“The difference was one: data, we used to cook, you know the previous paper was so complicated but at least now…We know what we are filling.” Community Health Volunteer
“The numbers are impressive; the numbers of Community Health Workers reporting…There
are some indicators which they were not reporting but nowadays I see figures for deliveries especially skilled and I’m still observing.” Sub-County Health Records Information Officer
Universal Health Coverage needs to encompass a focus on health service quality. We explored how Quality Improvement can be used to improve quality of community health programs and their outcomes through implementation research.
We implemented a QI intervention and evaluated it using a pre- and post-study design between October 2016 and July 2017.
As a result routine reporting rates in the District Health Information System improved from 64% to 94%. The quality of data collected by Community Health Workers improved and there was improved community–facility feedback due to representation of facility staff and community members in Work Improvement Team meetings.
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. As community health programs are being scaled up Quality Improvement approaches will ensure quality of data and quality of care.