Developing quality measures for mother and child Care centers

Background: About 70% of mother and child health-centers (MCH) in Israel are operated by the Israeli Ministry of Health (MOH), while the rest are operated by a range of providers. The Israeli Central Health District (CHD) includes 208 centers which serve about 213,000 infants and toddlers. Recently there has been a public debate who should be the main provider of services: government or private sector. This debate also raised the issue of developing quality measurements in order to compare and improve the public health services given in such centers. Since 2005 all administrative and health data is being reported by all providers to the CHD.

Objectives: 1. To Describe the performance rates of the various screening test for infants and toddlers in MCH 2. To compare the rates and results according to socio-demographic variables and according to the various providers

Methods: Since 2005 the CHD has built a comprehensive database of quality measurements for the various MCH operating in the district. This includes screening test results such as: hearing, vision, hemoglobin levels, growth and development. Comparisons were conducted using c² and one-way ANOVA.

Results: Number of infants and toddlers per MCH was significantly higher in MOH centers than in sick-funds (p<0.001). Performance of the various screening tests was not satisfactory and decreased according to age.

Discussion: This study serves as a foundation for quality measurements program in MCH in Israel. Such program should include also socio-demographic characteristics and community activities. It can serve policy makers for evidence based decision making.