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

Abstract #117997

Sadia Dilshad Parveen, Dr, Ikhtiaruddin Khandaker, Salah Uddin Ahmed, Dominic Robin Guda, Kazi Asadur Rahman, and Fatema Zannat. Quality Improvement, NGO Service Delivery Program, House No NE(N) 5, Road No. 88, Gulshan 2, Dhaka, 1212, Bangladesh, 8802-9883639, sdparveen@urc-chs.com

The USAID-funded NGO Service Delivery Program (NSDP) provides primary health care in Bangladesh through 318 NGO clinics. Its strategy is to help NGOs achieve technical, managerial and financial sustainability by project end in 2007. NSDP supported NGOs to institute a system of monitoring quality of service delivery using the Quality Monitoring and Supervision system, to foster efficiency. The system was designed as a bridge for NGO management and service providers to improve management. QMS uses provider knowledge, records review and process observations to score service delivery quality of each clinic. 41 NGOs conducted QMS in 281 clinics between July 2003 and June 2004. NSDP validated the scores of 52 of these clinics, identified through random sampling, between July and December 2004, to assess their correctness and identify areas for system re-design. Findings include - a. Composite QMS score by NGOs was 84%, while validation score was 80%. b. Knowledge and process observation scores were lower by 14% and 3% during validation, compared to actual QMS scores, while record review scores were higher by 4% during validation. c. Highest variations were observed for – i. STI/RTI in knowledge assessments; ii. Antenatal care in process observations. Variations may have been affected by – a. Timing of validations; b. Staff attrition; c. Subjective variation While 4 percentage point variation is acceptable programmatically, to ensure effective systems implementation, validations should be conducted jointly with NGOs at or immediately after actual visit. Without appropriate validation and subsequent support, NGOs cannot be expected to implement the system objectively.

Learning Objectives:

• Participants attending this session will be able to learn –
• a. Experiences about instituting systems for promoting sustainability;
• b. To use team building approaches between managers and service providers to bring positive change in service delivery quality;
• c. To foster program ownership at all levels of the infrastructure.

Keywords: Quality, Sustainability

Related Web page: www.urc-chs.com/services/health/bangladesh.html

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation