborns spent in KMC. Before these improvements, many mothers provided KMC contact for less than an hour each day. This was not the case for Sadhna or her premature baby, Laddu. Using charts and videos, AIIMS nurses counseled Sadhna on how KMC was done. Equipped with this knowledge, Sadhna provided ten hours of care, allowing her to bring her baby home much faster. Her father and brother-in-law also learned they too could be part of the postnatal care for baby Laddu and spent time providing skin-to-skin care so they could connect with the baby and give Sadhna time to rest. After the success achieved at AIIMS, USAID is expanding this effort and currently supports 125 facilities to use quality improvement approaches to help health workers deliver good care including KMC. As a result of this quality improvement method, these facilities have seen a 15.6% reduction in stillbirth and early newborn deaths.
USAID supports service delivery interventions to ensure people have access to effective, safe, and high-quality health services when and where they are needed. Strengthening service delivery in a health system entails increasing service availability throughout the country, developing cost-effective packages of essential health services, and improving and using links between incentives, productivity and quality. India’s focus on service delivery interventions, when scaled up with a package of other proven health systems interventions, can contribute to saving nearly 1.7 million lives from 2016-2020.
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