Online Program

Lessons from quality collaboratives for community level supply chains: Using peer-to-peer learning to improve supply chain knowledge and practices amongst CHWs in Rwanda

Tuesday, November 5, 2013

Alexis Heaton, JSI Research & Training Institute, Inc., Arlington, VA
Patrick Nganji, JSI Research & Training Institute, Inc., Kigali, Rwanda
Catherine Mugeni, Ministry of Health of Rwanda, Kigali, Rwanda
Amanda Ombeva, SC4CCM Project, JSI Research & Training Institute, Inc., Nairobi, Kenya
Megan Noel, SC4CCM Project, JSI Research & Training Institute, Inc., Arlington, VA
Yasmin Chandani, SC4CCM Project, JSI Research & Training Institute, Inc., Nairobi, Kenya
Sarah Andersson, B Phar , MPH, SC4CCM Project, JSI Research & Training Institute, Inc., Arlington, VA
Mildred Shieshia, SC4CCM Project, JSI Research & Training Institute, Inc., Nairobi, Kenya
Background: In Rwanda, community health workers (CHWs) treat children under five for pneumonia, diarrhea, and malaria. A 2010 baseline assessment of the community supply chain identified a lack of logistics knowledge and skills among CHWs and resupply point staff and low CHW motivation s for supply chain tasks as barriers to CCM medicine availability.

Methods: The SC4CCM Project partnered with three district health teams to implement Supply Chain Quality Improvement Collaboratives (QCs), establishing and training a network of 44 Quality Improvement Teams (QITs), of CHWs and health center staff to find team-led solutions for improving community resupply procedures. The QITs used tools to identify key challenges, set targets, and test their own innovations, addressing performance gaps. The goal was to generate best practices using a continuous plan-study-do-act cycle of assessment and improvement.

Results: The implementation period included monthly meeting support and quarterly, joint QIT meetings at the district level, sharing results across QITs and gauging progress. Using feedback, the QIT tools adapted to be more appropriate for the CHW context. During the final learning session, all QITs came together to identify learnings from the QC process and develop a package of supply chain best practices for national scale-up to improve supply availability.

Conclusions: Increased collaboration and fora to spread changes quickly across many teams can improve problem solving approaches to supply chain challenges. Because the QIT approach stresses local teamwork to identify problems and use of data to determine solutions, QC results ensure solutions are feasible and locally appropriate.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Program planning
Provision of health care to the public
Public health or related research

Learning Objectives:
Describe the process and learning from the implementation of quality improvement teams (QITs) at the community health worker level.

Keyword(s): Child Health, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Technical Advisor for the SC4CCM Project in Rwanda
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.