Taking steps toward sustainability for participatory quality improvement

Taking steps toward sustainability for participatory quality improvement

As a part of our commitment to strengthening community health systems in Mali, we are always looking for ways to turn control over to communities and existing structures. This year, we are taking big steps forward in integrating the participatory quality improvement methods we have been developing with partners since 2014, into the health system in Bamako.

In March, the Mali Health quality improvement (QI) team hosted a three-day workshop for staff at area CSRefs – the reference hospitals who oversee our partner community health centers, or CSComs. Joining the CSRef teams for the training was a representative from the Office of Community Health at the Regional Health Directorate.

Members of the Mali Health & CSRef teams gathered for three days of trainingStaff at the CSRef already have tools and protocols which they use to supervise community health centers in their district, so our team explored the similarities between current supervision methods and the tools we’ve created to support CSComs through their quality improvement processes. Over the coming months, we will work together to adapt these tools so that conducting supervision for QI is a manageable process for the CSRef staff, while also ensuring that health centers continue to have sufficient support and supervision for their QI efforts to remain effective.

Participants in the training attended brainstorming sessions and breakout groups, and they analyzed case studies. They learned about the participatory quality improvement techniques that our partner CSComs use, as well as how they can support health center staff in designing, implementing, and monitoring their QI processes. On the third day of the training, the CSRef teams were able to join us at the health centers to participate in meetings with the QI teams and practice what they’d learned over the previous two days.

Training CSRefs to supervise and support QI efforts will help ensure that CSComs are able to continue implementing changes that will improve care for patients.Though the CSRef is responsible for supervising CSComs, resources are limited and most staff have received little training. For most who attended, this three-day session was their first opportunity to learn about supervision methods. They were excited about having a chance to improve their own knowledge and abilities, and to apply what they learned not only to their supervision of the CSComs, but to other areas of their own operations.

We were thrilled by the enthusiasm that members of the CSRef teams showed for the quality improvement program and for the role they will play in ensuring it continues to benefit communities for years to come. They, and we, share the belief that in order to promote maternal and child health in the long term, we must build effective and sustainable structures and processes within the community health system, led by professionals like them and their colleagues in the CSComs.

We are excited to take this first step into a new phase of our quality improvement work and look forward to increasing local ownership and management of participatory quality improvement methods.