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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Isaac Achwal, MD, EngenderHealth - Kenya Office, P.O. Box 57964, Nairobi, Kenya, 011 254 2 444 922, iachwal@engenderhealth.org and Lorelei Goodyear, MPH, Postabortion Care Program, EngenderHealth, 440 9th Ave., New York, NY 10001.
To address the needs of Kenyan women, the Kenya Ministry of Health, with technical assistance from EngenderHealth and Ipas, implemented a six-month project aimed at improving the quality of emergency obstetric care (EOC) including postabortion care (PAC) services in four district hospitals in Kenya. These essential services were either previously not being offered in these districts, or were of poor quality.
Some of the lessons learned during the implementation included:
- Clear demonstration that mid-level providers in the public sector (nurses and clinical officers) can safely and effectively offer quality EOC services, including PAC, and thus reduce the workload on the generally overworked medical officers serving in understaffed facilities. Medical doctors constitute only 4% of all the health workers in Kenya, which translates to a doctor/population ratio of about 1: 10,000 population. The physician/population ratio situation is worse than this in most of the sub-Sahara Africa countries.
- Empowering mid-level service providers to offer integrated EOC and PAC services increases access to these services. The nurse ratio is 1:993 population. Nurses cover facilities where traditionally there are no doctors.
- Training providers and equipping the facilities with essential equipment and supplies motivates health care providers and improves their attitude toward patients.
- EngenderHealth’s quality improvement approaches such as COPE (client orientated, provider efficient), facilitative supervision, and whole-site training encourage hospital staff and regional supervisors to collaborate more closely and sustain the improvements achieved through training.
Learning Objectives:
Keywords: Maternal and Child Health, Quality Improvement
Presenting author's disclosure statement:
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.