Continuous Quality Improvement (CQI) strategy increases adherence to child nutrition guidelines

Often, health system guidelines are not applied at the operational level. In Bolivia, as part of the government policy to reduce malnutrition, health providers have been trained in IMCI interventions. However, it was noted that after training adherence to the guidelines was low. John Snow Inc., via the USAID-funded ¨Management and Quality in Health Project, ¨ implemented a CQI strategy using a collaborative model.

72 health facilities in four Departments participated. Quality control teams were composed of health staff that, together, developed managerial skills to monitor child nutrition standards based on policy guidelines. Additionally, the groups applied rapid improvement cycles that included identifying process deficiencies and generating ideas for change in established IMCI implementation guidelines.

The strategy was evaluated comparing preliminary results and those after 8 months of the intervention. Among relevant data, the following were noted: proper application of anthropometric techniques increased from 12% to 78%; follow up of malnourished children from 2% to 37%; and the proportion of care takers that identify key practices for complementary nutrition, from 35% to 68%.

The CQI strategy, using a collaborative model, achieved a 76% adherence rate to IMCI guidelines after 8 months.