We are excited to launch a new project to test and validate our participatory quality improvement approach in a new health system setting: southern Mali. Our project, officially titled Using Participatory Quality Improvement Methods to Improve Vaccine Timeliness, will bring together community maternal care providers, including health center staff, community health workers (ASC) and midwives (matrones), to develop local solutions for improving childhood immunization completion in the Sikasso region.
Since 2014, we have been developing a participatory, team-based approach that adapts traditional continuous quality improvement tools for use in the community health system. We will bring those participatory quality improvement (QI) methods, created in collaboration with health center partners in peri-urban Bamako, to the Sikasso region in southern Mali, for further development and to assess if they can improve vaccine delivery in a different health system setting.
In Bamako, our participatory, community-based QI strategies led to significant improvement in timely vaccine completion. For example, completion of BCG vaccine delivery from 57% to 92% and retention between doses of MMR rose from 38% to 83%. With average completion of childhood vaccines hovering around 20.2% in Mali, there is room for improvement in both rural, urban, and peri-urban contexts.
Our team is particularly excited about this opportunity because it allows us to continue working with partners in the Sikasso region, where we have worked to implement the Center for Disease Control’s (CDC) post-Ebola Global Health Security Agenda (GHSA). During that work, we observed significant gaps in the health system and integrated some of our quality improvement and governance strategies into the GHSA project. Our participation in that project ended in October 2017, when funding was significantly delayed during the budgeting process. We are glad to renew our relationships with communities and the health system in the Sikasso region, and to build new ones.
The project is supported by a Grand Challenges Explorations (GCE) grant from the Bill & Melinda Gates Foundation. The program “supports innovative thinkers worldwide to explore ideas that can break the mold in how we solve persistent global health and development challenges.” Our project is one of 35 Grand Challenges Explorations Round 20 grants awarded by the Foundation. This is our second GCE grant; the first, a part of Round 12, helped us to develop our QI approach.