Stimulating, cascading and sustaining quality: The role of Champions for community health

By Leonard Sharia Mbiu and Lynda Keeru

Kitui County is 170kms, south east of Nairobi City and was one of the pilot counties for the USAID SQALE program because of its high rate of maternal death.  Kitui has been implementing the national Community Health Strategy for over ten years but implementation has been hindered because of a lack of focus and coordination. The USAID SQALE program has brought a focus on embedding quality approaches in community health service delivery. It is currently working in nine Community Health Units and the plan is to cascade this model to a further 229.

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.

Leonard Sharia Mbiu is a passionate Quality Improvement Champion, who has done an impressive job at embedding quality approaches in his county where he is a County Community Health Services focal person. He has been working with the USAID SQALE program since 2016 and seen the establishment of Work Improvement Teams, training on how to identify and analyse the root causes of problems in the community health system, and the implementation of plans to improve maternal, newborn and child health.

Reflecting on his experiences Leonard felt,

“Achieving quality does not require the implementation of very complex strategies as is commonly thought.  It involves implementing simple approaches in a focused and systematic way and does not necessarily require huge amounts of resources to implement.”

However, Work Improvement Teams do need ongoing support to do their work and as a Champion Leonard works passionately and tirelessly to ensure that quality improvement is built into existing work plans, trainings are conducted so that everybody’s skills and knowledge are up to date, and Teams are stimulated to sustain the process.

Leonard has not only supported his own county but has travelled to Migori county to facilitate training for Community Health Units and newly formed Work Improvement Teams. He says,

“During the training in Migori, I was able to share my experiences, exchange idea with other key players in community health, build networks and get a deeper understanding of quality improvement in a different context. This opportunity broadened and sharpened my knowledge and skills on quality improvement, public speaking and presentation skills. It also gave me a chance to compare the structures in the different counties. In Migori, the quality improvement structures seem established; it just requires some focused attention on the small set of quality indicators for maternal, newborn and child health at community level and capacity building of the staff to get the program off the ground.”

Quality Improvement Champions are instrumental in the sustainability of the USAID SQALE program beyond the current funding as they are experts embedded in the community health system who can cascade the quality improvement agenda in their own counties and beyond. We salute all the Champions working for quality health services in their communities in Kenya.