Health Systems Strengthening with a Focus on Reproductive Health – Quality Management in the Health Sector

Donor organization: 
GIZ (German Agency for International Cooperation)
Start of Project: 
End of Project: 
Value of service: 
€ 1,996,200
Description of Project: 

The project “Health Systems Strengthening with a Focus on Reproductive Health – Quality Management in the Health Sector” is a module of the overall TC Programme "Health Systems Strengthening with a Focus on Reproductive Health" which builds upon the MGHP and its three result areas. In the political context, the module forms an integral part of the joint efforts to reform and improve the health care system in Malawi. The Government of Malawi through the Ministry of Health is developing a National Quality Management Strategy (NQMS) which will be the guiding document for this measure.

The overall objective of the module is to improve and institutionalise quality management in the four selected districts (Ntcheu, Dedza, Lilongwe and Mchinji) including one Central Hospital with special emphasis on maternal and newborn health and thereby contributing to result area 2 of the Malawi German Health Programme, Quality Management.

The tasks and activities to be implemented under this project are organised in three thematic service packages (SP) that are somehow aligned with the implementation of the National QM Strategy, and one service package for monitoring and evaluation.

SP 1: Quality management governance structures,

SP 2: Generation and use of accurate data for decision making,

SP 3: Quality of care and QI processes, and

SP 4: Monitoring and evaluation system.

The project is managed according to the GIZ management model Capacity WORKS, which operates with the five success factors: (1) Strategy, (2) Cooperation, (3) Steering Structure, (4) Processes, and (5) Learning and Innovation.

Description of Services: 

Services to be provided under the 4 SPs are as follows:

SP 1: Quality management governance structures

  • Establish and/or strengthen QM structures at central hospital, zonal, district and facility level, and build HR capacity in QM tools and techniques.

  • Organise benchmarking visits between districts to identify success stories and challenges with proposed structures.

  • Support in the development, implementation and quarterly review of district implementation plans for the NQMS.

  • Facilitate partner coordination at district level and explore options of integration and harmonisation of QM approaches across partners

  • Encourage the involvement of communities in QM activities.

SP 2: Generation and use of accurate data for decision making

  • Strengthen the quality and use of health information data for planning and quality improvement processes.

  • Define key indicators from HMIS and additional non-HMIS indicators that need to be monitored regularly for decision making at point of care.

  • Assess data quality.

  • Develop dashboards and support the transmission of accurate data from HMIS office to the dashboards.

  • Develop capacity and coach/ mentor in the use of data for evidence-based decision making, planning and quality improvement processes.

  • Support health facilities in the conduct of operational research on the impact of QM approaches on quality of care.

  • Monitor the referral patterns to determine the quality of care at each level.

SP 3: Quality of care and QI processes

  • Institutionalise QI processes at health centre and hospital department levels and improve the quality of care.

  • Assist district coordinators in making clinical guidelines, patient safety standards and SOPs available and support heads of departments in ensuring that these are applied.

  • Support clinical audits and documentation and analysis of adverse events.

  • Strengthen patient feedback mechanisms.

  • Use all data generated through QI processes to develop a comprehensive annual QI plan.

  • Facilitate integrated supportive supervision and coaching.

  • Support quality assessments and recognition system.

  • Introduce patient safety in the target hospitals.

SP 4: Monitoring and evaluation system

  • Agree with GIZ, MoH and the districts on the 40 facilities to be supported.

  • Agree on a standardised list of criteria for obstetric services.

  • Conduct a comprehensive baseline assessment to assess the facilities’ adherence to obstetric criteria.

  • Develop a project implementation plan and an M&E framework to monitor progress against module indicators and initiate modifications if needed.

  • Develop a capacity development M&E plan.

  • Conduct bi-annual quality assessments.

  • Conduct comprehensive endline assessment.

  • Document lessons learnt.

Project Volume: 
€ 1,996,200