Jaribu, Jennie

Manzi, Fatuma

Penfold, Suzanne

Schellenberg, Joanna

English

Digital Library of the Tanzania Health Community

 Implementation of quality improvement approaches for maternal and newborn care in 
Southern Tanzania  
Jennie Jaribu1 , Fatuma Manzi1, Suzanne Penfold2, Joanna Schellenberg1,2 
  1) Ifakara Health Institute, Tanzania   
  2) London School of Hygiene and Tropical Medicine, UK                                                                                                                            
                 
           
 
 
 
 
 
 
 
 
 
 
Project Background 
Despite  child  mortality  improving  rapidly  in  Tanzania, 
newborn mortality (deaths in the first month of life) is still 
high and its pace of reduction is slow. Improving Newborn 
Survival in Southern Tanzania (INSIST) is a  study aiming 
to evaluate the impact and cost of scalable package of 
interventions  at  community  level  with  health  system 
strengthening in terms of quality improvement, with the 
overall  goal  to  improve  neonatal  survival  in  Lindi  and 
Mtwara regions.  
Objective 
To  strengthen  health  care  provision  using  a  quality 
improvement  approach  in  implementing  essential 
interventions in antenatal, perinatal and postnatal care in 
health facilities which should be sustainable and scalable 
at national level. 
 
Methodology 
The Model for Improvement; multiple Plan-Do-Study-Act 
(PDSA) cycles and Improvement Collaborative Network 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
Results 
The QI approach was tested in Mtwara rural in four 
health facilities, Mahurunga, Tangazo, Mbawala and 
Nanguruwe and was able to increase health facility 
deliveries from a monthly median of 46 to 65 in six 
months of pilot. In Ruangwa district where we spread to 
all dispensaries and health centres health facility 
deliveries increased from a monthly median of 110 at 
baseline to a median of 161 in 17 months. 
The change package: Giving individual birth plan and 
complication preparedness counseling to all pregnant 
women attending ANC clinic and conducting meetings 
with community members (TBAs, villagers, village 
officials) in order to sensitize them to use health 
facilities for delivery.       
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
Conclusions 
 
The QI intervention helped to improve processes in 
essential RCH interventions in health facilities which led 
to an increase in institutional deliveries, improved data 
recording and strengthened the health care providers’ 
professional relationships.  
 
The study was funded by UNICEF, the Laerdal 
Foundation and the Bill & Melinda Gates Foundation 
through Save The Children US.              
                               
                               
                               
                               
                               
                               
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Individual health facility deliveries in Ruangwa Disp & HC 
from Jan 2009 - Jun 2011 
Deliveries at Health Facility  Median  Target 
Target 
QI start 
What are we trying to
accomplish?
How will we know that a
change is an improvement?
What change can we make that
will result in improvement?
Model for Improvement
Plan Act
Do Study
Assessment 
and Design 
Period
Learning 
Session 1
©  Institute for Healthcare Improvement
Learning 
Session 2
ACTIVITY 
PERIOD 
Repeated 
improvement 
cycles:
Learning 
Session 3
12 -24 months
Intensive support from project staff & DHMT 
ACTIVITY 
PERIOD 
Repeated 
improvement 
cycles:
Improvement Collaborative Network
Health 
Facilities

Implementation of Quality Improvement Approaches for Maternal and Newborn Care in Southern Tanzania

http://ihi.eprints.org/364/1/IHIposter_(4).pdf

Implementation of Quality Improvement Approaches for Maternal and Newborn Care in Southern Tanzania

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