Upgrading of health services much needed to address quality gaps

20Oct 2020
James Kandoya
The Guardian
Upgrading of health services much needed to address quality gaps

​​​​​​​IMPROVEMENT of healthcare services is a pre-requisite to enhance the effectiveness of health centres to offer quality services.

Assessors and representatives of Health centres assessed for quality improvement in Pemba showing their certificates after awarding ceremony recently. Photo: PAI

In Zanzibar for instance, various quality improvement initiatives are implemented in health centres such as training of assessors and assessment to health centres to improve its quality performance.

Fat-hiya Mohamed, a resident of Wete District in North Pemba Region is proud to be among four assessors trained to conduct quality assessment in health centres within the Zanzibar archipelago.

She got training from the PharmAccess International -Tanzania (PAI) on how to conduct quality improvement assessment in health centres within the island.

After the training, Mohamed assessed four health centres - Primary Health Care Unit Plus (PHCU+) and leveled them according to standards procedures.

These are Mzambarauni and Kangagani all in Wete district in North Pemba Region, Wesha in Chakechake District, the capital of Pemba Central region and Wingwi in Micheweni district in the North Pemba Region.

The project –Safecare further equipped with additional knowledge of storing data using mobile phones and therefore discouraged paper work.

Elaborating more, she says some health centres have already started working out on challenges that sometimes did not even need funds to be implemented.

“Indeed, the training enabled us as assessors to identify gaps and know standards procedures needed for a health Centre to observe while delivering quality healthcare as recommended.

In the neighbouring Chakechake district, Pemba South region Idrissa Mohamed says the training enables him to assess the quality delivered in the health centre using standards procedures.

Trained as assessor, Ally adds that he has now been trainer to other staff on how to follow standards procedures when delivering healthcare’s services.

“Indeed, I have acquired a huge knowledge from the training. This should continue and be sustainable to improve the quality of healthcare services delivered by our health centres,” he says.

The centres assessed were -Wamba, Kengeja, Michenzani, and Bogoa all in Mkoani district and Makangale centre in Micheweni district, North Pemba Region of Tanzania.

Ally has a special message “I call on the PharmAccess International- Tanzania (PAI) to further support us to take these challenges and turn them into opportunities.”

Both Mohamed and Ally are now trainers to other staff on how to observe standards procedures when delivering healthcare’s services.

Moreover, the health centres were also assessed and levelled depending on their health performance ranging from level 1 to 5.

According to standards, it covers the full range of medical to non-medical aspects of care; from PHCU as well as large district hospitals.

The In charge of Maternity at Junguni Health Centre (PHCU+), Genenea Omary, says that after assessment the Centre performs according to standards procedures hence improves quality delivery.

Located in Wete District, North Pemba Region, Junguni centre is among 20 health centres assessed for quality improvement and awarded a certificate. It serves between 100 -150 people per day.

She says that the centres serve 30-35 children coming for vaccines while pregnant mothers range between 20-25 per day and postnatal services 20-25 people per day.

"We are working out on the gaps identified in order to offer quality healthcare services as recommended.

Khadija Omary Ally, In Charge at Mzambarau Takau Centre (PHCU+) says that the training enabled her to identify errors.

"As a health centre, we have so far started working on the gaps to improve the quality of delivery of healthcare services," she says.

Since 2019, PAI has been consulting the Zanzibar’s Ministry of Health (MOH) to support the ministry’s efforts in health financing and quality improvement.

Through the Safecare Project, PAI reviewed and analyzed the current state of healthcare in Zanzibar, including the quality and performance of various providers.

It also trained the use of digital tools to improve quality and training to assessors. Digitalization plays a large role in the process where the facilities will start collecting more data on healthcare performance.

Once a Health centre assessed is awarded a certificate to show its level of performances according to the facility’s performance, ranging from level - I (very modest quality) to level - V (high quality).

The Safecare Project Director at PharmAccess International –Tanzania Dr Peter Risha notes that among the key implementations was training of ministry health’s assessors and facilities.

Also supporting health centres and facilities to use digital tools to improve quality as a very important step to be reconsidered.

With safecare, healthcare providers gain insight in identified gaps and challenges and plan a stepwise approach towards higher quality.

According to him, the phase II of the training assessment will follow all procedures including aligning and integrating the process with the ongoing ministry of health digitization strategy.

The project further expands the enrolment of facilities in Infection Prevention Control (IPC) self-assessment.

“Best human practice management is one of the big gaps noted in many facilities during the baseline assessment. Therefore, continuing to build their capacity is very important," he recommends.

“Information on how to address quality gaps in technical, financial support, and innovative quality improvement platforms help facilities progress along a quality improvement trajectory in achievable and measurable steps," he adds.