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Human Resources for Health Improvement Collaborative

Lauren Crigler

Senior QI Advisor

USAID Health Care Improvement Project

Initiatives, Inc.

www.hciproject.org/healthworkforce

International Forum on Quality Improvement, Amsterdam, 7 April

Roles and ResponsibilitiesCareer PathPerformance Incentives

Human Resources and How it Works:

First, policies are made…

Then, managers educate health workers

on policies to help them understand how

they might be affected…..

USAID HEALTH CARE IMPROVEMENT PROJECT

Niger

Lifetime risk of maternal mortality

Sub-Saharan Africa

Developing countries

USAID HEALTH CARE IMPROVEMENT PROJECT

• One doctor for every 100,000 people

• 1 nurse per 8,000 population

• One midwife per 9,000 women of child-bearing age

Human resources for health: Tahoua, Niger

USAID HEALTH CARE IMPROVEMENT PROJECT

Clear Tasks

Competency Development

Performance Feedback

Fair Evaluation

Reward & Recognition

Career Advancement

Adequate Environment

Applying improvement methods in Human Resources

Improve quality of services and HR management

Clinical Objectives

Improvement objective

Indicators Who measures

Increase rates for assisted deliveries

- Number of new ANC enrolled - % of facility deliveries - % of skilled deliveries by qualified staff - % compliance to ENC norms - % of compliance to PreEclampsia and Eclampsia - Compliance to norms

District Hospitals, Health Centers (CSI), Regional Maternity

Reduce post partum hemorrhage

Post partum hemorrhage rate

Maternity Hospital, District Hospitals, CSI

Increase family planning coverage in health facilities

- Contraceptive Prevalence - Number of newly enrolled women for FP services

Maternity Hospital, District Hospitals, CSI

USAID HEALTH CARE IMPROVEMENT PROJECT

Aligning goals:National, regional, district and facility

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USAID HEALTH CARE IMPROVEMENT PROJECT

Rationalizing roles and clarifying expectations:Process mapping for health workers

USAID HEALTH CARE IMPROVEMENT PROJECT

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adherence to norms % for essential newborn care

health workers with %job descriptions

Improving adherence to norms in Essential Newborn Care in five district hospitals

Strategy for Change: Clarified roles and job descriptions

USAID HEALTH CARE IMPROVEMENT PROJECTJ09 F M A M J J A S O N D J10 F M A M J J A S O N D

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All Sites

Improving contraceptive prevalence

Niger

Strategy for Change: Rationalizing and reassigningtasks in order to reach out into communities

USAID HEALTH CARE IMPROVEMENT PROJECT

Improving client wait time in three district hospitals

139.40

94.90

3.0

46.6 52.5

020406080

100120140160180

HD Konni HD Bouza CSI G Idder

Min

utes

Average waiting time for Pre-natal consulation visit in three collaborative sites at baseline in 2009 and midline in October

2010, Niger

2009

2010

USAID HEALTH CARE IMPROVEMENT PROJECT

Other Quality Improvement /Human Resources Applications

• This approach is also being applied in Tanzania as part of a ART/PMTCT collaborative

• In Mali in MNCH at the community level• In Ethiopia to improve community level HIV care

and support

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www.hciproject.org/healthworkforce

Lauren Crigler

Senior Technical Advisor

USAID HCI Project./Initiatives Inc