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"We really saw that it was working for us: No women ever delivered outside because they are triaged in time.”A Mphatlalatsane success story (South Africa, 2018 - 2022)
Odendaal, W Hunt, X Chetty, T Tomlison, M Singh, Y Nzuzo, A Makgatho, J Chauke, T Pillay, Y Makua, M
Odendaal, W
Hunt, X
Chetty, T
Tomlison, M
Singh, Y
Nzuzo, A
Makgatho, J
Chauke, T
Pillay, Y
Makua, M
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Abstract
"Background: Maternal and neonatal mortality, and still births in South Africa remain relatively high. To address this, the SA National Department of Health launched a multi-partner, facility-based, quality improvement (QI) programme (2018-2022), called Mphatlalatsane, in 21 resource-constrained facilities across three high burden provinces. The programme’s aim was to work with facility staff to establish QI teams. These teams identified key areas to improve maternal and neonatal health (MNH) services, then developed and implemented the QI plans (QIPs).
Methods: The Mphatlalatsane QI teams developed an inventory of replicable QIPs to improve MNH services in similar settings. The first steps were recently taken with spreading these QIPs in neighbouring facilities. Its outcomes are to be carefully monitored to optimise the potential of these QIPs.
Results: Across the facilities, 28 effective QIPs were developed and sustained, addressing a range of MNH services: promoting early antenatal care (ANC) booking (five facilities); triaging patients in labour admission and ANC high risk clinics (six facilities); improving completeness of records, e.g. the partogram (five facilities); TB screening of ANC patients (three facilities); and QIPs implemented in only one facility, e.g. post-partum family planning. Key components in successful implementation were: involving community health workers and traditional practitioners when needed; upskilling staff to use standard tools and protocols; and developing user-friendly tools to monitor effectiveness. The team leader and QI advisor were key drivers for successful teams. Staff shortages and attrition, and the high-pressured environment of MNH services were barriers to successful implementation.
Conclusion: The Mphatlalatsane QI teams developed an inventory of replicable QIPs to improve MNH services in similar settings. The first steps were recently taken with spreading these QIPs in neighbouring facilities. Its outcomes are to be carefully monitored to optimise the potential of these QIPs."
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2023-05-08
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Research Projects
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Odendaal W, Hunt X, Chetty T, Tomlinson M, Singh Y, Nzuzo A, Makgatho J, Chauke T, Pillay Y, Makua M, Khan L, Kauchali S, Goga A. Implementing effective quality improvement plans at health facilities to improve maternal and neonatal services in South Africa: identifying key components for replication in resource constrained settings. International Maternal Newborn Health conference, 08 - 11 May 2023, Cape Town (Oral poster)