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What quality improvement models exist in developing countries at the Ministry of Health level.
Thanks for this great question Juliet. The Ugandan Ministry of Health published a report in 2011 detailing their Health Sector Strategic and Investment Plan for 2010-2015 (HSSIP 2010/11‐2014/5). HSSIP 2010/11‐2014/5 emphasizes quality and patient safety and calls for "a high level of efficiency, effectiveness, transparency and accountability" in the Ugandan health system, aspects that many health systems in developed countries also recognize as drivers of quality and safety improvements. The publication can be found here: http://health.go.ug/docs/HSQIFS.pdfGHDonline also held a virtual Expert Panel on the Partners in Health and Rwandan Ministry of Health collaborative "Nurse Mentoring Program for Quality Improvement". This program aims to strengthen health care delivery and improve quality through "ongoing clinical mentoring of nurses, continuous quality improvement initiatives, and decentralized training of nurses". Investing in nurses and nursing education has been shown to be a key component in improving health systems around the world, especially considering nurses deliver 90% of health care services and make up the largest group of health care professionals. The Discussion Brief for this panel can be found here: http://www.ghdonline.org/nursing/discussion/building-nurse-mentoring-programs...Below I've included a few other resources regarding Rwandan quality improvement efforts that might of interest, but some require membership or institutional access to review: http://www.ncbi.nlm.nih.gov/pubmed/23164530http://www.biomedcentral.com/qc/1472-6963/13/S2/S5I hope this helps! I look forward to hearing others' responses as well.
HiThere are also some great innovations happening which highlight the variety of approaches people are trying. the program in Rwanda, which is now being scaled up for HIV has a great website which was provided to me by Manzi Anatole, the driving force behind the work (https://sites.google.com/site/imbmeshprogram/home/) and he has promised to join to add his insightsAnother example is HEALTHQUAL, which was started by Bruce Agins from the New York AIDS Institute has also been doing work building capacity at the MOH level focused initially on HIV and now more broadly in a number of countries including Uganda, Namibia, Haiti and Kenya. The work then supports teams as they help facilities roll out a program which integrates performance measurement of the national indicators, QI and building infrastructure to sustain the work (quality management committees and work plans as an example). They also have a strong focus on consumer involvement. (http://healthqual.org/) The work in Haiti has also been supported by Zamni LaSante as they incorporate the national approach and expand through the network of supported clinics. My colleague, Jean Paul Joseph is giving a great presentation on that work at Unite for Sight and is a great resource.