Applying QI models at the community level: Experiences from Mali and Afghanistan

Modern quality improvement approaches have been adapted from the industrial field to increase the effectiveness of health care services delivered at the health-facility level. Such applications have been widely tested in developing countries. However, the application of such approaches to improve community-level health services has not been adequately tested. This presentation will include a conceptual framework for applying quality improvement at the community level and a summary of how the framework has been applied in selected districts in Mali and Afghanistan. It will explain the methodology of identifying the community health system, establishing links with community, and applying quality improvement in the community context. The presenter will synthesize lessons learned thus far regarding challenges for achieving quality improvement at the community level and engaging the communities of Mali and Afghanistan in applying and measuring improvement in selected maternal and newborn health services. Baseline indicators measured by the community will be presented as well as interventions adopted by community health workers and community members to change the process of community service delivery to achieve better results. Challenges and lessons learned will be summarized in the context of Mali and Afghanistan, and general conclusions will be drawn about the approaches to improve the quality of community health care.