Improving quality assurance capacity at health centres in Ghana

In 2004 and 2005, the Ghana Health Service revitalized its quality assurance (QA) policy by introducing two manuals on QA implementation, one targeted at regional / district health management teams and hospitals and the other at health centres. The Quality Health Partners Project, funded by a five year cooperative agreement from USAID and managed by EngenderHealth, supports the roll-out of training on quality assurance where regions have made it a priority. Two years after the roll-out of the policy and with training completed in a number of target facilities has anything changed?

A baseline census of facilities was conducted in December 2004. Using a facility audit tool, these same facilities were visited again in December 2006. At baseline 34.4% of facilities had a quality assurance team and of these 22.9% had an action plan (n=157). In 2006 47.7% of facilities had a quality assurance team and 62.8% of these teams had an action plan (n=165), representing a significant increase (p=.02) in the uptake of QA programs in target facilities. The increase in the percentage of health centres with a QA team from 22.3% to 35.8% was also significant (p=.03). Regions and facilities that participated in quality assurance activities were more likely to have adopted a facility wide QA approach.

Quality assurance policies, even those targeting lower levels of service delivery are likely to succeed in Ghana, when backed by training and follow-up at the facility level.