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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
Rationalizing roles and clarifying expectations:Process mapping for health workers
USAID HEALTH CARE IMPROVEMENT PROJECT
J09 F M A M J J A S O N D J10 F M A M J J A S O N D0
10
20
30
40
50
60
70
80
90
100
%
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
0
10
20
30
40
50
60
70
80
Po
urc
enta
ge
Wadata
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
15
www.hciproject.org/healthworkforce
Lauren Crigler
Senior Technical Advisor
USAID HCI Project./Initiatives Inc