Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111862

Deo Mtasiwa, MD¹, Raz Stevenson, MD, MPH², Stephen Kinoti, MD³, Mary Drake, RN, MPH⁴, and Elizabeth Hizza, MD¹. (1) Dar es Salaam Regional Medical Office, c/o PO Box 4513, Dar es Salaam, Tanzania, (2) University Research Co., LLC, Quality Assurance Project, PO Box 4513, Dar -es-Salaam, Tanzania, (3) The Quality Assurance Project, University Research Co/LLC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, (4) Quality Assurance Project, University Research Co., LLC, 7200 Wisconsin Avenue, Bethesda, MD 20814, 301-941-8517, mdrake@urc-chs.com

Despite the large evidence base of effective interventions, family planning (FP) services in many countries experience a wide gap between best practices and actual service delivery. Improvement collaboratives offer a new methodology for bringing service providers together to share solutions to operational problems and to rapidly scale up improvements in a specific service delivery area. In Tanzania's Dar es Salaam Region, the Regional Medical Officer and the Quality Assurance Project began an improvement collaborative involving nine facilities in three districts to improve the quality of FP services and to strengthen linkages between FP and HIV/AIDS services within each district.

In September 2004, a baseline assessment was conducted by district supervisors in all nine facilities to identify and prioritize improvement needs. Subsequently facility teams developed indicators, identified existing data sources and began improvement activities. Activities introduced include: monitoring stock-outs to assess demand; re-organizing services to ensure privacy; strengthening counseling skills to enable informed choice; including HIV in FP sessions; introducing a job aid to strengthen information provided on FP and HIV in all service areas; and formalizing referral mechanisms between FP and HIV services. Importantly, the improvements are linked to indicators drawing on data from supervisory and reporting tools already in place in order to reduce the burden on providers in monitoring progress towards meeting improvement objectives.

The paper will present results from improvement activities underway and discuss lessons from application of the collaborative approach in improving quality of FP services and strengthening linkages between FP and HIV services.

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