Improved pregnancy outcomes for mothers and birth outcomes for newborns require multiple inputs at both a systems level and the individual level. In Burkina Faso, estimates of maternal mortality range from 566-910/100,000 live births (UNICEF/WHO, 1990). Although over 50% of women have at least one prenatal visit, the quality of these visits is not known (DHS, 1998) and fewer than 27% of women deliver in a facility with a skilled attendant.
To increase the availability and use of skilled attendants at birth, a two-tiered Performance Improvement approach was developed and implemented. The capacity of the District Health Management Team (DHMT) was increased using the Performance Improvement approach. The DHMT used this approach to determine what is the desired performance of a supervisory body such as the DHMT, how they were currently functioning, and the causes for those gaps between desired and actual. Through this process, they have identified mechanisms for strengthening their own ability to supervise and facilitate improvements at the facilities for which they are responsible. This capacity is being transferred into 4 model facilities representing multiple levels of health care in the Koupela district of Burkina Faso. The DHMT is implementing a Performance Needs Analysis (PNA) at the model facilities. With the identification of differences between desired and actual performance, the DHMT staff will assume the responsibility for facilitating the cause analysis with stakeholders. The resultant strategic plan will prioritize the needs at the 4 model system sites and implement interventions according to feasibility, potential impact and cost.
Learning Objectives: Learning Objectives: 1. Describe how the utilization of the Performance Improvement process increases the capacity of the District Health Management Teams (DHMT) to assist facilities in the goal of improving pregnancy outcomes for mothers and birth outcomes for their newborns.
Keywords: Performance Measures, Reproductive Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: JHPIEGO
Disclosure not received
Relationship: Not Received.