News and Events

12 August 2019

Reflections on a three-year journey in quality improvement in community health
As the USAID SQALE project comes to an end, teams took time to reflect on the changes that have occurred in community health over the past three years. The legacy of USAID SQALE is large and it has impacted on national level policy and tools and how communities and health care staff plan to sustain positive change in the longer term.

23 June 2019

Webinar report: The unfinished agenda in community health
The unfinished agenda in community health: the design, governance and quality of Community Health Worker (CHW) programs webinar was held on 22nd May 2019.

08 May 2019

What are we up to? USAID SQALE learning event
More detail about our Learning Event which marks the end of the USAID SQALE program.

04 December 2018

The power of photography in documenting impact in the community
Photos and stories of change are a powerful health advocacy tool at the community level and policy maker level. They are a great motivation to implementers, both emotionally and psychologically, as they document change and progress and realize that the work they are doing is truly creating an impact on peoples’ lives.

28 November 2018

How WhatsApp has enhanced supervision for Quality Improvement in Community Health Services in Kenya
There is a growing recognition of the importance of supervision and mentorship of community health workers as means of improving and enhancing their performance. However, the most effective ways of supervising community health workers are still unclear. Technology and social media are emerging as one mechanism for improving supervision in low- and middle-income countries, including Kenya.

22 November 2018

How to measure the quality of household visits by community health workers in Kenya?
We introduced a Community Follow Up Tool to our program to get household perspectives on the Community Health Volunteers’ work. Data was collected, door-to-door, by community members. They received half a day's training on the tool and were paid for their time.

12 November 2018

“Do you trust that data?” – A mixed-methods study assessing the quality of data reported by Community Health Workers in Kenya and Malawi
High-quality data are essential to monitor and evaluate the performance, quality and equity of community health programmes. However community health information system data quality in low- and middle-income countries is poor.

05 November 2018

A novel approach to improve performance and outcomes of community health programs in Kenya
We found that Community Health Workers can learn and apply Quality Improvement concepts in a rigorous manner once they are adapted to their context. Through this process they are able to dramatically improve reporting, community engagement with the health system, efficiency and performance by focusing on priority issues which improve health outcomes.

29 October 2018

Creating a forum for shared learning and advocacy in strengthening community health systems
The USAID SQALE program has implemented simple, innovative, quality improvement capacity building for front line workers. County teams were brought together in events that created a dynamic, interactive learning environment. They ensured inclusive participation across cadres and levels of the health system.

03 October 2018

NEW! Policy brief from the USAID SQALE team
We are delighted to launch a new brief that provides guidance on applying a quality improvement approach within community health systems in Kenya. "How can we achieve Universal Health Coverage with quality? A quality improvement model for community health from Kenya" provides an overview of the model that USAID SQALE has used in three counties in Kenya, gives tips on implementation, and makes recommendations for policy and practice.

23 August 2018

USAID SQALE at the Global Symposium on Health Systems Research
We are delighted to be attending the upcoming Global Symposium on Health Systems Research which will be held in Liverpool, UK on the 8-12 October 2018.

26 July 2018

Achieving the impossible: Implementing quality improvement at the community level
Lydia Kwamboka is the Lang’ata Sub-County Health Records Information Officer in Kenya. This is the story of how involvement in the USAID SQALE program changed her view on quality improvement at the community level.

16 May 2018

Stimulating, cascading and sustaining quality: The role of Champions for community health
The USAID SQALE model relies on the work of Quality Improvement Champions. These are people who provide coaching and supportive supervision to sub-counties and Community Work Improvement Teams, facilitating bimonthly quality improvement coaching meetings, engaging in resource mobilization for community health services, encouraging participation and innovation by community members and highlighting and documenting success.

09 April 2018

NEW BRIEF! Improving data quality in community health programmes: Recommendations from inter-country research
This brief provides suggestions for national policy makers and the supervisors of close-to-community providers of health care on how data quality can be improved in community health programs.

29 March 2018

How does gender impact the quality of community-level health data? Examples from rural and urban settings in Kenya
Focus group discussions to explore data quality, conducted with CHVs in rural and urban sites in Kenya, as part of the five-year international REACHOUT research project, revealed direct impacts of gender on the quality of data reported by CHVs due to gendered barriers in data collection.

22 March 2018

The iron women of Kitui
Although Kitui has several hospitals and health centres, many citizens live in remote villages that are far from healthcare facilities. To increase access to primary healthcare services among such citizens, Kitui County organises a team of Community Health Volunteers, like Carol Mutua, who go door-to-door checking on their neighbours and referring those who need care to nurses and doctors.

24 January 2018

How male involvement was achieved through Quality Improvement in community health
After undergoing training on quality improvement under the USAID SQALE project, the team sought to ensure that maternal and child health indicators were improved within the Kavutei Kawala community units, in Kitui County, which was characterized by unskilled child deliveries and low immunization coverage prior to the training.

03 January 2018

Tackling community health challenges through PATUMA, Kenya
The USAID SQALE team, working alongside the PATUMA volunteers, has provided a tailored maternal child health training, including how and when to refer women and children to health services and how to accurately capture the good work that is being done.

05 December 2017

Quality Improvement training: A tool to empower Community Health Volunteers to document and improve their work
CHVs generate data at the lower level which feeds to the facility, sub county, county and national level health information systems. Their data is used to make informed decision on health priorities or focus. It is essential that they collect accurate data and information so that this analysis can inform decision making among policy makers.

29 November 2017

“Viva la Revolución!” Long Live the Quality Revolution in Community Health!
In 2017 twenty-four Work Improvement Teams from Nairobi and Kitui all came together for the first time to share their experience in measuring, assessing and improving quality of community health services.

25 July 2017

From despondency to pride: Transforming attitudes towards the quality and collection of data at community level
Community health services and the volunteers at the front line of the health system are a vital resource in tackling maternal and new born ill health. But too often managers in the health sector find it difficult to make good decisions about how to deploy them because they don’t have accurate and good quality information at their fingertips.

08 September 2016

Sustaining Quality Approaches for Locally Embedded Community Health Services (SQALE) Symposium
This meeting will take place 08.00 - 13.00, 20 September 2016 at the Kenya School of Monetary Studies. To attend contact Daniel Kavoo (

30 August 2016

Launch of the USAID SQALE Program
An introduction to the USAID SQALE Program and what we hope to achieve.