The 130th Annual Meeting of APHA

Abstract #43184

Anbrasi Edward-Raj, PhD, MPH¹, Albert Webale, Msc², Richard H. Morrow, MD MPH FACP³, and Grace Maina, MSc². (1) International Health, Johns Hopkins University, 615 N Wolfe, Baltimore, MD 21205, 410-955-3928, aedward@jhsph.edu, (2) Community Based Nutrition Program, City Hall Way, Nairobi, Kenya, (3) Department of International Health/Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe, Baltimore, MD 21205

A significant proportion of the world’s poorest populations rely on community health workers as their primary health providers. However several factors impede the optimal performance of these workers. The study examined the application of quality management principles in assessing and improving quality at the community level. Method: A systems approach was adapted and assessments were conducted jointly with community members and program managers through standard methodologies. Results: Findings indicated that 85% of the health workers knew the purpose of regular weighing, detecting growth failure, 74% could identify signs of malnutrition, 78% knew to counsel the caretaker to feed the child during illness, 48% knew that they should refer the child if it showed danger signs for diarrhea, 85% knew to provide more fluid during diarrhea, and 67% used the growth cards to identify children requiring follow up. More than 80% of the workers accurately recorded the weight and plotted on the growth card but only 50% detected the nutritional and growth status and very few (3%) connected the growth curve. Almost 70% of the children requiring counseling were sent for counseling. Caretaker feedback indicated that 64% knew the nutritional status of the child. Results of the assessment were examined and problem-solving approaches were applied to identify gaps in performance. The health workers prioritized problems and developed solutions applying the analytical tools. The study indicates that community health workers can be equipped to assess, analyze, identify and solve some of the problems in program and provider performance.

Learning Objectives:

• 1. Describe the components of the performance assessment and improvement process.
• 2. Illustrate the results of performance improvement process for the community based growth monitoring program
• 3. Discuss the implications for capacity building of community based systems

Keywords: Community Capacity, Quality Improvement

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Quality Assurance Project Community Based Nutrition Program
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.